Health is Physical @ Mental @ Social @ Spiritual Well Being-- Not Just Absence of Disease

Value added life - How to add value to ones life

2009-08-06T03:48:00.000-07:00

Value-added Life

Whenever we invest our hard-earned money to buy a car, home, or property, we look at the value. We would like to see the initial quality, the long-term utility and re-sale or disposal value of it. In other words, we do look for “value” in every thing we buy or acquire in our lives even though we know some of them may appreciate or depreciate in value over the time. But we often forget that our lives also have some value at birth, and the value of our lives may also appreciate or depreciate over time depending on how we lead our lives. In fact, if there is any thing in this world that has a real value, it is only our lives. Every other thing else that we acquire in life has only a “relative value” as compared to the value of our lives. The value of many material objects that we acquire, such as a luxury car, may depreciate over time. There is no way we can increase the value of a used BMW car. But we can constantly increase the values of our lives. That is entirely feasible and is in our own hands. Furthermore, while valuable goods and property that we acquire can provide us comfortable life, they can never substitute the immense happiness and peace of mind that one can derive from a value-added life. In fact, our scriptures emphasize the importance of value-added life or VAL. Our ancestors built the foundation of our culture on VAL. However, in the recent past the cultural edifice of India is showing some deep cracks due to lack of interest in the people to pursue a VAL. Here are some thoughts on how to develop and nurture a VAL and regain our lost glory, happiness and peace of mind in our lives.
How to Develop a Value-added Life (VAL)? First we have to assign certain core values to our lives based on our inherent or inner nature, not on the external world or its demands or expectations or temptations. To do this, we need to understand what our inherent nature, potentials, aptitude, and qualities are. Once we understand those, we need to relentlessly pursue them and build them inch by inch by dedication, constant practice and application. If we keep on doing this, soon we will realize that the VAL will start growing like a big tree within ourselves, bringing light and joy into our lives. Furthermore, once these values are created and nurtured, then they will become the driving force within us to conquer external aberrations that may result in frustration, depression, anxiety etc. Then we will become masters of our lives. We shape and lead our lives as we desire. Our lives will not be shaped or led by this world any more. This de-links our minds from the frustration, depression etc generated by our worldly sojourn. Frustration, depression and similar types of mental
1
agonies cannot be defeated by improving our external conditions alone, as they originate within us. Only a VAL can conquer and de-link them from our minds and thus keep us happy all the time. That is the meaning of life, even as per our scriptures – Dharma, Artha, Kama and Moksha. All our sufferings are due to the fact that we fail to build a VAL and thus break this order of life given to us by our great ancestors, and at the same time we expect to have a happy life. That is the paradoxical situation we are facing. The real solutions for the problems of our life are not as easy. They need deep thinking and contemplation and inner search. Whether we like it or not, that is the only way we can find the answers to our problems.
The values that we create and nurture in our lives are comparable to the value of a car that we want to have. When we shop around for a great car, we look for a powerful turbo-charged engine with a high horsepower that can hit 0-60 mph in less than 10 seconds, traction control (TC), electronic stabilization system (EST), and anti-lock braking system (ABS) and perhaps six airbags supplemental restrain system (SRS). That is the value we want to have for a vehicle that we simply use to commute around the town, and we will keep for just 10 years only before trading it for a new car. There is nothing wrong in that. But we should translate such vision and values to our own lives as well. Unless we are equipped with turbo-charged high values, a good horsepower to propel us in the proper direction in life, a traction control to keep our grip at times of adversity, a stabilization system that takes care of our mental balance through the ups and downs in our lives, an anti-locking system that prevents our mind being locked on issues, and six virtues that can deploy like airbags in a crisis and protect us, our lives do not have more value than the BMW car that we drive around.
Be Focused and Clean in the Thought Process: Mind is like a computer. It functions efficiently when its memory is clean, and its hard drive is not cluttered with loose files in a disorganized fashion. Internally well structured computers, protected by good anti-virus software and other programs, rarely crash. So also the situation with the mind, which needs well-organized grey matter, anti-temptation software, pop-up blocker and a firewall to keep us protected and function efficiently. Then there is no reason why a person cannot be happy in his/her life.
Happiness is a State of Mind: Every religion, faith and scripture known to mankind said this. But we still have to realize it on our own. We cannot search for happiness outside like a commodity, because it is already within us. We need to only uncover it. Take for instance when we were small children, we were all the time happy even though we did not posses anything at that time. But as we grow older and older, as our possessions and attributes
2
increase in number we start losing the happiness. Where did it go? No where. We just covered it with our thought process, which goes outward looking for happiness in the external world. Our thoughts can be like the ashes that cover the burning cinders and thus make them look like extinguished. When we blow out the ashes, the burning cinders will be once again revealed. We should cultivate the habit of uncovering the happiness within and at the same time we should pursue our worldly goals. Then only the worldly goals will have great meaning for us. The external happiness that we derive from our worldly goals or objectives is only a reflection of the happiness within us. Without that inner happiness, the external world has no meaning at all. So the more we uncover the inner happiness, the more we can enjoy our lives – both personal and professional. Then the whole world looks like a play ground for us to play happily.
Be Prepared to Sacrifice Smaller Things in Life to Achieve Greater Objectives: This is very important, especially if one wants to achieve great objectives in life. We may set higher goals, have the potential to attain them, but if we are not willing or reluctant to sacrifice small or even petty things and cannot overcome over temptations, then we cannot achieve our goals. Frustration is often the “difference” between what we want to achieve, and what we are willing to sacrifice to achieve that. Please remember that nothing is easy or free in this world. We have to earn every thing we want to have in this life. Life is not going to be a bed of roses or a cake walk. But that does not mean that we do not have happiness in this life. We do have. But we need a balanced approach toward the dualities – gain and loss, pleasure and pain, joy and sorrow, riches and rags. We need to develop equanimity of mind in life to face them. Then the mind is less fluctuating and more peaceful.
It is never too Late to Change for the better in the Life: It is never too late in the life to change for good. History of mankind is a proof for this statement. Emperor Ashoka who ruled India during the 1st century AD, started his life with a great ambition to conquer all the kings and acquire their kingdoms and thus become a Great Emperor. He fiercely fought many battles and won them. Finally in the battle of Kalinga, the toughest one he ever fought and won, he literally saw human massacre with blood flowing in streams. That changed his life forever. He became compassionate and embraced Buddhism and spread its gospel throughout the Asia and Far East, which changed the lives of hundreds of millions of people for good. He became a great ruler who worked for the welfare and happiness of his people. He erected great monuments and constructed shelters, hospitals, schools and other public places. Today, the pillar he erected in Saranath about two thousand years ago, the lion heads of which adore the official seal of the Republic of India, the largest democracy in the world, stands as an eternal proof that when one soul truly changes, it can do tremendous things in life, and can influence 3
the lives of generations of people to come. Such is the power of the true change even it occurs late in the life. Similarly Valmiki was born as a hunter, but the sight of a bird lamenting for its fallen mate hit by a hunter’s arrow changed him and made him a great sage, who composed Ramayana, one of the greatest epics of India. We may not be so great as Emperor Ahsoka or Sage Valmiki to do such great things by changing. But by changing for the better we can definitely make a big difference in our small lives and in the lives of people around us. What else we want in our lives? Every one of us has to strive and do at least one good and great thing in our lives which will immensely benefit the people around us. Then our lives have a lot of meaning and value to make us happy, especially when become old.
Each Person has Three Different Entities: Each one of us has three different entities. The one we think about ourselves, the one that others think about us, and the third one – what we really are. The closer these three are the better will be our lives. But it is not an easy task, and needs years of practice and contemplation. The easier one to achieve, with more or less similar outcome is to keep the two – what we think of ourselves and what we really are as close as possible. This will allow us to be very realistic in our lives thus eliminating mental conditions, such as frustration, depression and thus make us happy and enjoy our lives. This only needs self-discipline and contemplation. This is my philosophy in life which I pursued for decades, and I found it works. In the long run I gained much from this perspective in life.

My Spiritual toughness

2009-05-17T10:37:00.001-07:00

I am strong.
To look at me,
you might laugh
at such a bold statement.
But my strength is not
of my arms, legs, and chest.
My strength is within.

Those that seek to harm me
do not use fists and clubs.
They use words,
of fear,
of judgment.
They’ll even try to use
their “love.”

No castle high
nor armor strong
can protect me from words.
When I fight back
I find myself
bloodied and beaten.
In a war of words,
we all get killed.

So I have chosen
a new way to protect my Self—
by not protecting me at all.
What use are words
fired in anger
if they cannot cause me pain?
What weapons of words
can hurt me
if they never reach their mark?

Within my heart
I know my truth.
In this knowing
I find my strength.

If I do not erect defenses,
there are no defenses to penetrate.
Defenses can crumble.
Defenses can burn.
Defenses can be destroyed.
But I am eternal.

I know that when I feel
emotional pain,
one of my defenses
has been breached.

So I seek to tear them down,
to leave myself raw and open.
In this undefended state,
I find myself amidst fighting
yet unperturbed by it.
I have found true toughness.

To be tough
is to remain at peace
amidst the storms
that rage around us.
To be tough
is to stay the course.

The truth I live by
is my truth,
given to me by God
to live a healed and joyful life.

Yet there are many
who find my truth
built on love
threatens their nightmare
built on fear.

To them I only say,
“I love you,”
and know they’ll find their way someday.

To argue or debate,
to defend and counterattack,
only serves to make
my truth a lie.

So when another
calls me to battle,
to defend my truth
against their mighty fears,
I exercise my spiritual muscles,
and let their challenge pass by.

In that act
I demonstrate
the toughness of my spirit.
I stay firmly on my path,
guided by my heart,
grounded in love,
and at peace.

University of cincinnati

2009-05-12T12:05:00.001-07:00

ASPARTAME - THE SILENT KILLER

2009-05-04T08:20:00.000-07:00

Silent Killers-sweets to avoid

Deadly news... worth to read...

ASPARTAME - THE SILENT KILLER
For those who take Ricola & Fisherman , please note that they both contain Aspartame - the silent killer.

This website shows the adverse effects of ASPARTAME:
http://www.nexusmagazine.com/articles/aspartame.html

Fisherman Sweets
FOR THOSE WHO LIKE TO EAT FISHERMAN SWEETS BE CAREFUL: Sugar free products contain ASPARTAME .. So don't consume Sugar free product esp. 'fisherman sweets' ASPARTAME - THE SILENT KILLER (by Ron Harder)

To those who prefer to consume artificial flavoring:

There is an epidemic across North America today of Multiple Sclerosis and Lupus. Most people do not understand why this epidemic is happening, and they do not know why these diseases are so rampant. I would like to share with you the main reason we are having this very serious problem. Many people today use artificial sweeteners in their tea or coffee.

They do this because the ads they see on TV tell them that sugar is bad for their health. This is absolutely true. Sugar is toxic to us , but what most people use as a replacement for sugar is much more deadly. I am talking about ASPARTAME. It is the cause of the epidemic that was mentioned above. ASPARTAME is an extremely toxic chemical that is produced by a chemical company called Monsanto.

ASPARTAME is being marketed around the world as a sugar substitute and is found in all diet soft drinks, such as Diet Coke and Diet Pepsi . It is also found in artificial sweeteners such as NutraSweet, Equal, and Spoonful; and it is used in many other products as a sugar replacement.

ASPARTAME is marketed as a diet product, but it is not a diet product at all. In fact, it will cause you to GAIN weight because it makes you crave carbohydrates. Causing you to gain weight is only a very small part of what ASPARTAME does. It is a toxic chemical that changes the brain's chemistry. It can and does cause severe seizures.

This chemical changes the dopamine level in the brain, and it is particularly deadly for anyone suffering from Parkinson's disease.

ASPARTAME is extremely poisonous, and here is why one of the toxic ingredients of it is wood alcohol. When the temperature of

ASPARTAME exceeds 86 degrees F, the wood alcohol in it is converted to Formaldehyde, and then to formic acid, which in turn causes folic acidosis..

FORMALDEHYDE is grouped in the same class of poisons as Cyanide and Arsenic which are very deadly toxins. The only difference is, Formaldehyde kills quietly, and it takes a little longer. And, in the process of killing people, it causes all kinds of neurological problems. There are 92 documented symptoms of Aspartame Poisoning leading to coma and death.

The majority of these symptoms are neurological, because the ASPARTAME attacks and destroys the nervous system. One of these symptoms is Lupus, which has become almost as rampant as Multiple Sclerosis, especially with Diet Coke and Diet Pepsi drinkers.

MENTAL TOUGHNESS

2009-05-03T11:58:00.001-07:00

Mental toughness is the ability to consistently sustain one’s ideal performance state during adversities in competition. Performing to one's potential requires good technique and mental skills. Ups and downs in performance are often directly traceable to psychological ups and downs. Players who create a special atmosphere within them perform consistently. Mental toughness is learnt, not inherited. The ultimate measure of mental toughness is consistency.

CHARACTERISTICS OF MENTAL TOUGHNESS

The mentally tough competitor is self-motivated and self directed. He/she does not need to be pushed from outside as he is controlled from within. The player is in total control of his emotions. He/she is positive and realistic about his/her goals and success. The individual is generally calm and relaxed under pressure situations. The person is also mentally alert, focussed, confident and responsible for his actions. He is ready for action, usually energetic and determined.

Fundamental areas of mental toughness are:

* Self-Confidence
* Self-Motivation
* Negative Energy Control
* Positive Energy Control
* Attention Control
* Visual/Imagery Control
* Attitude Control

Self-Confidence: It is a way of feeling. One can develop self-confidence with practice. The key ingredient is belief in self. You develop self-confidence by elevation of self-image, learning to stay calm, goal setting, positive thinking, self discipline and reviewing performance.

Self-Motivation: It is a source of positive energy. It helps to endure pain, discomfort and self-sacrifice. To overcome low self-motivation, set meaningful long-term goals, commit the goals on a training book, keep a daily record, associate with self-motivated players, enjoy the activity.

Negative Energy Control: Controlling negative emotions like fear, anger, envy, frustration and temper. Performing with negative energy results in inconsistency. To overcome negative energy, increase awareness, psycho, regulation, physical exercise and stimulate competitive situations.

Positive Energy Control: It is the ability to become energized with joy, determination and team spirit. It helps players to maintain the required arousal level to achieve peak performance. To overcome low positive energy control, increase awareness, develop enthusiasm, start feeling good and ensure physical fitness.

Attention Control: It is the ability to tune what is important and what is not important (i. e., to disassociate from what is irrelevant). Improve calming and quieting skills, time awareness, get the positive energy flowing and concentration training.

Visual/Imagery Skills: It is process of creating pictures or images in mind (i. e., thinking in pictures) This is one of the most powerful techniques to develop mental toughness as it is the connecting link between the mind and body. To overcome low visual/imagery skills- practice visualization with all the senses, ensure internal calmness, use photographs and start rehearsing mentally in advance.

Attitude Control: It is a reflection of the player's habits of thoughts. The right attitude produces emotional control and right flow of energy. To overcome low attitude control, identify positive and negative attitudes. Positive affirmation reinforces positive attitude, keep records and have a vision or commitment.

PSYCHOLOGICAL CONCEPTS

Acquiring new modes of behavior by assimilating varied changes is a continuous process that occurs throughout the life. In sports the ultimate aim of achieving fine motor skills is to enhance one’s performance. Therefore, to bring in this desirable effect, certain principles are to be borne in mind.

Reinforcement – is any event or response which serves to increase the frequency of the behaviors that preceded its presentation. Positive or negative reinforcement helps or avoids repeating a desirable performance or stopping an undesirable performance. Delayed reinforcements are often less productive.

Motivation – is a process by which an individual is inspired to do something? Motivated condition is essential for effective learning. A need is to be created within the individual.

Feedback – is the knowledge of result which helps to check the performance and make the necessary modification after a self-evaluation.

Individual Differences – pertaining to physical, psychological and socio-cultural differences can affect the learning and performance.

Emotional Arousal – if in optimum level, is the most desirable for performance. Different games require different levels of arousal.

Insight – means sensing intuitively the inner nature of something. In a game situation, it may perceive the situations in a new way, and applying new tactics and strategy.

Information Processing – is collecting the right information that may be any idea, image, fact, knowledge etc. and putting these together for interpreting and responding to incoming stimuli.

Transfer of Training – indicates that an earlier habit influences the performance of later habit. Bilateral transfer occurs when one part of the body facilitates learning by another. Positive effect occurs when similarity in skills is established. Negative effect occurs if the skills have been mastered and if major changes are attempted.

Level of Aspiration – is the level to which one aspires, a standard set by a person by which success or failure can be personally gauged. In sports, choosing a realistic level as a strong motivator makes the learning effective.

Plateau – is a transition stage, which is only a temporary stagnation phase where the rate of improvement in learning is at the minimum. With appropriate corrective measures, this stage can be overcome. The duration of plateau stage varies from person to person.

Mental Practice – with physical activity results in early learning and aids in better performance by chalking out appropriate game strategies.

STAGES OF PSYCHOLOGICAL PREPARATION

Stage 1: Psychodiagnosis

When a training camp commences, after the initial rapport is established with the players, it is desirable to have the base level of the psychological parameters. This will help the coach to have a general view of the psychological status of each player. The psychodiagnosis includes psychological tests, which have to be designed keeping in mind the demands of the particular game, age and skill level.

Broadly, the psychological tests can include the area of psychomotor abilities, information processing, personality, motivation and socio-psychological factors. The coach can identify the dominant psychological state of player. The testing is to be conducted during selection trials or even when the training camps are in progress. Testing during selection helps the coach to have an idea of the kind of tasks the player would suit.

Stage 2: Psychological Recommendations

After the psychological assessment is done in the first stage, psycho-pedagogical recommendations are given. The recommendation is to be given to all the personnel involved with the team – coaches, teammates, players, family friends, doctor and other paramedical staff.

For example, a casual remark by a masseur that a player’s muscles are not relaxed or any such negative statement while working with the player can become a source of worry and hinder high level performance. Well meaning close associates of the player can also cause anxiety prior to the competition by their over-concern or over-indulgence.

In such instances, it is recommended to refrain from doing things that could cause deterioration in performance. The recommendation can be given for appropriate selection of the sport for young children, besides developing the required skills of the players during the period of training camps. For example, if the visual skills of a hockey player have to be developed, the psychologist along with the coach can formulate exercises for the same. The recommendation can be provided for the choice of game, for the coaches to decide the kind of training to be imparted.

Stage 3: Psychological Preparation

The psychological preparation of the coach is important because it is he who is looked upto in times of crises. He is the person who inspires the player to think about new and interesting task variations. A coach often succumbs to pressure from the society, and his or her self-worth is associated with the team's performance. Hence winning becomes an important issue.

However, it is vital that the coach doesn't lose his nerve under pressure or become dictatorial. Coaches should take adequate measures to remain a counselor, adviser and most importantly, a person who provides knowledge and wisdom to young players.

Psychological preparation of a team will include different exercises to improve upon those qualities that have been evaluated. The psychologist and the coach should be sensitive to observing the motivational levels of a player and the group dynamics of the team. This is especially important in team sports.

Psychological stress management has to be an integral part of the training. Stress can destroy a sports person's self-confidence and cause digression from tactical skills. It can cause burnout in a sportsperson at a crucial time in an important competition.

Psychological training should be individually directed for each trainee, and it should include relaxation training, stress management, positive thinking, regulation of self, training for improving concentration and psychological energy control. While practically doing the above training, it is important that the sportsperson develops a self-awareness of his initial level. While training is in progress, after each session, the trainee has to be encouraged to record the effects, observations and associated feelings. The training log will thus provide a feedback of the effectiveness of the training program, and it can even be modified if needed.

Stage 4: Psychological Control

Psychological control during competition will be achieved if the sportsperson has learned the management techniques during the long-term training. In competitions which are prolonged, self-control and regulation of arousal becomes important so that performance is not negatively affected.

Often during a critical period of the competition, even well-meaning suggestions offered by a coach elicits little change in the player’s behavior. This is due to the stress that the player is undergoing. However, if the athlete is able to regulate his activation, positive improvement can occur.

Therefore, a coach should be cognizant of the activation demand of the task, and the individual level of the sportsperson. Self-control and self-regulation gains significance because on the playfield, the player is competing alone or with his teammates only. It is in the best interests of the game that the coach or psychologist leaves the player alone without excessive interference.

Stage 5: Evaluation

Every competition provides feedback of strengths, weaknesses and the strategies used. Based on these, future strategies can be chalked out. The emotion which follows is often related to the outcome of the competition. Each player will interpret his unique contribution to the result of the competition differently.

For instance, a player from the winning team can feel depressed if he feels his role was not successfully executed. Likewise, a loss is not necessarily an unsuccessful effort. Therefore, during the process of evaluation, the coach should be extra cautious while interpreting the present and formulating future strategies. The experience and the background of a player is to be considered individually. After ensuring proper rest and relaxation, a coach can offer objective, constructive criticism in precise terms to each player irrespective of the win or loss of the game. This would provide direction for future competitions to follow.

6 Mental Training Tips - How to Improve Your Mental Toughness

2009-05-03T11:57:00.001-07:00

6 Mental Training Tips - How to Improve Your Mental Toughness

softball player 6 Mental Training Tips How to Improve Your Mental ToughnessThe mental is such a big part of our game. It's often the determining factor between success or failure.

Almost every day, I get emails from players, coaches, and parents about how to improve confidence or be mentally tougher.

I thought I would share with you a few tips to help you become almost instantly mentally tougher.

READ THEM SLOWLY and take time to study them. This stuff is what helps the best athletes in the world be successful.

Tip #1 Overcome fear of failure. Fear of failure might be what is holding you back. Dare to be great by taking risks, chances. Nobody has ever achieved greatness without facing hardship first. Failing is a good thing if you learn from it. Instead of seeing problems or obstacles, see challenges to overcome. The most successful people on the planet are risk-takers. You will never achieve anything by risking nothing.

Tip #2 - Make no excuses and take full responsibility for all your failures and all your successes. The world’s most successful people never make excuses and they hold themselves accountable. Achieving success and making excuses are mutually exclusive, wholly incompatible.

Tip #3 - Accept the fact that you will fail, make a lot of mistakes and learn from them. Failing is a big part of the game. If you succeed only 30% of the time at the plate, it’s excellent. That means that you will be failing more often than you succeed. Failing is part of life and sport in general. You actually learn more by failing than by succeeding. The key point is to look at mistakes and failures as learning opportunities. Ask yourself: “What didn’t go well and how can I do things differently next time to be successful?”

Tip #4 - Be here, now. Play one pitch at a time, confident and focused on each pitch as it is played with disregard for past or future pitches. Ignore the emotional baggage of scores, innings, and pitch counts; just focus on the next pitch. Playing a full game in the present is to ultimate goal and the best way to ensure that you perform at your best.

Tip #5 - Focus on the process rather than the outcomes. You have much more control over the process than the outcome. For example, when hitting, focus on having a good at bat (proper mental approach to the plate, selecting the right pitches, using your best swing, hitting a line drive, etc.) rather than focusing on getting a hit or not striking out.

Tip #6 - Develop routines to help you get in the zone. The use of routine is one of the most widespread practices among elite softball players. They perform routines before games, between innings and between pitches
at the plate and on the field. A routine integrates both the mental and the physical aspects. It is a specific way of doing things to stay focus, block distraction and put you in the ideal mindset. Routines are powerful and you should definitely use them.

Again, take time to re-read slowly these 6 tips. They can tremendously help you perform on the softball field.

Be mentally tough.

Who loves ya? ;-)

9 secrets for bigger stronger muscles

2008-11-12T11:24:00.000-08:00

Your body has about 650 muscles. It doesn't matter that you only care about four or five of them. You need every one in order to perform the normal functions of everyday life—eating, breathing, walking, holding in your stomach at the beach.

Granted, you don't need to spend a lot of time thinking about most of your muscles. The 200 muscles involved in walking do the job whether you monitor them or not.

You could try to impress your friends at parties by telling them the gluteus maximus is the body's strongest muscle, or that the latissimus dorsi (in your middle back) is the largest, or that a middle-ear muscle called the stapedius is the smallest. But it probably won't work, unless you have some really unusual friends. And muscle trivia can't capture the wonder of muscles themselves—the brilliance of coordinated muscles in motion, the magnificence of well-developed muscles in isolation.

We hope, in the following story, to help you understand a little more about how your muscles work, and thus how to make them bigger, stronger, and more aesthetically pleasing (if you're into that sort of thing). You can accomplish all three, if you know what's going on beneath the surface.

1..Muscle Fibers Do Different Things

Your skeletal muscles—the ones you check out in the mirror—have two main types of fibers.

Type I fibers, also called slow-twitch, are used mainly for endurance activities. Type II, or fast-twitch, begin to work when a task utilizes more than 25 percent of your maximum strength. A movement doesn't have to be "slow" for the slow-twitch fibers to take over; it just has to be an action that doesn't require much of your fast-twitch strength. And an effort doesn't have to be "fast" to call your fast-twitch fibers into play.

2...To Grow Large, Lift Large

When you begin a task, no matter if it's as simple as getting out of bed or as complex as swinging a golf club, your muscles operate on two basic principles of physiology:

1. The all-or-nothing principle states that either a muscle fiber gets into the action or it doesn't. (As Yoda said, long ago in a galaxy far away, "There is no try.") If it's in, it's all the way in. So when you get up to walk to the bathroom, incredibly enough, a small percentage of your muscle fibers are working as hard as they can to get you there. And, more important, all the other fibers are inactive.

2. The size principle requires that the smallest muscle fibers get into a task first. If the task—a biceps curl, for example—requires less than 25 percent of your biceps' strength, then the slow-twitch fibers will handle it by themselves. When the weight exceeds 25 percent of their strength, the type II, fast-twitch fibers jump in. The closer you get to the limits of your strength, the more fast-twitch fibers get involved.

Here's why this is important: One of the most pervasive myths in the muscle world is that merely exhausting a muscle will bring all its fibers into play. So, in theory, if you did a lot of repetitions with a light weight, eventually your biggest type II fibers would help out because the smaller fibers would be too tired to lift the weight.

But the size principle tells you that the biggest fibers are the Mafia hit men of your body. They don't help the underlings collect money from deadbeats. They suit up only when the work calls for their special talents, and when no one else can be trusted to do the job right.

In other words, a guy who's trying to build as much muscle as possible must eventually work with weights that require something close to an all-out effort. Otherwise, the highest-threshold fibers would never spring into action. Moreover, the smaller fibers don't need any special high-repetition program of their own, since the size principle also says that if the big fibers are pushed to the max, the small ones are getting blasted, too.

3...Building Muscles Saves Your Bones

Many have tried to disparage the squat, framing it as an exercise that's brutal to back and knees. The charges never stick. Sure, the exercise can be tough on the knees, but no tougher than full-court basketball or other full-bore sports.

And for guys with healthy backs and knees, the squat is among the best exercises for strength, mass, sports performance, and even long-term health. The heavy loads build muscle size and strength, along with bone density, and thicker bones will serve you well when you finally break into that 401(k). So you won't be the guy who fractures his hip and ends up in a nursing home, although you'll probably pay some visits to your nonsquatting friends.

Setup: Set a bar in supports that are just below shoulder height and load the weight plates. (Be conservative with these weights if you've never squatted before. There's a learning curve.) Grab the bar with your hands just outside your shoulders, then step under the bar and rest it on your back. When you pull your shoulder blades together in back, the bar will have a nice shelf to rest on. Lift the bar off the supports and take a step back. Set your feet shoulder-width apart, bend your knees slightly, pull in your lower abs, squeeze your glutes, and set your head in line with your spine, keeping your eyes forward.

Descent: To begin the squat, bend your knees and hips simultaneously to lower your body. Squat as deeply as you can without allowing your trunk to move forward more than 45 degrees from vertical. Make sure your heels stay flat on the floor.

Ascent: Squeeze your glutes together and push them forward to start the ascent, which should mirror the descent. Keep your knees the same distance apart (don't let them move in or out). Your hips and shoulders need to move at the same angle--if your hips come up faster, you increase your trunk angle and risk straining your lower back. At the top, keep a slight bend in your knees.

4...You Can Improve Muscle Quality

On the day you were conceived, the gene gods had made three decisions that you might want to quibble with as an adult, if you could:

1. Your maximum number of muscle fibers

2. Your percentages of fast- and slow-twitch fibers

3. The shapes of your muscles when fully developed

On the downside, unless you were born to anchor the 4x100 relay at next summer's Olympics, you can forget about ever reaching that goal. The athletes at the extremes—the fastest and strongest, the ones with the best-looking muscles, and the ones capable of the greatest endurance—were already at the extremes from the moment sperm swam headlong into egg.

The upside is that there's a lot of wiggle room in between. Few of us ever approach our full genetic potential. You probably will never be a freak, but with the right kind and amount of work, you can always be a little freakier than you are now.

The best way to do that is to learn to use your muscles' very own juice machine.

5....More Muscle Comes from More T

Everyone has some testosterone—babies, little girls playing with tea sets, grandparents shuffling through the laxative aisle at CVS—but no one has hormonal increases from one year to the next like a maturing male. His level increases tenfold during puberty, starting sometime between ages 9 and 15, and he hits near-peak production in his late teens. From there, his testosterone level climbs slowly until about age 30, at which point he hits or passes a few other peaks.

His muscle mass will top out between the ages of 18 and 25, unless he intervenes with some barbell therapy. Sexual desire peaks in his early 30s. Sports performance, even among elite athletes, peaks in the late 20s and starts to decline in the early 30s.

None of this is inevitable, of course. Unless you're that elite athlete who's trained for his sport since before the short hairs sprouted, you probably have the potential to grow bigger and stronger than you've ever been. And that could also put a little of that teenage explosiveness back into your sex life.

The testosterone/muscle-mass link is pretty clear in general terms: The more you have of one, the more you get of the other. Strength training, while it doesn't necessarily make your testosterone level go up permanently, certainly makes it get a little jiggy in the short term. We know of four ways to create a temporary surge in your most important hormone.

1. Do exercises that employ the most muscle mass, such as squats, deadlifts, pullups, and dips.

2. Use heavy weights, at least 85 percent of the maximum you can lift once on any given exercise.

3. Do a lot of work during your gym time—multiple exercises, multiple sets, multiple repetitions.

4. Keep rest periods fairly short—30 to 60 seconds. Of course, you can't do all these things in the same workout. For example, when you work a lot of muscle mass with heavy weights, you can't do a high volume of exercise, nor can you work effectively with short rest periods. This is among the many reasons you should periodize your workouts, which is a polysyllabic way of saying change your workouts every few weeks, rather than do the same thing from now till the gene gods recall the merchandise.

6...Muscles Need More than Protein

The mythology surrounding protein and muscle building could fill a book, even though the science is fairly straightforward. Your muscles are made of protein (except the four-fifths that's water), so you have to eat protein to make them grow. You also have to eat protein to keep them from shrinking, which is why men trying to lose fat without sacrificing muscle do best when they build their diets around high-quality, muscle-friendly protein from lean meat, fish, eggs, poultry, and low-fat dairy products.

But if you're young, lean, and trying to gain solid weight, a lot of extra protein may not help as much as you think. Protein has qualities that help weight loss and may curtail weight gain. First, protein is metabolically expensive for your body to process. Your body burns about 20 percent of each protein calorie just digesting it. (It burns about 8 percent of carbohydrate and 2 percent of fat during digestion.)

Second, protein creates a high level of satiety, both during meals and between them. In other words, it makes you feel fuller faster and keeps you feeling full longer between meals. (This effect does wear off as you grow accustomed to a higher-protein diet, so it may not have an impact on long-term weight gain or weight loss.)

Finally, if you eat more protein than your body needs, it will learn to use the protein for energy. You want your body to burn carbohydrates and fat for energy, obviously, so a body that's relying on protein for energy is like a car that's using pieces of its engine for fuel.

The best weight-gain strategy is to focus on calories first, protein second. You should make sure you're eating at least 2 grams (g) of protein per kilogram (kg) of muscle mass. A kilogram is 2.2 pounds, so a 160-pound guy weighs about 73 kg and should take in a minimum of 146 g protein a day. But that's just 584 calories of protein, the amount you'd find in 15 ounces of chicken, two salmon fillets, or a 28-ounce steak. A protein-powder shake can amp up your totals, as well. If you need to eat more than 3,000 calories a day to gain weight, you'd better have some sweet potatoes with those steaks.

7...Do Deadlifts

Ever watched a Strongman competition on TV? They start with large men picking something even larger up off the ground. That's a deadlift—the most basic and practical of all strength-building movements. Now, have you ever watched a Strongman competition with your wife or girlfriend? She'll notice something you probably wouldn't: Not a single one of those guys has a flat ass. So pull up a barbell: You'll be able to perform everyday feats of strength—lifting a sleeping child or a dying TV—and you'll look a lot better when she follows you upstairs to the bedroom.

Setup: Load a barbell and roll it up to your shins. Stand with your feet shoulder-width apart. Position your shoulders over the bar as you grab it with an overhand grip, your hands just outside your knees. Keep your back in a straight line from head to pelvis. Finally, pull your shoulder blades together and down.

Just before the lift: Straighten your legs a bit to establish tension on the bar. Pull in your lower abs and squeeze your glutes.

First pull, from floor to knees: Straighten your legs while keeping your trunk and hips at or near the same angle. The bar should stay in contact with your skin at all times.

Second pull, from knees to midthighs: Stand up, driving your hips forward. Finish upright, with your shoulder blades back and down and your lower back flat.

Lowering: No need to perfectly reverse the motion; just slide the bar down your thighs and shins to the floor. Don't annoy your fellow lifters by dropping the bar.

Next repetition: Repeat the setup, letting go of the bar and regripping if necessary. You want perfect form on every repetition, and you won't get that if you bang out reps without stopping to set up properly before each lift. Remember, it's a deadlift. That means no momentum from one repetition to the next.

If you use perfect form, your lower back should give you no trouble. However, if you have preexisting back problems, your muscles may not fire properly for this exercise. Try the sumo deadlift instead. Set your feet wide apart, toes pointed slightly outward, and grip the bar overhand with your hands inside your knees. Your back will be more upright at the start, taking away some of the potential for strain.

8...Dip for Big Triceps

Beginners almost invariably hit their triceps with light weights, limited ranges of motion, and simple, easy exercises. Which is fine . . . for beginners. For sizeaholics, the key to triceps development is lifting really, really heavy loads.

If you have time for just one triceps exercise, make it a dip. It's the big, basic movement that works all three parts of the muscle (thus the name "triceps"). And, because the bigger, stronger chest muscles are the prime movers—the ones that get your body moving from a dead-hang position—your triceps get to work against a much heavier load than they would in a triceps-isolating exercise.

How to dip: Hoist yourself up on parallel bars with your torso perpendicular to the floor; you'll maintain this posture throughout the exercise. (Leaning forward will shift emphasis to your chest and shoulders.) Bend your knees and cross your ankles. Slowly lower your body until your shoulder joints are below your elbows. (Most guys stop short of this position.) Push back up until your elbows are nearly straight but not locked.

Making progress: For most men, doing sets of dips with their own body weight is challenging enough. But when you reach a point at which you can do multiple sets of 10 dips, you want to add weight. The best way is to attach a weight plate or dumbbell to a rope or chain that's attached to a weight belt. Many gyms have belts specially designed for weighted dips and chinups. Another solution, especially if you work out at home, is to wear a backpack with weight plates inside it.

But the more weight you add, the more careful you have to be. Always lower yourself slowly—you don't ever want to pop down and up quickly on a weighted dip, unless you think you'll relish the feeling of your pectoral muscles detaching from your breastbone.

Precautions: Aside from the pec-tearing thing, you want to protect your shoulders. If you have preexisting shoulder problems, or feel pain there the first few times you try dips, you should skip them.

A comparable but more shoulder-friendly exercise is the decline close-grip bench press, using a barbell or dumbbells held togethe

9...Run Less to Grow Faster

Running doesn't build muscle mass. If it did, marathoners would have legs like defensive linemen, and workers in Boston would have to repave the streets each year following the city's signature race. But running shrinks muscle fibers to make them more metabolically efficient, thereby saving the pavement.

You'd think you could get around this by lifting weights in addition to running, but your body negates that work through a mysterious "interference effect." Your type II fibers—the biggest ones—will still grow if you run and lift. But your type I fibers won't, and even though they're smaller than the type IIs, they probably comprise 50 percent of the muscle fibers in your body that have any growth potential.

Cut back on your running program and you'll see growth in both your slow- and fast-twitch muscle fibers, and perhaps finally get your body to look the way you think it should.
A personal-record bench press is going to use every possible fast-twitch fiber (plus all the slow-twitchers, as we'll explain below), even though the bar probably isn't moving very fast.

Most people are thought to have a more or less equal mix of slow- and fast-twitch fibers. (Elite athletes are obvious exceptions—a gifted marathoner was probably born with more slow- than fast-twitch fibers, just as an Olympic-champion sprinter or NFL running back probably started life with more fast-twitch fibers.) However, the fast-twitch fibers are twice as big as the slow ones, with the potential to get even bigger. Slow-twitch fibers can get bigger, too, although not to the same extent.

So one strategy comes immediately to mind . .

Best speech ---president obama acceptance speech

2008-11-05T12:31:00.000-08:00

Obama -victory speech (one of the best ever) at grant park. Chicago

2008-11-04T21:40:00.001-08:00

PRESIDENT-ELECT BARACK OBAMA: If there is anyone out there who still doubts that America is a place where all things are possible; who still wonders if the dream of our founders is alive in our time; who still questions the power of our democracy, tonight is your answer.

Its the answer told by lines that stretched around schools and churches in numbers this nation has never seen; by people who waited three hours and four hours, many for the very first time in their lives, because they believed that this time must be different; that their voice could be that difference.

Its the answer spoken by young and old, rich and poor, Democrat and Republican, black, white, Latino, Asian, Native American, gay, straight, disabled and not disabled - Americans who sent a message to the world that we have never been a collection of Red States and Blue States: we are, and always will be, the United States of America.

Its the answer that led those who have been told for so long by so many to be cynical, and fearful, and doubtful of what we can achieve to put their hands on the arc of history and bend it once more toward the hope of a better day.

Its been a long time coming, but tonight, because of what we did on this day, in this election, at this defining moment, change has come to America.

I just received a very gracious call from Senator McCain. He fought long and hard in this campaign, and hes fought even longer and harder for the country he loves. He has endured sacrifices for America that most of us cannot begin to imagine, and we are better off for the service rendered by this brave and selfless leader. I congratulate him and Governor Palin for all they have achieved, and I look forward to working with them to renew this nations promise in the months ahead.

I want to thank my partner in this journey, a man who campaigned from his heart and spoke for the men and women he grew up with on the streets of Scranton and rode with on that train home to Delaware, the Vice President-elect of the United States, Joe Biden.

I would not be standing here tonight without the unyielding support of my best friend for the last sixteen years, the rock of our family and the love of my life, our nations next First Lady, Michelle Obama. Sasha and Malia, I love you both so much, and you have earned the new puppy thats coming with us to the White House. And while shes no longer with us, I know my grandmother is watching, along with the family that made me who I am. I miss them tonight, and know that my debt to them is beyond measure.

To my campaign manager David Plouffe, my chief strategist David Axelrod, and the best campaign team ever assembled in the history of politics - you made this happen, and I am forever grateful for what youve sacrificed to get it done.

But above all, I will never forget who this victory truly belongs to - it belongs to you.

I was never the likeliest candidate for this office. We didnt start with much money or many endorsements. Our campaign was not hatched in the halls of Washington - it began in the backyards of Des Moines and the living rooms of Concord and the front porches of Charleston.

It was built by working men and women who dug into what little savings they had to give five dollars and ten dollars and twenty dollars to this cause. It grew strength from the young people who rejected the myth of their generations apathy; who left their homes and their families for jobs that offered little pay and less sleep; from the not-so-young people who braved the bitter cold and scorching heat to knock on the doors of perfect strangers; from the millions of Americans who volunteered, and organized, and proved that more than two centuries later, a government of the people, by the people and for the people has not perished from this Earth. This is your victory.

I know you didnt do this just to win an election and I know you didnt do it for me. You did it because you understand the enormity of the task that lies ahead. For even as we celebrate tonight, we know the challenges that tomorrow will bring are the greatest of our lifetime - two wars, a planet in peril, the worst financial crisis in a century. Even as we stand here tonight, we know there are brave Americans waking up in the deserts of Iraq and the mountains of Afghanistan to risk their lives for us. There are mothers and fathers who will lie awake after their children fall asleep and wonder how theyll make the mortgage, or pay their doctors bills, or save enough for college. There is new energy to harness and new jobs to be created; new schools to build and threats to meet and alliances to repair.

The road ahead will be long. Our climb will be steep. We may not get there in one year or even one term, but America - I have never been more hopeful than I am tonight that we will get there. I promise you - we as a people will get there.

There will be setbacks and false starts. There are many who wont agree with every decision or policy I make as President, and we know that government cant solve every problem. But I will always be honest with you about the challenges we face. I will listen to you, especially when we disagree. And above all, I will ask you join in the work of remaking this nation the only way its been done in America for two-hundred and twenty-one years - block by block, brick by brick, calloused hand by calloused hand.

What began twenty-one months ago in the depths of winter must not end on this autumn night. This victory alone is not the change we seek - it is only the chance for us to make that change. And that cannot happen if we go back to the way things were. It cannot happen without you.

So let us summon a new spirit of patriotism; of service and responsibility where each of us resolves to pitch in and work harder and look after not only ourselves, but each other. Let us remember that if this financial crisis taught us anything, its that we cannot have a thriving Wall Street while Main Street suffers - in this country, we rise or fall as one nation; as one people.

Let us resist the temptation to fall back on the same partisanship and pettiness and immaturity that has poisoned our politics for so long. Let us remember that it was a man from this state who first carried the banner of the Republican Party to the White House - a party founded on the values of self-reliance, individual liberty, and national unity. Those are values we all share, and while the Democratic Party has won a great victory tonight, we do so with a measure of humility and determination to heal the divides that have held back our progress. As Lincoln said to a nation far more divided than ours, We are not enemies, but friendsâ€¦though passion may have strained it must not break our bonds of affection. And to those Americans whose support I have yet to earn - I may not have won your vote, but I hear your voices, I need your help, and I will be your President too.

And to all those watching tonight from beyond our shores, from parliaments and palaces to those who are huddled around radios in the forgotten corners of our world - our stories are singular, but our destiny is shared, and a new dawn of American leadership is at hand. To those who would tear this world down - we will defeat you. To those who seek peace and security - we support you. And to all those who have wondered if Americas beacon still burns as bright - tonight we proved once more that the true strength of our nation comes not from our the might of our arms or the scale of our wealth, but from the enduring power of our ideals: democracy, liberty, opportunity, and unyielding hope.

For that is the true genius of America - that America can change. Our union can be perfected. And what we have already achieved gives us hope for what we can and must achieve tomorrow.

This election had many firsts and many stories that will be told for generations. But one thats on my mind tonight is about a woman who cast her ballot in Atlanta. Shes a lot like the millions of others who stood in line to make their voice heard in this election except for one thing - Ann Nixon Cooper is 106 years old.

She was born just a generation past slavery; a time when there were no cars on the road or planes in the sky; when someone like her couldnt vote for two reasons - because she was a woman and because of the color of her skin.

And tonight, I think about all that shes seen throughout her century in America - the heartache and the hope; the struggle and the progress; the times we were told that we cant, and the people who pressed on with that American creed: Yes we can.

At a time when womens voices were silenced and their hopes dismissed, she lived to see them stand up and speak out and reach for the ballot. Yes we can.

When there was despair in the dust bowl and depression across the land, she saw a nation conquer fear itself with a New Deal, new jobs and a new sense of common purpose. Yes we can.

When the bombs fell on our harbor and tyranny threatened the world, she was there to witness a generation rise to greatness and a democracy was saved. Yes we can.

She was there for the buses in Montgomery, the hoses in Birmingham, a bridge in Selma, and a preacher from Atlanta who told a people that We Shall Overcome. Yes we can.

A man touched down on the moon, a wall came down in Berlin, a world was connected by our own science and imagination. And this year, in this election, she touched her finger to a screen, and cast her vote, because after 106 years in America, through the best of times and the darkest of hours, she knows how America can change. Yes we can.

America, we have come so far. We have seen so much. But there is so much more to do. So tonight, let us ask ourselves - if our children should live to see the next century; if my daughters should be so lucky to live as long as Ann Nixon Cooper, what change will they see? What progress will we have made?

This is our chance to answer that call. This is our moment. This is our time - to put our people back to work and open doors of opportunity for our kids; to restore prosperity and promote the cause of peace; to reclaim the American Dream and reaffirm that fundamental truth - that out of many, we are one; that while we breathe, we hope, and where we are met with cynicism, and doubt, and those who tell us that we cant, we will respond with that timeless creed that sums up the spirit of a people:

Yes We Can. Thank you, God bless you, and may God Bless the United States of America.

Happy Election Day!

2008-11-04T15:10:00.000-08:00

State-by-State Changes Last 3 Months

Date State Previous Status Current Status RCP Electoral Count RCP National Avg.
11/03 Minnesota Solid Obama »»» Leaning Obama Obama 278 - McCain 132 Obama +7.3
11/02 Virginia Leaning Obama »»» Toss Up Obama 278 - McCain 132 Obama +6.4
11/02 Ohio Leaning Obama »»» Toss Up Obama 278 - McCain 132 Obama +6.4
11/01 South Dakota Solid McCain »»» Leaning McCain Obama 311 - McCain 132 Obama +6.8
11/01 Arkansas Solid McCain »»» Leaning McCain Obama 311 - McCain 132 Obama +6.8
Click Here for Previous Electoral College Changes
Obama 278, McCain 132, Toss Ups 128 | No Toss Ups: Obama 338, McCain 200
Solid Obama Leaning Obama Solid McCain Leaning McCain Toss Up (Click Header to Sort)
State Obama (D) McCain (R) RCP Average RCP Status 2004 2000
Florida (27) 49.0 47.2 Obama +1.8 Toss Up Bush +5.0 Bush +0.1
North Carolina (15) 48.0 48.4 McCain +0.4 Toss Up Bush +12.4 Bush +12.8
Missouri (11) 47.8 48.5 McCain +0.7 Toss Up Bush +7.2 Bush +3.3
Indiana (11) 46.4 47.8 McCain +1.4 Toss Up Bush +20.7 Bush +15.7
Georgia (15) 45.8 49.8 McCain +4.0 Toss Up Bush +16.6 Bush +11.7
Montana (3) 45.0 48.8 McCain +3.8 Toss Up Bush +20.5 Bush +25.0
Arizona (10) 45.8 49.3 McCain +3.5 Toss Up Bush +10.5 Bush +6.3
Virginia (13) 50.2 45.8 Obama +4.4 Toss Up Bush +8.2 Bush +8.1
Ohio (20) 48.8 46.3 Obama +2.5 Toss Up Bush +2.1 Bush +3.5
Colorado (9) 50.8 45.3 Obama +5.5 Leaning Bush +4.7 Bush +8.4
Nevada (5) 50.0 43.2 Obama +6.8 Leaning Bush +2.6 Bush +3.5
Pennsylvania (21) 51.0 43.7 Obama +7.3 Leaning Kerry +2.5 Gore +4.2
New Mexico (5) 50.3 43.0 Obama +7.3 Leaning Bush +0.7 Gore +0.1
South Dakota (3) 42.0 50.3 McCain +8.3 Leaning Bush +21.5 Bush +22.7
West Virginia (5) 42.4 51.4 McCain +9.0 Leaning Bush +12.9 Bush +6.3
Arkansas (6) 43.0 52.3 McCain +9.3 Leaning Bush +9.7 Bush +5.4
Minnesota (10) 51.6 41.8 Obama +9.8 Leaning Kerry +3.5 Gore +2.4
New Hampshire (4) 52.8 42.2 Obama +10.6 Solid Kerry +1.3 Bush +1.3
South Carolina (8) 43.0 53.0 McCain +10.0 Solid Bush +17.1 Bush +15.9
Wisconsin (10) 52.8 41.8 Obama +11.0 Solid Kerry +0.4 Gore +0.2
Mississippi (6) 39.3 50.7 McCain +11.4 Solid Bush +19.6 Bush +16.9
Iowa (7) 54.0 38.7 Obama +15.3 Solid Bush +0.7 Gore +0.3
New Jersey (15) 54.5 39.0 Obama +15.5 Solid Kerry +6.7 Gore +15.8
Oregon (7) 55.3 39.7 Obama +15.6 Solid Kerry +4.2 Gore +0.5
Washington (11) 53.7 40.7 Obama +13.0 Solid Kerry +8.2 Gore +5.5
Michigan (17) 52.5 39.0 Obama +13.5 Solid Kerry +3.4 Gore +5.2
Maine (4) 54.4 38.8 Obama +15.6 Solid Kerry +9.0 Gore +5.1
Texas (34) 40.5 53.5 McCain +13.0 Solid Bush +22.9 Bush +21.3
California (55) 58.7 34.3 Obama +24.4 Solid Kerry +9.9 Gore +11.8
Massachusetts (12) 57.0 35.7 Obama +21.3 Solid Kerry +25.1 Gore +27.3
Kentucky (8) 41.0 54.5 McCain +13.5 Solid Bush +19.9 Bush +15.1
Alaska (3) 40.7 56.0 McCain +15.3 Solid Bush +25.6 Bush +30.9
Connecticut (7) 55.3 36.0 Obama +19.3 Solid Kerry +10.3 Gore +17.5
New York (31) 62.0 32.3 Obama +29.7 Solid Kerry +18.3 Gore +25.0
Tennessee (11) 38.8 52.8 McCain +14.0 Solid Bush +14.3 Bush +3.9
Alabama (9) 33.5 56.8 McCain +23.3 Solid Bush +25.7 Bush +14.9
Illinois (21) 59.0 34.3 Obama +24.7 Solid Kerry +10.4 Gore +12.0

Happy Election Day!

2008-11-04T14:57:00.000-08:00

Happy Election Day!

If you haven't already voted, this would be a good day to do it. Even if the presidential election is decided early and you live out West, be sure to vote because there are many key Senate races and House races up for grabs. In addition, members of the state legislatures will be elected and there are important ballot propositions in some states. For example, proposition 8 in California, which would ban same-sex marriage. Unlike previous days, this site will be updated multiple times today and I will attempt to do live blogging and update the maps in real time this evening. That failed in 2004 due to the load. We had 1.34 million visitors yesterday (and 19 million in October) but the servers seem to be up to the job this time. Three cheers for lighttpd.
Final Polling Map

So after 2 years, nearly a billion dollars raised and spent, dozens of debates, and many surprises, what does it look like? If you are a Democrat, it looks good; correspondingly, if you are a Republican, it looks gloomy. John McCain made a last-ditch effort to gain ground in Pennsylvania, but it appears to have failed. Obama will take all the states John Kerry won in 2004, worth 252 electoral votes. He also has led consistently in three Bush states: Iowa, New Mexico, and Colorado, worth a total of 21 electoral votes. Together with the Kerry states, this gives Obama 273 EVs and the presidency, even if McCain runs the table on the other swing states. However, Obama is leading in Nevada, Ohio, and Virginia, and essentially tied in Florida, North Carolina, and Missouri. It is likely that Obama will win the election with well over 300 electoral votes, possibly 350 of them.

The Senate Map doesn't look any cheerier for the Republicans. Democrats are very likely to pick up Senate seats in Alaska, Colorado, New Hampshire, New Mexico, North Carolina, Oregon, and Virginia, giving them 58 (counting independents Joe Lieberman and Bernie Sanders who caucus with the Democrats). They have a 50-50 shot at knocking off Norm Coleman in Minnesota, which would give them 59. They have a chance to win seats in Kentucky, Georgia, and Mississippi, but these appear to be longshots. Our best guess is that the Democrats will end up with 58-60 seats in the Senate (counting Lieberman and Sanders).

The House is going to be like the Senate: a Democratic landslide. There are too many races to list in detail here, but a Democratic pickup of 25-35 seats seems probable.

In governorland, the Democrats will probably hold Washington and Montana, maybe North Carolina, and pick up Missouri. Republicans will hold Indiana. The others weren't really contested.

Even Karl Rove is now predicting an Obama victory, 338 to 200 electoral votes. However, he is predicting McCain wins of 1% or less in Indiana, North Carolina, and Missouri, worth 37 EVs, which could conceivable flip to Obama.
Finally McCain Gets a Break

John McCain has had a run of bad luck this year ranging from little public interest in foreign policy to the Wall St. meltdown just before the election. Finally, he is getting the ultimate gift a Republican could ask for: rain on election day. The forecast is rain and storm in Pennsylvania, Virginia, and North Carolina. Rain lowers turnout and low turnout always helps Republicans as the people most discouraged from standing in the rain for hours are low-income voters. Whether this will be enough to swing those states is another matter though. They could be close. But turnout is crucial to determining who wins.
The First Election Results Are in Already

The polls have already closed in Dixville Notch, NH because all 21 eligible voters have cast their ballots. This village of 75 people traditionally opens the polls at midnight on election day and closes them a few minutes later after the last voter has performed his or her civic duty. Barack Obama got 71% of the vote here today. Dixville Notch is not a good bellwether, however; it has voted solidly Republican for decades. The last Democrat to carry the Notch was Hubert Humphrey in 1968. It is probably not a good start for McCain to have early election day news dominated by a story about a solidly Republican rural village voting overwhelmingly for Obama.
What to Watch for Tonight

The table below gives a list of races to watch, including those for President, Senate, and House. Blank fields and missing states indicate the results are probably predictable right now. The times indicate when the polls close. An asterisk means that in parts of the state the polls close an hour earlier than the time given here. All times are Eastern Time, not local time. The House races listed are from CQ Politics, but see also our list of Hot House races. Names with question marks indicate the more probable winner. The House races are clickable for more detail.
NOTE: Poll Closing Times Are All EST -- NOT Local Time
State Close (EST) Pres Senate House
AL 8:00 P.M. AL-02, AL-03, AL-05
AK 1:00 A.M. Begich? AK-AL
AZ 9:00 P.M. McCain? AZ-01, AZ-03, AZ-05, AZ-08
CA 11:00 P.M. CA-03 CA-04 CA-11 CA-26 CA-46 CA-50
CO 9:00 P.M. Obama? Udall? CO-04
CT 8:00 P.M. CT-02 CT-04 CT-05
FL 8:00* P.M. Obama? FL-08 FL-13 FL-15 FL-16 FL-21 FL-22 FL-24 FL-25
GA 7:00 P.M. McCain? Chambliss? GA-08 GA-12
ID 11:00* P.M. ID-01
IL 8:00 P.M. IL-06 IL-08 IL-10 IL-11 IL-13 IL-14 IL-18
IN 7:00* P.M. McCain? IN-03 IN-09
IA 10:00 P.M. IA-04
KS 9:00 P.M. KS-02 KS-03
LA 9:00 P.M. Landrieu? LA-01 LA-04 LA-06
ME 8:00 P.M. Collins? ME-01
MD 8:00 P.M. MD-01
MI 9:00* P.M. MI-07 MI-09
MN 9:00 P.M. Franken? MN-01 MN-02 MN-03 MN-06
MS 8:00 P.M. Wicker? MS-01
MO 8:00 P.M. ? MO-06 MO-09
NV 10:00 P.M. Obama? NV-02 NV-03
NH 8:00* P.M. Shaheen? NH-01 NH-02
NJ 8:00 P.M. NJ-03 NJ-05 NJ-07
NM 9:00 P.M. NM-01 NM-02
NY 9:00 P.M. NY-13 NY-19 NY-20 NY-24 NY-25 NY-26 NY-29
NC 7:30 P.M. ? Hagan? NC-08 NC-10
OH 7:30 P.M. Obama? OH-01 OH-02 OH-14 OH-15 OH-16 OH-18
OR 11:00* P.M. Merkley? OR-05
PA 8:00 P.M. PA-03 PA-04 PA-06 PA-08 PA-10 PA-11 PA-15 PA-18
SC 7:00 P.M. SC-01 SC-02
TX 9:00* P.M. TX-07 TX-10 TX-22 TX-23
VA 7:00 P.M. Obama? VA-02 VA-05 VA-10 VA-11
WA 11:00 P.M. WA-08
WV 7:30 P.M. WV-02
WI 9:00 P.M. WI-08
WY 9:00 P.M. WY-AL

Breakdowns Expected in Multiple Swing States

The National Journal has a good piece on likely voting problems today. Here are some of the highlights (lowlights?).

Colorado: Public-interest groups have sued the state because 35,000 voters have been illegally purged from the rolls. Also, the voting equipment was decertified and then immediately recertified. To top it off, the secretary of state has been barely doing his job since he is campaigning for Congress (and supervising his own election).

Florida: Many voters will be using the third type of voting machine in as many presidential elections, machines that lost 3500 votes in the August primary in a single county. Also, 12,000 voters have been purged from the roles because their voting data does not match other state data bases, often due to clerical errors.

Ohio: The (Democratic) secretary of state, Jennifer Brunner, has been involved in half a dozen lawsuits over 200,000 voters whose registration data do not match other state data bases (as in Florida). She has won most of them, including one in the Supreme Court, but these battles could lay the groundwork for GOP challenges if McCain loses the state.

Pennsylvania: Many voting machines here do not produce a paper trail so no recount is possible. Futhermore, the allocation of machine and poll workers is a contentious issue (putting few resources into poor areas creates long waits during which time some voters give up and go home). There were large numbers of flyers distributed in Philadelphia saying that Republicans should vote on Tuesday and Democrats on Wednesday to reduce the crowds. This could form the basis of a legal challenge in the unlikely event of a McCain win.

Virginia: The NAACP sued the state over the allocation of resources. State law requires one machine per 750 voters. Assuming it takes 5 minutes to vote, it would take the 750 voters 62.5 hours to vote, so some of them will still be voting on Friday. Problems are also expected with student voters.
Crosstabs on the Oct. 28th Poll Are Now Available

Several professional statisticians analyzed the Oct. 28 poll and produced crosstabs. Each one looked at things a bit differently and presented the data differently. While this wasn't a random sample (so it is completely useless for predicting who will win the election), the crosstabs contain a lot of detailed information not found elsewhere. For example, among the people surveyed here who consider abortion the most important issue, 46.6% support McCain and 46.5% support Obama. Thanks to all the statisticians: David Leahy (Cocoa Beach schools), Daniel Berebitsky (U. of Michigan), Jessi Schoner, Jason Holloway, Carolyn Broullon (Gazelle Global Research Services), and Alan Jordan.
Obama Goes into Election Day Ahead

Here is the final batch of national polls. With 13 polls reporting, Obama has a mean lead of 7.3%. If he indeed wins the popular vote by 7%, he will certainly win the majority of the swing states and be elected President. However, turnout, especially among blacks and younger voters will be crucial. If they fail to show up in the numbers predicted, McCain still has a small chance to win.
- Battleground (Obama +6)
- CBS News (Obama +9)
- Diageo (Obama +5)
- Fox News (Obama +7)
- Gallup (Obama +11)
- IBD (Obama +5)
- Ipsos (Obama +7)
- Marist (Obama +9)
- Rasmussen (Obama +6)
- Research 2000 (Obama +6)
- WSJ/NBC News (Obama +8)
- Washington Post/ABC News (Obama +9)
- Zogby (Obama +7)
Today's Polls

We have 23 presidential polls today. In Colorado, Obama still leads 51% to 47% in this must-win state for McCain. Florida is up in the air, but Obama has a miniscule lead here. Missouri and North Carolina are pure tossups. Ohio seems to be leaning for Obama, with 3 of 4 polls showing him with a slight lead there. Pennsylvania is solid for Obama. McCain made a last-minute effort here, but it failed. Without Pennsylvania, McCain has to hold all the swing states, and some of those, especially Colorado and Virginia, look tough for him.
State Obama McCain Start End Pollster
Colorado 51% 47% Nov 02 Nov 02 Rasmussen
Florida 47% 45% Oct 27 Nov 02 Quinnipiac U.
Florida 47% 48% Nov 01 Nov 02 Datamar
Florida 49% 50% Nov 02 Nov 02 Rasmussen
Florida 50% 47% Oct 31 Nov 03 SurveyUSA
Georgia 45% 52% Oct 30 Nov 02 SurveyUSA
Georgia 47% 48% Nov 02 Nov 02 Insider Advantage
Missouri 48% 48% Oct 30 Nov 02 SurveyUSA
Missouri 49% 49% Nov 02 Nov 02 Rasmussen
North Carolina 48% 49% Oct 30 Nov 02 SurveyUSA
North Carolina 49% 48% Oct 31 Nov 03 ARG
North Carolina 49% 50% Nov 02 Nov 02 Rasmussen
New Jersey 57% 42% Nov 02 Nov 02 Rasmussen
Ohio 48% 46% Oct 30 Nov 02 SurveyUSA
Ohio 49% 49% Nov 02 Nov 02 Rasmussen
Ohio 50% 43% Oct 27 Nov 02 Quinnipiac U.
Ohio 52% 46% Oct 29 Nov 02 U. of Cincinnati
Pennsylvania 52% 42% Oct 27 Nov 02 Quinnipiac U.
Pennsylvania 52% 43% Oct 31 Nov 03 SurveyUSA
Virginia 51% 47% Nov 02 Nov 02 Rasmussen
Virginia 51% 47% Oct 31 Nov 03 ARG
Washington 56% 40% Oct 30 Nov 02 SurveyUSA
West Virginia 42% 53% Oct 31 Nov 03 ARG

We also have four Senate polls. Kay Hagan (D) seems likely to knock off Sen. Elizabeth Dole (R-NC) in North Carolina, something few people would have predicted a year ago. In Georgia, Sen. Saxby Chambliss (R-GA) looks a bit ahead of Jim Martin (D). However, he is under 50% and if he fails to get half the total votes, there will be a runoff on Dec. 4. If the Democrats get 59 seats in the Senate, then this seat will determine whether they have that magic 60 to invoke cloture (although in truth, cloture votes are rarely strictly along party lines). Still, Chambliss is extremely conservative and can be counted on to oppose everything the Democrats do, so this seat is important. If it does go to a runoff, every politician in the country will make an appearance in Georgia during November. And you thought the election was over today?
State Democrat D-pct Republican R-pct Start End Pollster
Georgia Jim Martin 43% Saxby Chambliss* 48% Nov 02 Nov 02 Insider Advantage
Georgia Jim Martin 44% Saxby Chambliss* 48% Oct 30 Nov 02 SurveyUSA
North Carolina Kay Hagan 45% Elizabeth Dole* 46% Oct 29 Oct 30 Mason-Dixon
North Carolina Kay Hagan 50% Elizabeth Dole* 43% Oct 30 Nov 02 SurveyUSA

We also have two House polls today.
Cong. Distr. Democrat D-pct Republican R-pct Start End Pollster
PA-11 Paul Kanjorski* 45% Louis Barletta 51% Oct 30 Nov 02 SurveyUSA
VA-05 Tom Perriello 47% Virgil Goode* 50% Oct 30 Nov 02 SurveyUSA

Some Acknowledgements

A number of people have provided invaluable help through the campaign season. Dirk Evertse, Tiffany Fackler-Watson, Lucia Lodolina, Breandan Knowlton, and Colleen Shannon have diligently and accurately collected the data every day. Without their help, I couldn't have done it. John Sinteur (who runs a great blog The Daily Irrelevant) helped with managing the servers and keeping everything going. Eric Paulson of Vikingdev.com wrote the software that automated the map generation. "Grumpy" wrote the rest of the graphics software and provided valuable advice on site design. Thanks to all of them and also to the other people who helped in the past, some of whom are listed on the Welcome page.

18 Big Ideas to Fix Health Care Now

2008-10-24T23:02:00.000-07:00

1. Fight the Big Five
Common chronic conditions (including coronary artery disease, diabetes, congestive heart failure, asthma, and depression) are responsible for 75 percent of our health care spending. George Halvorson, chairman and CEO of Kaiser Foundation Health Plan and author of Health Care Reform Now! A Prescription for Change, argues that we should follow the money -- and fight these diseases with all we've got, including early intervention and consistent follow-up care.

The payoff: If just 1 percent of people with these conditions were successfully treated, we could shave at least $77 billion off the health care tab. "Diabetes is the fastest-growing disease in America," he says, so focusing on that alone could save billions. "Medicare can be saved if we could cut the number of people becoming diabetic in half."

The action plan: Type 2 diabetes, in particular, is a lifestyle disease. Just a simple 30-minute walk every day, says Halvorson, could help achieve his 50 percent goal. We can all take more responsibility for our own health. Start a walking club. If you have diabetes or heart disease, follow up with your doctor and commit to a treatment plan. Learn more at fightchronicdisease.org. Need more motivation? Check out deathclock.com, suggests Rep. Jim Cooper (D-TN). It lets you see your statistical expiration date, given the risk factors of age, weight, and smoking.

2. Reduce Medical Errors by Thinking Like an Airline
Medical mistakes kill nearly 100,000 people every year, according to the Institute of Medicine. "That is equivalent to a 747 crashing every other day," says Denis Cortese, MD, president and CEO of the Mayo Clinic. These errors, more than half of them preventable, cost the United States as much as $29 billion each year.

Dr. Cortese thinks the health care system can learn from its mistakes the way the airline industry does. If a 747 crashed here, he says, the FAA would swoop in and analyze the accident, check airplanes nationwide, and do everything possible to prevent another accident. "All employees of the airline industry are expected to report near misses and mistakes within 24 hours," he says. "There is an investigation, people are thanked for making the report, and efforts are made to try to improve the services. In our health care system, when mistakes occur, we try to keep it as quiet as possible." Dr. Cortese suggests a federal health care safety reporting agency using a systems engineering approach so that medical errors can be logged, studied, and addressed -- without fear of punishment.

The payoff: A program like this could save lives and at least $17 billion a year.

The action plan: Find out more about the Mayo Clinic's health care reform efforts at mayoclinic.org/healthpolicycenter. For other efforts, visit the nonprofit National Patient Safety Foundation at npsf.org.

3. Get It Right the First Time
What a waste: As much as $312 billion is frittered away each year when patients are misdiagnosed or given the wrong treatment. Best Doctors, a health benefit offered through hundreds of insurers, health plans, and companies, is one way to help.

Founded by physicians affiliated with Harvard University School of Medicine, the Boston-based company offers its members in 30 countries customized second opinions from its network of top specialists and subspecialists around the world. For example, scans of a 12-year-old girl in Maine showed tumors in her liver and one lung, an apparent relapse from the rare form of cancer she battled as a toddler, her doctors said. But when the biopsy came back negative for malignant cancer, no one knew what to do.

The girl's father decided to try Best Doctors, a benefit offered and paid for by his employer. After top experts reviewed the girl's scans and records, they concluded the masses in her liver were a side effect from a drug she had taken years ago, while a spot on the lung was damaged tissue from her previous surgeries. The treatment? Leave the harmless masses alone. The review helped the girl avoid further biopsies and costly invasive surgeries.

The payoff: EMC Corporation, a large technology firm in Hopkinton, Massachusetts, consulted Best Doctors on 60 cases in its first year using the program. Diagnoses were changed in 15 percent of those and treatments were modified in 85 percent, resulting in $500,000 in savings.

"If everyone got the right diagnosis and treatment the first time," says Evan Falchuk, president of Best Doctors, "we could save tens of billions of dollars and an untold amount of unnecessary suffering and give millions of people the best chance to get well."

The action plan: For more information, go to bestdoctors.com or ask your employer's benefits department about a second-opinion program.

4. Pay Employees for Healthy Habits
When Safeway CEO Steve Burd discovered that 70 percent of health care costs are linked to unhealthy habits, he created incentives that sent his employees scrambling for the produce aisle. "No one quarrels with the fact that if you have three speeding tickets a year, you're a higher risk and should pay more for auto insurance," says the 58-year-old fitness buff. "Our new plan encourages employees to live healthier, and if they don't, then they bear some of the costs." Perks include lower premiums for those who lose weight or quit smoking, free or cheap gym memberships, and a $1,000 health care reimbursement check to encourage cheaper choices like generics over name-brand drugs.

The payoff: The company's new plan has saved 13 percent so far, and employees who've signed up have saved 20 to 30 percent on their premiums. If other companies followed Safeway's lead, the country could save $600 billion to $800 billion.

The action plan: Watch a video of Steve Burd at safeway.com (click on About Us), and learn more about his reform plan at coalition4healthcare.org.

5. E-Prescribe
Paper prescriptions are archaic and lead to 1.5 million injuries and 7,000 deaths each year from errors. But if every doctor got on board with an electronic Rx system, it would improve safety by making prescriptions easier to read and providing instant checks on drug interactions, dosages, and a patient's medication history. Doctors have been slow to make the expensive switchover, but now they can get free e-prescribing software through an initiative (nationalerx.com) launched by software company Allscripts. Also, physicians can now securely trade patient health and medication history through SureScripts-RxHub, the first nationwide network for e-prescriptions. Congress is providing incentives to increase Medicare payments to doctors who e-prescribe.

The payoff: This could cut drug-related injuries by a third and save $4 billion annually.

The action plan: Find out about studies, conferences, and events at ehealthinitiative.org, run by two nonprofits.

6. Use Retail Clinics for Routine Care
"Minute" clinics in major drugstore chains can help simplify health care, says Harvard business professor Clayton Christensen, by "offloading some of the work to nurse practitioners, physician assistants, and even patients." The AMA isn't keen on the idea: It wants doctors to at least supervise these clinics. Still, they're safe for minor things like sore throats, pulled muscles, pinkeye, wart removal, and vaccines.

The payoff: They're faster and more convenient. Plus, if you're uninsured, you'll pay 30 to 80 percent less than what you'd shell out for a doctor (and much less than you'd pay by going to the ER). For those who do have coverage, major insurance is usually accepted.

The action plan: Visit the Convenient Care Association at ccaclinics.org to find a clinic in your area.

7. Share Information to Fight Cancer
Could it really be this simple? Get the FDA and the pharmaceutical industry to talk more openly so patients can get safer drugs more quickly and inexpensively. The nonprofit Critical Path Institute (C-Path) believes we can save money and lives by speeding up our nation's sluggish and costly drug-approval process.

One project under way: C-Path brought 18 drug, biotech, and diagnostic companies together (many of them fierce competitors) to collaborate on a major lung cancer trial. The 18 companies are hoping to develop mutually agreed-upon tests that would allow the FDA to get results in as little as a week rather than years, says Raymond Woosley, MD, president of C-Path.

The payoff: Speeding up the trial process could reduce the number of costly failed drugs and lower the price of prescription drugs in general.

The action plan: Visit c-path.org for more information.

8. Measure Results and Make Them Public
When doctors and patients work together to meet tangible health goals that yield proven results, great things can happen. That's the idea behind nonprofit Minnesota Community Measurement. The group sets standards of care for 14 conditions, and the onus is on doctors to counsel, motivate, and even push their patients to get with the program. The organization gathers outcome data and posts the percentage of patients at each clinic who meet all the standards for a particular condition on mnhealthcare.org.

The payoff: While it's not easy to get people to change their lifestyles, compliance in diabetes patients has risen from 4 percent in 2004 to 11 percent in 2007. Jim Chase, executive director, estimates that if these improvements were adopted nationally, we could save more than $1.6 billion a year.

The action plan: If you have a chronic condition, work with your doctor to set goals in writing.

9. Stop Unnecessary Treatments
We spend more than any other country on health care, but we're not healthier for it, partly because so much of the care delivered here is unnecessary, says Shannon Brownlee, author of Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer.

"The way to fight waste," she says, "is by reorganizing the way doctors and nurses and hospitals provide care. There are models out there of high-quality, low-cost care, and they include some of the most trusted names in medicine: the Mayo Clinic, Kaiser, and Intermountain Healthcare. These programs have a primary provider coordinate all the care. They understand that 21st-century medicine is a team sport. They also put a premium on analyzing the best available evidence and then ensuring that their doctors follow it."

The payoff: "Cutting out even half of the unnecessary health care in this country," Brownlee says, "would be enough to cover every citizen who is now uninsured."

The action plan: Go to overtreated.com to learn which questions to ask your doctor; you'll find resources and links for further information.

10. Reduce Infant Mortality
More than 2,000 infants die in the United States every month, many because they're premature. "The rate of premature births has been increasing steadily for decades," explains Joann Petrini, PhD, director of the perinatal data center for the March of Dimes. More smokers, more moms over 35, and more multiple births (due in part to more women having fertility treatments) are just some of the reasons. "You could do everything right and still end up having a preterm baby," says Petrini. "We need more research into how and why it happens."

The payoff: Preterm births cost us more than $26 billion a year, so preventing them would save billions of dollars and thousands of lives.

The action plan: Support the campaign at marchofdimes.com.

11. Make Schools Healthier

* Reward healthy eating. The nine million obese kids in this country are set to become the first generation with a shorter life expectancy than that of their parents. Schools can help by encouraging fun physical activity and rewarding healthy eating. One school's success story: When Yvonne Sanders-Butler became principal of Browns Mill Elementary School in Lithonia, Georgia, a decade ago, 20 percent of her students were overweight, and just over half were passing state academic tests. She soon discovered that a typical breakfast for many students was a doughnut, candy, soda -- or nothing at all. She also found 300 slips on file excusing students from gym. "These kids were couch potatoes," says Sanders-Butler. She approached her PTA with a drastic plan: Ban candy, soda, and sugary snacks from brown bags and cafeteria lunches. Homeroom teachers now inspect all lunches and snacks and replace contraband treats with a banana or an apple. Kids and parents sign a wellness pledge, and students who stick to the program (called Healthy Kids, Smart Kids) win homework passes and other prizes. Now Sanders-Butler is working with the Robert Wood Johnson Foundation to help spread the word (healthykidshealthycommunities.org).

The payoff: Today you won't see a single obese child walking the halls, and 80 percent of students pass the state tests. As of September, 17 other schools had joined the program.

The action plan: Make the sugar-free case to the principal and PTA at your child's school. For more information, go to healthykidssmartkids.com.

* Rescue recess. In many schools, where recess hasn’t been pushed aside for academics, many students use those precious minutes to hang out rather than burn off the cheeseburgers. But at William H. Ohrenberger Elementary School in Boston, nearly 90 percent of all students participate in recess games. Fewer than half of all kids did two years ago, before the group Sports4Kids started visiting the school, says principal Stephen Zrike.

"We feel play is the single most effective way to promote physical activity," says the group’s founder, Jill Vialet. "It's not someone wagging a finger at them, telling them they need to lose weight." Through fat-busting sports like kickball and dodgeball, trained recess coordinators teach kids the fundamentals of play, including the rock-paper-scissors method of resolving conflicts.

The payoff: Making daily physical activity fun can set good habits for life.

The action plan: Visit sports4kids.org, or search for the group’s videos on YouTube.com.

* Expand gym class. The award-winning PE curriculum in the Hortonville, Wisconsin, school district includes non-jock activities, including golf, archery, dance, and fly-fishing. The goal is to help students find something they love so they’ll continue to do it well into adulthood. Students regularly use pedometers and heart monitors, both during gym and in the state-of-the-art cardio rooms.

The payoff: This past year, 70 to 80 percent of middle and high school students were within fitness targets based on heart rate and number of laps completed in an endurance test. A decade ago the rate was less than 40 percent.

The action plan: The National Association for Sport & Physical Education rewards schools across the country that have outstanding phys ed programs. See what makes the grade at aahperd.org/naspe/stars.

12. Don't Hire Smokers
Drop the smokes or don't bother applying: That's the ultimatum Jim Hagedorn, CEO of Scotts Miracle-Gro, gives his prospective employees.

It all started back in 2003, when Hagedorn learned that a quarter of his 6,000 employees were smokers and half were overweight. What's more, health care costs were up 42 percent in four years, jeopardizing the health of his company. Invoking some of the bravado of his years as an F-16 fighter pilot, Hagedorn implemented a sweeping wellness program to hold his employees accountable. Now those who don't get help to kick the habit or take a comprehensive health-risk assessment pay higher premiums.

A former chain-smoker, Hagedorn also developed a $5 million Wellness Center, including a medical clinic that employees use free. There are no co-pays for the doctors, nurses, dietitian, physical therapist, or pharmacy (where generic drugs are free). Hagedorn predicts the facility will pay for its $4 million operating costs in the next few years. "Only a focus on wellness can change things for the better," he says. "If companies don't demand creative solutions, then we have no right to complain. We will get what we deserve: increasingly less productive workers, higher costs, and reduced profitability."

The payoff: He has reduced the number of smokers from 25 percent to 8 percent and wants to get it even lower. About 90 percent of employees complete the assessment, and 82 percent use the medical center.

The action plan: Learn more at takecareemployersolutions.com.

13. Electronic Medical Records
Experts agree that electronic medical records (EMRs) are a must, but fewer than 25 percent of hospitals and 15 percent of doctors have these systems, mainly because of cost, privacy issues, and the lack of one compatible, easy-to-use infrastructure.

One model that works is the VistA system, which has been keeping electronic health records for seven million veterans since 1996. Everything is electronic, including images from CT and MRI scans. "I can check a San Francisco patient's scans from my office in Washington, D.C.," says Ross Fletcher, MD, chief of staff at the VA Medical Center. Congress is considering a bill that would invest at least $300 million in setting up a health information infrastructure similar to VistA. But why not just use VistA nationwide?

The payoff: If 90 percent of hospitals and doctors' offices participated, we could save about $80 billion a year, says public-policy researcher Richard Hillestad, PhD.

The action plan: Start by keeping your own EMRs with free, secure online services such as Google Health or Microsoft HealthVault. Ask your MD to make the switch too. Urge your representative on Capitol Hill to support bills that promote EMRs.

14. Save Primary Care
Soaring office costs, demanding insurance companies, low Medicare payments, staggering medical school debt (the average is $140,000), and politicians who refuse to make hard choices are driving primary care physicians out of business. That, experts caution, will result in fragmented care and higher costs as Americans turn to high-priced ERs and urgent care centers for even routine problems.

Already, 20 percent of internists have bailed since the early '90s, and a survey by the American College of Physicians (ACP) suggests that if Medicare rates aren't increased, another 62 percent will "retire" early. And they won't be replaced. The number of medical school students going into primary care is half what it was ten years ago. "It's an evolving crisis of unprecedented proportions," says ACP president-elect Joe Stubbs, MD, an Albany, Georgia, physician.

Three things will help: "forgiving" medical school loans, digitizing medical records to help deal with insurance company demands, and improving the way Congress dictates Medicare payments, which influences how much health insurance companies pay doctors.

The payoff: Keeping primary care physicians in towns all across America, many studies show, would keep us in far better health than relying on hospital-based care. "If we were to increase the number of primary care physicians from 35 percent of doctors, as it now stands, to 40 percent, we could expect 800,000 fewer hospital admissions every year and 4.8 million fewer ER visits and save $10 billion a year," says researcher Steven Kravet, MD, chief medical officer for quality and patient safety at Johns Hopkins Bayview Medical Center.

The action plan: Find out more about Medicare reform and share your story at the AMA Patients' Action Network, patientsactionnetwork.org.

15. Award Prizes for Affordable Drugs
Drug companies spend as much as $800 million to develop a drug and get it approved. In return, they may get a patent and the exclusive rights to sell it for 20 years. Prices have risen 500_percent since 1990, and many patients can't afford their prescription meds.

Washington, D.C., economist James Love has a simple proposal: Scrap the "monopolies" and sponsor government-funded billion-dollar prizes for breakthrough medicines instead. After clinical trials, rights to make and sell the drug would extend to competing generic firms, which produce pills for up to 80 percent less.

The payoff: Love says the current exclusive pricing system may have accounted for as much as $480 billion of the $600 billion worldwide sales in 2006. Abolishing drug monopolies could remove much of that cost and lower prices for consumers at the pharmacy.

The action plan: Go to Love's home page, keionline.org, for links to blogs, articles, and ways to learn more.

16. Visit a Virtual Doc
Doctors can often diagnose or prescribe without seeing the patient. Problem is, in most plans, doctors don't get paid for phone or e-mail time. That's starting to change. GroupHealth Cooperative in Seattle (ghc.org) has reduced costs and won high satisfaction scores by having patients and doctors discuss medication changes and test results through an online system.

Roy Schoenberg, MD, is taking the concept further with Online Healthcare Marketplace, an interactive service that lets you talk to a physician in real time 24/7. (It rolls out in January, starting in Hawaii, with thousands of doctors to choose from.) You log on, scroll through a list of available top specialists, and connect immediately via phone or webcam. The physician sends e-notes to keep your personal doctor up to speed. Anyone can use it for a small fee. If your insurance plan offers it, you pay a co-pay, the doctor gets paid, and everybody's happy.

The payoff: Dr. Schoenberg says this could save millions of dollars for even small health plans.

The action plan: Get more information at americanwell.com.

17. Team Up in Hospitals
The Cleveland Clinic is tearing down traditional silos for a more team-based approach designed to detect problems early, provide the best treatment, and save money and lives, says CEO Toby Cosgrove, MD.

The clinic's Neurological Institute was the first to reap the rewards. Patients who suffer from seizures, for example, are screened by a neurosurgeon, a psychiatrist, a neuropsychologist, and a neurologist to determine whether an attack was triggered by a neurological imbalance or a psychological problem.

The payoff: Epilepsy patients' hospital stays have declined 10 to 20 percent.

The action plan: Read the book that inspired the plan: Redefining Health Care: Creating Value-Based Competition on Results by Michael E. Porter and Elizabeth Olmsted Teisberg.

18. Let Everyone Shop for the Best Plan
Members of Congress get to shop among 250 affordable health insurance plans to find the one that's best for them. Within each plan, premiums are the same for everyone regardless of age or other risk factors. They can even take it into retirement. What if we could all do that? The Federal Employees Health Benefits Program (FEHBP) has maintained stable prices for years, often rising less than private plans and Medicare. Part of the reason is that it doesn't pay providers a "fee for service" but rather negotiates one price to access a bundle of benefits, such as doctor's visits, inpatient care, surgery, and more.

The payoff: A bipartisan health care bill before Congress would offer similar benefits to all Americans with estimated savings of $1.5 trillion over ten years.

The action plan: For more details on this plan, go to lewin.com and search for Healthy Americans Act.

(good article from readers digest).

Matrix---Most thought provoking film

2008-10-23T22:37:00.000-07:00

In the Matrix, the red or the blue?

The question of which pill to take illustrates the personal aspect of the decision to study philosophy. Do you live on in ignorance (and potentially bliss) or do you lead what Aristotle called 'the examined life'...

The Matrix is a film filled with religious and philosophical symbolism. The plot supposes that humans live in vats many years in the future, being fed false sensory information by a giant virtual reality computer (the Matrix). The perpetrators of this horror are machines of the future who use humans as a source of power. Humans are literally farmed.

The central character of the film, Neo, is presented to us in the opening part of the film as a loner who is searching for a mysterious character called Morpheus (named after the Greek god of dreams and sleep). He is also trying to discover the answer to the question "What is the Matrix?"

Morpheus contacts Neo just as the machines (posing as sinister 'agents') are trying to keep Neo from finding out any more. When Morpheus and Neo meet, Morpheus offers Neo two pills. The red pill will answer the question "what is the Matrix?" (by removing him from it) and the blue pill simply for life to carry on as before. As Neo reaches for the red pill Morpheus warns Neo "Remember, all I'm offering is the truth. Nothing more."

The film as a whole and especially the choosing scene is deeply compelling. Why is the choice between what you believe you know and an unknown 'real' truth so fascinating? How could a choice possibly be made? On the one hand everyone you love and everything that you have built you life upon. One the other the promise only of truth.

The question then is not about pills, but what they stand for in these circumstances. The question is asking us whether reality, truth, is worth pursuing. The blue pill will leave us as we are, in a life consisting of habit, of things we believe we know. We are comfortable, we do not need truth to live. The blue pill symbolises commuting to work every day, or brushing your teeth.

The red pill is an unknown quantity. We are told that it can help us to find the truth. We don't know what that truth is, or even that the pill will help us to find it. The red pill symbolises risk, doubt and questioning. In order to answer the question, you can gamble your whole life and world on a reality you have never experienced.

However, in order to investigate which course of action to take we need to investigate why the choice is faced. Why should we even have to decide whether to pursue truth?

The answer in short, is inquisitiveness. Many people throughout human existence have questioned and enquired. Most of them have not been scientists or doctors or philosophers, but simply ordinary people asking 'what if?' or 'why?' Asking these questions ultimately leads us to a choice. Do you continue to ask and investigate, or do you stop and never ask again? This in essence, is the question posed to Neo in the film.

So what are the advantages of taking the blue pill? As one of the characters in the film says, "ignorance is bliss" Essentially, if the truth is unknown, or you believe that you know the truth, what is there to question or worry about?

By accepting what we are told and experience life can be easier. There is the social pressure to 'fit in', which is immensely strong in most cultures. Questioning the status quo carries the danger of ostracism, possibly persecution. This aspect has a strong link with politics. People doing well under the current system are not inclined to look favourably on those who question the system. Morpheus says to Neo "You have to understand that many people are not ready to be unplugged, and many of them are so inured, so hopelessly dependent on the system that they will fight to protect it."

The system also has a place for you, an expected path to follow. This removes much of the doubt and discomfort experienced by a trailblazer.

Another argument on the side of the blue pill is how does anyone know that the status quo is not in fact the truth? The act of simply questioning does not infer a lack of validity on the questioned. Why not assume that your experience is innocent until proven guilty? Just accept everything?

So if the arguments for the blue pill are so numerous, why take the red pill? Why pursue truth even though it may be unpalatable and the journey to it hard? In the film, Neo risks death to escape the virtual reality and discovers a brutal reality from which he cannot return. As he discovers the trouble with asking questions is that the answers are not necessarily what you want to hear.

To justify taking the red pill we might ask what is the purpose of an ignorant existence? Further still, what is there in merely existing? Simply existing brings humans down to the level of objects; they might have utility or even purpose, but where is the meaning? Existence without meaning is surely not living your life, but just experiencing it. As Trinity says to Neo, "The Matrix cannot tell you who you are."

Given the potential disadvantages of choosing the red pill, the motivation for discovering the truth must then be very strong. The film makes much of this point. Trinity says to Neo "It's the question that drives us, Neo." and Morpheus compares the motivation for Neo's search to "a splinter in your mind - driving you mad." The motivation for answering the question is obviously strong as the answer will help us to find the meaning in our lives.

What we are looking at here is the drive to answer a question, but the key to this is what drove the question in the first place. The asking of questions about our environment our experience and ourselves is fundamental to the human condition. Children ask a seemingly never-ending stream of questions from an early age. It is only with education and socialisation that some people stop asking these questions. However, we remain, as it were, hard-wired to enquire.

This is an inevitable consequence of consciousness. A being with a mind, conscious of itself and its existence, experiencing a reality, needs to organise the data that it receives from its senses. Simply observing and recording does not allow for consciousness. It is what we do with that information that allows us to think. In order to process and store the vast amount of information received, the human brain attempts to identify patterns in the data; looking for the patterns behind what is experienced. This is asking questions of the sensory information, and requires reasoning. By definition a conscious mind seeks to know. Knowing something requires more than just data, but intelligence or reasoning applied to that data. To attempt to obtain knowledge we must therefore question the data our mind receives; thus, consciousness questions.

So the metaphor of the journey to truth that Neo takes is complete. The journey starts with a question, there is a search for the answer and the answer may be reached. This shows us that the journey does not start with Neo choosing between the pills, or with ourselves deciding whether to question. The act of asking the question is itself the starting point as the aim of asking the question is to seek truth and knowledge.

We have established that consciousness is aware and seeks knowledge and that thus the conscious mind must question. To question is to seek the truth and start on the journey to knowledge. Therefore the choice between the pills is surely made for us. The fact that we are conscious appears to require us to take the red pill.

However, this can be simply countered by someone who would prefer to take the blue pill. They may wish to seek the truth in a different way, or in a less mind jarring set of circumstances. They can choose the blue pill and not deny their consciousness, but to stop seeking the truth entirely would be to deny their consciousness.

Thus we are philosophically driven to seek the truth and the act of questioning whether to seek it is in itself seeking the truth. As conscious minds we will always seek the truth. However, the choice over the red or blue pills is not solely a choice between whether to question or not, it is a personal choice on the method of discovering the truth.

VALUE ADDED LIFE

2008-10-17T21:04:00.000-07:00

I saw this very interesting post in our medical college groups from one of our medical college alumni who is currently working as professor of medicine(research nephrologist) in university of utah . For privacy purpose iam not posting the name.

VALUE ADDED LIFE

Whenever we invest our hard-earned money to buy a car, home, or property, we look at the value. We would like to see the initial quality, the long-term utility and re-sale or disposal value of it. In other words, we do look for “value” in every thing we buy or acquire in our lives even though we know some of them may appreciate or depreciate in value over the time. But we often forget that our lives also have some value at birth, and the value of our lives may also appreciate or depreciate over time depending on how we lead our lives. In fact, if there is any thing in this world that has a real value, it is only our lives. Every other thing else that we acquire in life has only a “relative value” as compared to the value of our lives. The value of many material objects that we acquire, such as a luxury car, may depreciate over time. There is no way we can increase the value of a used BMW car. But we can constantly increase the values of our lives. That is entirely feasible and is in our own hands. Furthermore, while valuable goods and property that we acquire can provide us comfortable life, they can never substitute the immense happiness and peace of mind that one can derive from a value-added life. In fact, our scriptures emphasize the importance of value-added life or VAL. Our ancestors built the foundation of our culture on VAL. However, in the recent past the cultural edifice of India is showing some deep cracks due to lack of interest in the people to pursue a VAL. Here are some thoughts on how to develop and nurture a VAL and regain our lost glory, happiness and peace of mind in our lives.

How to Develop a Value-added Life (VAL)? First we have to assign certain core values to our lives based on our inherent or inner nature, not on the external world or its demands or expectations or temptations. To do this, we need to understand what our inherent nature, potentials, aptitude, and qualities are. Once we understand those, we need to relentlessly pursue them and build them inch by inch by dedication, constant practice and application. If we keep on doing this, soon we will realize that the VAL will start growing like a big tree within ourselves, bringing light and joy into our lives. Furthermore, once these values are created and nurtured, then they will become the driving force within us to conquer external aberrations that may result in frustration, depression, anxiety etc. Then we will become masters of our lives. We shape and lead our lives as we desire. Our lives will not be shaped or led by this world any more. This de-links our minds from the frustration, depression etc generated by our worldly sojourn. Frustration, depression and similar types of mental agonies cannot be defeated by improving our external conditions alone, as they originate within us. Only a VAL can conquer and de-link them from our minds and thus keep us happy all the time. That is the meaning of life, even as per our scriptures – Dharma, Artha, Kama and Moksha. All our sufferings are due to the fact that we fail to build a VAL and thus break this order of life given to us by our great ancestors, and at the same time we expect to have a happy life. That is the paradoxical situation we are facing. The real solutions for the problems of our life are not as easy. They need deep thinking and contemplation and inner search. Whether we like it or not, that is the only way we can find the answers to our problems.
The values that we create and nurture in our lives are comparable to the value of a car that we want to have. When we shop around for a great car, we look for a powerful turbo-charged engine with a high horsepower that can hit 0-60 mph in less than 10 seconds, traction control (TC), electronic stabilization system (EST), and anti-lock braking system (ABS) and perhaps six airbags supplemental restrain system (SRS). That is the value we want to have for a vehicle that we simply use to commute around the town, and we will keep for just 10 years only before trading it for a new car. There is nothing wrong in that. But we should translate such vision and values to our own lives as well. Unless we are equipped with turbo-charged high values, a good horsepower to propel us in the proper direction in life, a traction control to keep our grip at times of adversity, a stabilization system that takes care of our mental balance through the ups and downs in our lives, an anti-locking system that prevents our mind being locked on issues, and six virtues that can deploy like airbags in a crisis and protect us, our lives do not have more value than the BMW car that we drive around.

Be Focused and Clean in the Thought Process: Mind is like a computer. It functions efficiently when its memory is clean, and its hard drive is not cluttered with loose files in a disorganized fashion. Internally well structured computers, protected by good anti-virus software and other programs, rarely crash. So also the situation with the mind, which needs well-organized grey matter, anti-temptation software, pop-up blocker and a firewall to keep us protected and function efficiently. Then there is no reason why a person cannot be happy in his/her life.

Happiness is a State of Mind: Every religion, faith and scripture known to mankind said this. But we still have to realize it on our own. We cannot search for happiness outside like a commodity, because it is already within us. We need to only uncover it. Take for instance when we were small children, we were all the time happy even though we did not posses anything at that time. But as we grow older and older, as our possessions and attributes increase in number we start losing the happiness. Where did it go? No where. We just covered it with our thought process, which goes outward looking for happiness in the external world. Our thoughts can be like the ashes that cover the burning cinders and thus make them look like extinguished. When we blow out the ashes, the burning cinders will be once again revealed. We should cultivate the habit of uncovering the happiness within and at the same time we should pursue our worldly goals. Then only the worldly goals will have great meaning for us. The external happiness that we derive from our worldly goals or objectives is only a reflection of the happiness within us. Without that inner happiness, the external world has no meaning at all. So the more we uncover the inner happiness, the more we can enjoy our lives – both personal and professional. Then the whole world looks like a play ground for us to play happily.

Be Prepared to Sacrifice Smaller Things in Life to Achieve Greater Objectives: This is very important, especially if one wants to achieve great objectives in life. We may set higher goals, have the potential to attain them, but if we are not willing or reluctant to sacrifice small or even petty things and cannot overcome over temptations, then we cannot achieve our goals. Frustration is often the “difference” between what we want to achieve, and what we are willing to sacrifice to achieve that. Please remember that nothing is easy or free in this world. We have to earn every thing we want to have in this life. Life is not going to be a bed of roses or a cake walk. But that does not mean that we do not have happiness in this life. We do have. But we need a balanced approach toward the dualities – gain and loss, pleasure and pain, joy and sorrow, riches and rags. We need to develop equanimity of mind in life to face them. Then the mind is less fluctuating and more peaceful.

It is never too Late to Change for the better in the Life: It is never too late in the life to change for good. History of mankind is a proof for this statement. Emperor Ashoka who ruled India during the 1st century AD, started his life with a great ambition to conquer all the kings and acquire their kingdoms and thus become a Great Emperor. He fiercely fought many battles and won them. Finally in the battle of Kalinga, the toughest one he ever fought and won, he literally saw human massacre with blood flowing in streams. That changed his life forever. He became compassionate and embraced Buddhism and spread its gospel throughout the Asia and Far East, which changed the lives of hundreds of millions of people for good. He became a great ruler who worked for the welfare and happiness of his people. He erected great monuments and constructed shelters, hospitals, schools and other public places. Today, the pillar he erected in Saranath about two thousand years ago, the lion heads of which adore the official seal of the Republic of India, the largest democracy in the world, stands as an eternal proof that when one soul truly changes, it can do tremendous things in life, and can influence 3
the lives of generations of people to come. Such is the power of the true change even it occurs late in the life. Similarly Valmiki was born as a hunter, but the sight of a bird lamenting for its fallen mate hit by a hunter’s arrow changed him and made him a great sage, who composed Ramayana, one of the greatest epics of India. We may not be so great as Emperor Ahsoka or Sage Valmiki to do such great things by changing. But by changing for the better we can definitely make a big difference in our small lives and in the lives of people around us. What else we want in our lives? Every one of us has to strive and do at least one good and great thing in our lives which will immensely benefit the people around us. Then our lives have a lot of meaning and value to make us happy, especially when become old.

Each Person has Three Different Entities: Each one of us has three different entities. The one we think about ourselves, the one that others think about us, and the third one – what we really are. The closer these three are the better will be our lives. But it is not an easy task, and needs years of practice and contemplation. The easier one to achieve, with more or less similar outcome is to keep the two – what we think of ourselves and what we really are as close as possible. This will allow us to be very realistic in our lives thus eliminating mental conditions, such as frustration, depression and thus make us happy and enjoy our lives. This only needs self-discipline and contemplation. This is my philosophy in life which I pursued for decades, and I found it works. In the long run I gained much from this perspective in life.

Shocking / Bad News:

2008-10-17T19:56:00.000-07:00

Shocking / Bad News:

Pepsi and Coca Cola contains extract from Pork (Pig)

Most of the people avoid Pepsi and Coca-Cola for various reasons:- because of harmful chemical contents such as excessive carbonates, etc.

Now there is yet another reason which is more dangerous. The scientific and medical research says that drinking Pepsi & Cola leads to cancer because the key element is taken from Pigs sausage.

According to a report published in Jordanian magazine, the Head of Delhi University Science and Technology, Dr. Mangoshada scientifically proved that the key element in Pepsi and Cola contains extract from the intestines of Pig which causes cancer and other deadly diseases.

The Indian university conducted tests on the impact of drinking Pepsi and Coca Cola which proved that drinking them lead to more rapid heart rate and low pressure.
Also drinking 6 bottles of Pepsi or Cola at a time causes instant death. It also contains chemicals such as carbonic and phosphoric acids, citric acid which harms teeth and causes bone fragility. Bones kept in the Cup of Pepsi melts during the week knowing that the bones of the dead remain in the grave for thirty years.
Research itself confirmed that the calcium dissolved in Pepsi and it weakens the bladder, kidneys, kills the pancreatic, leads to diabetes and infectious diseases.

Pepsi or Coca-Cola lovers nothing to worry as it is not the only drinks available on this earth, as we have other healthy alternatives such as natural fruit juices, canned coconut water, flavoured milks, buttermilk etc., all of them are conveniently available even in the small stores.

Knowing little bit about the country makes huge difference" why we are facing the biggest economy crisis after the great depression?"

2008-10-08T09:56:00.000-07:00

Aptly enough,after the much awaited who is going to handle the worst economic crisis in america after the great depression in 1930's, the official selected to handle the 700-billion-dollar bailout for America, Neel Kashkari, who is of Indian origin get ready to solve the biggest economic puzzle. In a way India — along with the rest of the world — has been an accomplice, witting or otherwise, in the process that has led to the financial earthquake which, with America as its epicentre, has sent seismic shock waves around the world, and will continue to do so for months, if not years, to come.

It wasn’t Wall Street greed — the huge pay packets, bonuses and other sumptuary perks of ‘fat cat’ bankers and speculators — that has brought about the worst economic crisis since the Great Depression of the 1930s. Wall Street — and the subprime loans it generated — was only the trigger or the proximate cause. The final, or karmic, cause of the crash was US gluttony, an excess of consumption which the rest of the world, India included, willy-nilly subsidised.

Long before Freddie Mac and Fannie Mae became the stuff of urban nightmares, America had been super-stuffing itself. Morgan Spurlock’s 2004 documentary film, ‘Super Size Me’, is an allegory of the economics — and the consequences — of gluttony. The title of the film refers to the American practice of ‘supersizing’ fast-food items by adopting a pricing policy which induces customers to opt for larger portions. For a 30-day period the 32-year-old film-maker subsisted on a diet of three McDonald’s meals a day, ‘supersized’ only at the initiative of the vendors. The result: in a month, Spurlock had put on 11.1 kg, developed high blood pressure, psychological disorders and liver problems. It took him 14 months of rigorous detoxification to come back to normal.

Spurlock’s cautionary tale is a parable about America’s chronic, insatiable appetite for not just fast food, but for everything, from gas-guzzling cars to climate-controlled condominiums. The statistics have become an environmentalist’s litany: with 5 per cent of the world’s population, the US consumes 24 per cent of the world’s energy; an average American consumes as much energy as 13 Chinese, or 31 Indians, or 128 Bangladeshis, or 370 Ethiopians.

America’s total calorie intake is 815 billion calories a day, which nutritionists say is some 200 billion in excess of requirement, sufficient to feed 80 million people. Moreover, each day, Americans throw away 2,00,000 tons of edible food. If developing countries wanted to live like this, four new Earth-sized planets would have to be created to provide the necessary resources.

And the best part is that it’s not America which has been picking up the tab for its prodigal, supersized lifestyle, but the rest of the world. On the tried-and-tested principle that if you owe your bank a hundred bucks you’re a defaulter, but if you owe it a couple of million you’re its most valued customer, the US has been blithely living on credit for years, funded by trade deficits and foreign investments. In 2007, the total US trade deficit (i.e. the amount by which imports exceeded exports) was a little over 700 billion dollars (does that figure have a topical ring to it?).

Of the 4.4 trillion dollars worth of US treasury bonds (basically IOUs issued by America’s Federal Reserve Bank) more than 25 per cent are held by foreign countries, China alone accounting for 414 billion dollars. If all these IOUs were to be called in, not just the US but the whole global economy would implode. At the risk of its own bankruptcy, the world can’t afford to let America go bust.

Like a supersized Humpty Dumpty, America has fallen off the wall, or rather, off Wall Street. Will all the world’s resources and all the world’s banks be able to put Humpty Dumpty together again? That’s the 4.4-trillion-dollar question for all of us, and not just for the US.

so whats ur idea on this?

A Roadmap to the 2008 Physical Activity Guidelines for Americans

2008-10-08T09:50:00.001-07:00

A Roadmap to the 2008 Physical Activity Guidelines for Americans

* For an overview of the development of the Physical Activity Guidelines for Americans and important background information about physical activity, read Chapter 1—Introducing the 2008 Physical Activity Guidelines for Americans.

NOTE
The Guidelines assume that many readers will not read all the chapters, but will read only what is relevant to them. Important information may therefore be repeated in several chapters.
* To learn about the health benefits of physical activity, read Chapter 2—Physical Activity Has Many Health Benefits. This information may help motivate people to become regularly active.
* To understand how to do physical activity in a manner that meets the Guidelines:
o For youth aged 6 to 17, including youth with disabilities, read Chapter 3—Active Children and Adolescents.
o For adults aged 18 to 64, read Chapter 4—Active Adults.
o For adults aged 65 and older, read Chapter 5—Active Older Adults. This chapter is also appropriate reading for adults younger than age 65 who have chronic conditions. The Guidelines for older adults are similar to those for other adults but add some specific considerations, such as guidelines for fall prevention.
o For women who are pregnant or who have recently given birth (postpartum period), read the age-appropriate chapter and also the section on physical activity and pregnancy in Chapter 6—Safe and Active and Chapter 7—Additional Considerations for Some Adults.
o For adults with disabilities, read Chapter 4—Active Adults and Chapter 7—Additional Considerations for Some Adults.
* To understand how to reduce the risks of activity–related injury, read Chapter 6—Safe and Active.
* Those interested in an overview of ways to help people participate regularly in physical activity should read Chapter 8—Taking Action: Increasing Physical Activity Levels of Americans.
* The Glossary contains definitions of key terms used in the Guidelines. Terms that are defined in the glossary are in bold the first time they are used.
* Additional information and resources relevant to the Guidelines are available in the Appendices.

Introducing the 2008 Physical Activity Guidelines for Americans

2008-10-08T09:49:00.002-07:00

Chapter 1: Introducing the 2008 Physical Activity Guidelines for Americans

Being physically active is one of the most important steps that Americans of all ages can take to improve their health. This inaugural Physical Activity Guidelines for Americans provides science-based guidance to help Americans aged 6 and older improve their health through appropriate physical activity.

The U.S. Department of Health and Human Services (HHS) issues the Physical Activity Guidelines for Americans. The content of the Physical Activity Guidelines complements the Dietary Guidelines for Americans, a joint effort of HHS and the U.S. Department of Agriculture (USDA). Together, the two documents provide guidance on the importance of being physically active and eating a healthy diet to promote good health and reduce the risk of chronic diseases.

This chapter provides background information about the rationale and process for developing the Guidelines. It then discusses several issues that provide the framework for understanding the Guidelines. The chapter also explains how these Guidelines fit in with other published physical activity recommendations and how they should be used in practice.
Why and How the Guidelines Were Developed
The Rationale for Physical Activity Guidelines

We clearly know enough now to recommend that all Americans should engage in regular physical activity to improve overall health and to reduce risk of many health problems. Physical activity is a leading example of how lifestyle choices have a profound effect on health. The choices we make about other lifestyle factors, such as diet, smoking, and alcohol use, also have important and independent effects on our health.

The primary audiences for the Physical Activity Guidelines for Americans are policymakers and health professionals. The Guidelines are designed to provide information and guidance on the types and amounts of physical activity that provide substantial health benefits. This information may also be useful to interested members of the public. The main idea behind the Guidelines is that regular physical activity over months and years can produce long-term health benefits. Realizing these benefits requires physical activity each week.

These Guidelines are necessary because of the importance of physical activity to the health of Americans, whose current inactivity puts them at unnecessary risk. Healthy People 2010 set objectives for increasing the level of physical activity in Americans over the decade from 2000 to 2010. Unfortunately, the latest information shows that inactivity among American adults and youth remains relatively high and that little progress has been made in meeting these objectives.
The Development of the Physical Activity Guidelines for Americans

Since 1995 the Dietary Guidelines for Americans has included advice on physical activity. However, with the development of a firm science base on the health benefits of physical activity, HHS began to consider whether separate physical activity guidelines were appropriate. With the help of the Institute of Medicine, HHS convened a workshop in October 2006 to address this question. The workshop's report, Adequacy of Evidence for Physical Activity Guidelines DevelopmentExternal Link Disclaimer (http://www.nap.edu/catalog.php?record_id=11819 ), affirmed that advances in the science of physical activity and health justified the creation of separate physical activity guidelines.

The steps used to develop the Physical Activity Guidelines for Americans were similar to those used for the Dietary Guidelines for Americans. In 2007 HHS Secretary Mike Leavitt appointed an external scientific advisory committee called the Physical Activity Guidelines Advisory Committee. The Advisory Committee conducted an extensive analysis of the scientific information on physical activity and health. The Physical Activity Guidelines Advisory Committee Report, 2008 and meeting summaries are available at http://www.health.gov/PAGuidelines/.

HHS primarily used the Advisory Committee's report but also considered comments from the public and Government agencies when writing the Guidelines. The Guidelines will be widely promoted through various communications strategies, such as materials for the public, Web sites, and partnerships with organizations that promote physical activity.
The Framework for the Physical Activity Guidelines for Americans

The Advisory Committee report provided the content and conceptual underpinning for the Guidelines. The main elements of this framework are described in the following sections.
Baseline Activity Versus Health-Enhancing Physical Activity

Physical activity has been defined as any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. However, in this document, the term "physical activity" will generally refer to bodily movement that enhances health. Bodily movement can be divided into two categories:

* Baseline activity refers to the light-intensity activities of daily life, such as standing, walking slowly, and lifting lightweight objects. People vary in how much baseline activity they do. People who do only baseline activity are considered to be inactive. They may do very short episodes of moderate- or vigorous-intensity activity, such as climbing a few flights of stairs, but these episodes aren't long enough to count toward meeting the Guidelines. The Guidelines don't comment on how variations in types and amounts of baseline physical activity might affect health, as this was not addressed by the Advisory Committee report.
* Health-enhancing physical activity is activity that, when added to baseline activity, produces health benefits. In this document, the term "physical activity" generally refers to health-enhancing physical activity. Brisk walking, jumping rope, dancing, lifting weights, climbing on playground equipment at recess, and doing yoga are all examples of physical activity. Some people (such as postal carriers or carpenters on construction sites) may get enough physical activity on the job to meet the Guidelines.

We don't understand enough about whether doing more baseline activity results in health benefits. Even so, efforts to promote baseline activities are justifiable.

In this document, the term "physical activity" will generally refer to bodily movement that enhances health.

After all, baseline activities are normal lifestyle activities. Encouraging Americans to increase their baseline activity is sensible for several reasons:

* Increasing baseline activity burns calories, which can help in maintaining a healthy body weight.
* Some baseline activities are weight-bearing and may improve bone health.
* There are reasons other than health to encourage more baseline activity. For example, walking short distances instead of driving can help reduce traffic congestion and the resulting air pollution.
* Encouraging baseline activities helps build a culture where physical activity in general is the social norm.
* Short episodes of activity are appropriate for people who were inactive and have started to gradually increase their level of activity, and for older adults whose activity may be limited by chronic conditions.

The availability of infrastructure to support short episodes of activity is therefore important. For example, people should have the option of using sidewalks and paths to walk between buildings at a worksite, rather than having to drive. People should also have the option of taking the stairs instead of using an elevator.
Health Benefits Versus Other Reasons To Be Physically Active

Although the Guidelines focus on the health benefits of physical activity, these benefits are not the only reason why people are active. Physical activity gives people a chance to have fun, be with friends and family, enjoy the outdoors, improve their personal appearance, and improve their fitness so that they can participate in more intensive physical activity or sporting events. Some people are active because they feel it gives them certain health benefits (such as feeling more energetic) that aren't yet conclusively proven for the general population.

The Guidelines encourage people to be physically active for any and all reasons that are meaningful for them. Nothing in the Guidelines is intended to mean that health benefits are the only reason to do physical activity.
Focus on Disease Prevention

The Guidelines focus on preventive effects of physical activity, which include lowering the risk of developing chronic diseases such as heart disease and type 2 diabetes.

Physical activity also has beneficial therapeutic effects and is commonly recommended as part of the treatment for medical conditions. The Advisory Committee report did not review the therapeutic effects of activity, and the Guidelines do not discuss the use of physical activity as medical treatment.
Health-Related Versus Performance-Related Fitness

The Guidelines focus on reducing the risk of chronic disease and promoting health-related fitness, particularly cardiovascular and muscular fitness. People can gain this kind of fitness by doing the amount and types of activities recommended in the Guidelines.

The Guidelines do not address the types and amounts of activity necessary to improve performance-related fitness. Athletes need this kind of fitness when they compete. Medical screening issues for competitive athletes also are outside the scope of the Guidelines.

People who are interested in training programs to increase performance-related fitness should seek advice from other sources. Generally, these people do much more activity than required to meet the Guidelines.
Lifespan Approach

The best way to be physically active is to be active for life. Therefore, the Guidelines take a lifespan approach and provide recommendations for three age groups: Children and Adolescents, Adults, and Older Adults.

The Physical Activity Guidelines are for Americans aged 6 and older. The Advisory Committee report did not review evidence for children younger than age 6. Physical activity in infants and young children is, of course, necessary for healthy growth and development. Children younger than 6 should be physically active in ways appropriate for their age and stage of development.
Individualized Health Goals

The Guidelines generally explain the amounts and types of physical activity needed for health benefits. Within these overall parameters, individuals have many choices about appropriate types and amounts of activity.

To make these choices, American adults need to set personal goals for physical activity. Setting these goals involves questions like, "How physically fit do I want to be?" "How important is it to me to reduce my risk of heart disease and diabetes?" "How important is it to me to reduce my risk of falls and hip fracture?" "How much weight do I want to lose and keep off?"

People can meet the Guidelines and their own personal goals through different amounts and types of activity. Written materials, health-care providers, and fitness professionals can provide useful information and help people set and carry out specific goals.
Four Levels of Physical Activity

The Advisory Committee report provides the basis for dividing the amount of aerobic physical activity an adult gets every week into four categories: inactive, low, medium, and high (see table below). This classification is useful because these categories provide a rule of thumb of how total amount of physical activity is related to health benefits. Low amounts of activity provide some benefits; medium amounts provide substantial benefits; and high amounts provide even greater benefits.
Classification of Total Weekly Amounts of Aerobic Physical Activity Into Four Categories

Levels of Physical Activity

Range of Moderate-Intensity Minutes a Week

Summary of Overall Health Benefits

Comment

Inactive

No activity beyond baseline

None

Being inactive is unhealthy.

Low

Activity beyond baseline but fewer than 150 minutes a week

Some

Low levels of activity are clearly preferable to an inactive lifestyle.

Medium

150 minutes to 300 minutes a week

Substantial

Activity at the high end of this range has additional and more extensive health benefits than activity at the low end.

High

More than 300 minutes a week

Additional

Current science does not allow researchers to identify an upper limit of activity above which there are no additional health benefits.

Action is needed at the individual, community, and societal levels to help Americans become physically active.

* Inactive is no activity beyond baseline activities of daily living.
* Low activity is activity beyond baseline but fewer than 150 minutes (2 hours and 30 minutes) of moderate-intensity physical activity a week or the equivalent amount (75 minutes, or 1 hour and 15 minutes) of vigorous-intensity activity.
* Medium activity is 150 minutes to 300 (5 hours) minutes of moderate-intensity activity a week (or 75 to 150 minutes of vigorous-intensity physical activity a week). In scientific terms, this range is approximately equivalent to 500 to 1,000 metabolic equivalent (MET) minutes a week.
* High activity is more than the equivalent of 300 minutes of moderate-intensity physical activity a week.

For More Information

Appendix 1 provides a detailed explanation of MET-minutes, a unit useful for describing the energy expenditure of a specific physical activity.
Relationship to Previous Public Health Recommendations

In 1995 the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) published physical activity recommendations for public health. The report stated that adults should accumulate at least 30 minutes a day of moderate–intensity physical activity on most, preferably all, days per week. In 1996 Physical Activity and Health: A Report of the Surgeon General supported this same recommendation.

In order to track the percentage of adults who meet this guideline, CDC specified that "most" days per week was 5 days. Since 1995 the common recommendation has been that adults obtain at least 30 minutes of moderate-intensity physical activity on 5 or more days a week, for a total of at least 150 minutes a week.

The Physical Activity Guidelines for Americans affirms that it is acceptable to follow the CDC/ACSM recommendation and similar recommendations. However, according to the Advisory Committee report, the CDC/ACSM guideline was too specific. In other words, existing scientific evidence does not allow researchers to say, for example, whether the health benefits of 30 minutes on 5 days a week are any different from the health benefits of 50 minutes on 3 days a week. As a result, the new Guidelines allow a person to accumulate 150 minutes a week in various ways.
Putting the Guidelines Into Practice

Although the Advisory Committee did not review strategies to promote physical activity, action is needed at the individual, community, and societal levels to help Americans become physically active. Publications such as the Guide to Community Preventive ServicesExternal Link Disclaimer) (http://www.thecommunityguide.org/pa/) and the recommendations of the U.S. Preventive Services Task Force (http://www.ahrq.gov/clinic/cps3dix.htm) summarize evidence-based strategies for promoting physical activity on the community level and through primary health care. Accordingly, the final chapter of the Physical Activity Guidelines for Americans provides only a brief discussion on promoting physical activity, and indicates how to link the Guidelines to action strategies.
Assessing Whether Physical Activity Programs Are Consistent With the Guidelines

Programs that provide opportunities for physical activity, such as classes or community activities, can help people meet the Guidelines. These programs do not have to provide all, or even most, of the recommended weekly activity. For example, a mall walking program for older adults may meet only once a week yet provide useful amounts of activity, as long as people get the rest of their weekly recommended activity on other days.

Programs that are consistent with the Guidelines:

* Provide advice and education consistent with the Guidelines;
* Add episodes of activity that count toward meeting the Guidelines; and
* May also include activities, such as stretching or warming up and cooling down, whose health benefits are not yet proven but that are often used in effective physical activity programs.

The Importance of Understandable Guidelines

HHS has tried to keep the Physical Activity Guidelines straightforward and clear, while remaining consistent with complex scientific information. In each chapter the key Guidelines are set apart from the text, in order to identify the most important information to communicate to the public. The messages contained in these Guidelines should be disseminated to the general public and to anyone involved in promoting physical activity.

Physical Activity Has Many Health Benefits

2008-10-08T09:49:00.001-07:00

Chapter 2: Physical Activity Has Many Health Benefits

All Americans should be regularly physically active to improve overall health and fitness and to prevent many adverse health outcomes. The benefits of physical activity occur in generally healthy people, in people at risk of developing chronic diseases, and in people with current chronic conditions or disabilities. This chapter gives an overview of research findings on physical activity and health. The box below provides a summary of these benefits.

Physical activity affects many health conditions, and the specific amounts and types of activity that benefit each condition vary. In developing public health guidelines, the challenge is to integrate scientific information across all health benefits and identify a critical range of physical activity that appears to have an effect across the health benefits. One consistent finding from research studies is that once the health benefits from physical activity begin to accrue, additional amounts of activity provide additional benefits.

Although some health benefits seem to begin with as little as 60 minutes (1 hour) a week, research shows that a total amount of 150 minutes (2 hours and 30 minutes) a week of moderate-intensity aerobic activity, such as brisk walking, consistently reduces the risk of many chronic diseases and other adverse health outcomes.
Examining the Relationship Between Physical Activity and Health

In many studies covering a wide range of issues, researchers have focused on exercise, as well as on the more broadly defined concept of physical activity. Exercise is a form of physical activity that is planned, structured, repetitive, and performed with the goal of improving health or fitness. So, although all exercise is physical activity, not all physical activity is exercise.

Studies have examined the role of physical activity in many groups—men and women, children, teens, adults, older adults, people with disabilities, and women during pregnancy and the postpartum period. These studies have focused on the role that physical activity plays in many health outcomes, including:

* Premature (early) death;
* Diseases such as coronary heart disease, stroke, some cancers, type 2 diabetes, osteoporosis, and depression;
* Risk factors for disease, such as high blood pressure and high blood cholesterol;
* Physical fitness, such as aerobic capacity, and muscle strength and endurance
* Functional capacity (the ability to engage in activities needed for daily living);
* Mental health, such as depression and cognitive function; and
* Injuries or sudden heart attacks.

These studies have also prompted questions as to what type and how much physical activity is needed for various health benefi ts. To answer this question, investigators have studied three main kinds of physical activity: aerobic, muscle-strengthening, and bonestrengthening. Investigators have also studied balance and fl exibility activities. These latter two activities are addressed in Chapters 4, 5, and 6.
The Health Benefits of Physical Activity—Major Research Findings

* Regular physical activity reduces the risk of many adverse health outcomes.
* Some physical activity is better than none.
* For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration.
* Most health benefits occur with at least 150 minutes a week of moderate-intensity physical activity, such as brisk walking. Additional benefits occur with more physical activity.
* Both aerobic (endurance) and muscle-strengthening (resistance) physical activity are beneficial.
* Health benefits occur for children and adolescents, young and middle-aged adults, older adults, and those in every studied racial and ethnic group.
* The health benefits of physical activity occur for people with disabilities.
* The benefits of physical activity far outweigh the possibility of adverse outcomes.

Aerobic Activity

In this kind of physical activity (also called an endurance activity or cardio activity), the body's large muscles move in a rhythmic manner for a sustained period of time. Brisk walking, running, bicycling, jumping rope, and swimming are all examples.

Aerobic activity causes a person's heart to beat faster than usual.

Aerobic physical activity has three components:

* Intensity, or how hard a person works to do the activity. The intensities most often examined are moderate intensity (equivalent in effort to brisk walking) and vigorous intensity (equivalent in effort to running or jogging);
* Frequency, or how often a person does aerobic activity; and
* Duration, or how long a person does an activity in any one session.

Although these components make up a physical activity profile, research has shown that the total amount of physical activity (minutes of moderate–intensity physical activity, for example) is more important for achieving health benefits than is any one component (frequency, intensity, or duration).
Muscle-Strengthening Activity

This kind of activity, which includes resistance training and lifting weights, causes the body's muscles to work or hold against an applied force or weight. These activities often involve relatively heavy objects, such as weights, which are lifted multiple times to train various muscle groups. Muscle-strengthening activity can also be done by using elastic bands or body weight for resistance (climbing a tree or doing push-ups, for example).

Muscle-strengthening activity also has three components:

* Intensity, or how much weight or force is used relative to how much a person is able to lift;
* Frequency, or how often a person does muscle strengthening activity; and
* Repetitions, or how many times a person lifts a weight (analogous to duration for aerobic activity). The effects of muscle-strengthening activity are limited to the muscles doing the work. It's important to work all the major muscle groups of the body: the legs, hips, back, abdomen, chest, shoulders, and arms.

Bone-Strengthening Activity

This kind of activity (sometimes called weight-bearing or weight-loading activity) produces a force on the bones that promotes bone growth and strength. This force is commonly produced by impact with the ground. Examples of bone-strengthening activity include jumping jacks, running, brisk walking, and weight-lifting exercises. As these examples illustrate, bone-strengthening activities can also be aerobic and muscle strengthening.
The Health Benefits of Physical Activity

Studies clearly demonstrate that participating in regular physical activity provides many health benefits. These benefits are summarized in the accompanying table. Many conditions affected by physical activity occur with increasing age, such as heart disease and cancer. Reducing risk of these conditions may require years of participation in regular physical activity. However, other benefits, such as increased cardiorespiratory fitness, increased muscular strength, and decreased depressive symptoms and blood pressure, require only a few weeks or months of participation in physical activity.
Health Benefits Associated With Regular Physical Activity

Children and Adolescents

Strong evidence

* Improved cardiorespiratory and muscular fitness
* Improved bone health
* Improved cardiovascular and metabolic health biomarkers
* Favorable body composition

Moderate evidence

* Reduced symptoms of depression

Adults and Older Adults

Strong evidence

* Lower risk of early death
* Lower risk of coronary heart disease
* Lower risk of stroke
* Lower risk of high blood pressure
* Lower risk of adverse blood lipid profile
* Lower risk of type 2 diabetes
* Lower risk of metabolic syndrome
* Lower risk of colon cancer
* Lower risk of breast cancer
* Prevention of weight gain
* Weight loss, particularly when combined with reduced calorie intake
* Improved cardiorespiratory and muscular fitness
* Prevention of falls
* Reduced depression
* Better cognitive function (for older adults)

Moderate to strong evidence

* Better functional health (for older adults)
* Reduced abdominal obesity

Moderate evidence

* Lower risk of hip fracture
* Lower risk of lung cancer
* Lower risk of endometrial cancer
* Weight maintenance after weight loss
* Increased bone density
* Improved sleep quality

Note: The Advisory Committee rated the evidence of health benefits of physical activity as strong, moderate, or weak. To do so, the Committee considered the type, number, and quality of studies available, as well as consistency of findings across studies that addressed each outcome. The Committee also considered evidence for causality and dose response in assigning the strength-of-evidence rating.

The Beneficial Effects of Increasing Physical Activity: It's About Overload, Progression, and Specificity

Overload is the physical stress placed on the body when physical activity is greater in amount or intensity than usual. The body's structures and functions respond and adapt to these stresses. For example, aerobic physical activity places a stress on the cardiorespiratory system and muscles, requiring the lungs to move more air and the heart to pump more blood and deliver it to the working muscles. This increase in demand increases the efficiency and capacity of the lungs, heart, circulatory system, and exercising muscles. In the same way, muscle–strengthening and bone-strengthening activities overload muscles and bones, making them stronger.

Progression is closely tied to overload. Once a person reaches a certain fitness level, he or she progresses to higher levels of physical activity by continued overload and adaptation. Small, progressive changes in overload help the body adapt to the additional stresses while minimizing the risk of injury.

Specificity means that the benefits of physical activity are specific to the body systems that are doing the work. For example, aerobic physical activity largely benefits the body's cardiovascular system.

The health benefits of physical activity are seen in children and adolescents, young and middle-aged adults, older adults, women and men, people of different races and ethnicities, and people with disabilities and chronic conditions. The health benefits of physical activity are generally independent of body weight. Adults of all sizes and shapes gain health and fitness benefits by being habitually physically active. The benefits of physical activity also outweigh the risk of injury and sudden heart attacks, two concerns that prevent many people from becoming physically active.

The following sections provide more detail on what is known from research studies about the specific health benefits of physical activity and how much physical activity is needed to get the health benefits.
Premature Death

Strong scientific evidence shows that physical activity reduces the risk of premature death (dying earlier than the average age of death for a specific population group) from the leading causes of death, such as heart disease and some cancers, as well as from other causes of death. This effect is remarkable in two ways:

* First, only a few lifestyle choices have as large an effect on mortality as physical activity. It has been estimated that people who are physically active for approximately 7 hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week.
* Second, it is not necessary to do high amounts of activity or vigorous-intensity activity to reduce the risk of premature death. Studies show substantially lower risk when people do 150 minutes of at least moderate-intensity aerobic physical activity a week.

Research clearly demonstrates the importance of avoiding inactivity. Even low amounts of physical activity reduce the risk of dying prematurely. As the figure on page 11 shows, the most dramatic difference in risk is seen between those who are inactive (30 minutes a week) and those with low levels of activity (90 minutes or 1 hour and 30 minutes a week). The relative risk of dying prematurely continues to be lower with higher levels of reported moderate- or vigorous-intensity leisure-time physical activity.

All adults can gain this health benefit of physical activity. Age, race, and ethnicity do not matter. Men and women younger than 65 years as well as older adults have lower rates of early death when they are physically active than when they are inactive. Physically active people of all body weights (normal weight, overweight, obese) also have lower rates of early death than do inactive people.
The Risk of Dying Prematurely Declines as People Become Physically Active

The Risk of Dying Prematurely Declines as People Become Physically Active. Text-only data points follow this graphic.
Minutes per Week of Moderate- or Vigorous-Intensity Physical Activity

The Risk of Dying Prematurely Declines as People Become Physically Active—Data Points

Minutes per Week of Moderate- or Vigorous-Intensity Physical Activity

Relative Risk

30

1

90

0.8

180

0.73

330

0.64

420

0.615
Cardiorespiratory Health

The benefits of physical activity on cardiorespiratory health are some of the most extensively documented of all the health benefits. Cardiorespiratory health involves the health of the heart, lungs, and blood vessels.

Heart diseases and stroke are two of the leading causes of death in the United States. Risk factors that increase the likelihood of cardiovascular diseases include smoking, high blood pressure (called hypertension), type 2 diabetes, and high levels of certain blood lipids (such as low-density lipoprotein, or LDL, cholesterol). Low cardiorespiratory fitness also is a risk factor for heart disease.

People who do moderate- or vigorous-intensity aerobic physical activity have a significantly lower risk of cardiovascular disease than do inactive people. Regularly active adults have lower rates of heart disease and stroke, and have lower blood pressure, better blood lipid profiles, and fitness. Significant reductions in risk of cardiovascular disease occur at activity levels equivalent to 150 minutes a week of moderate-intensity physical activity. Even greater benefits are seen with 200 minutes (3 hours and 20 minutes) a week. The evidence is strong that greater amounts of physical activity result in even further reductions in the risk of cardiovascular disease.

Everyone can gain the cardiovascular health benefits of physical activity. The amount of physical activity that provides favorable cardiorespiratory health and fitness outcomes is similar for adults of various ages, including older people, as well as for adults of various races and ethnicities. Aerobic exercise also improves cardiorespiratory fitness in individuals with some disabilities, including people who have lost the use of one or both legs and those with multiple sclerosis, stroke, spinal cord injury, and cognitive disabilities.

Moderate-intensity physical activity is safe for generally healthy women during pregnancy. It increases cardiorespiratory fitness without increasing the risk of early pregnancy loss, preterm delivery, or low birth weight. Physical activity during the postpartum period also improves cardiorespiratory fitness.
Metabolic Health

Regular physical activity strongly reduces the risk of developing type 2 diabetes as well as the metabolic syndrome. The metabolic syndrome is defined as a condition in which people have some combination of high blood pressure, a large waistline (abdominal obesity), an adverse blood lipid profile (low levels of high-density lipoprotein [HDL] cholesterol, raised triglycerides), and impaired glucose tolerance.

People who regularly engage in at least moderate intensity aerobic activity have a significantly lower risk of developing type 2 diabetes than do inactive people. Although some experts debate the usefulness of defining the metabolic syndrome, good evidence exists that physical activity reduces the risk of having this condition, as defined in various ways. Lower rates of these conditions are seen with 120 to 150 minutes (2 hours to 2 hours and 30 minutes) a week of at least moderate-intensity aerobic activity. As with cardiovascular health, additional levels of physical activity seem to lower risk even further. In addition, physical activity helps control blood glucose levels in persons who already have type 2 diabetes.

Physical activity also improves metabolic health in youth. Studies find this effect when young people participate in at least 3 days of vigorous aerobic activity a week. More physical activity is associated with improved metabolic health, but research has yet to determine the exact amount of improvement.
Obesity and Energy Balance

Overweight and obesity occur when fewer calories are expended, including calories burned through physical activity, than are taken in through food and beverages. Physical activity and caloric intake both must be considered when trying to control body weight. Because of this role in energy balance, physical activity is a critical factor in determining whether a person can maintain a healthy body weight, lose excess body weight, or maintain successful weight loss. People vary a great deal in how much physical activity they need to achieve and maintain a healthy weight. Some need more physical activity than others to maintain a healthy body weight, to lose weight, or to keep weight off once it has been lost.

Strong scientific evidence shows that physical activity helps people maintain a stable weight over time. However, the optimal amount of physical activity needed to maintain weight is unclear. People vary greatly in how much physical activity results in weight stability. Many people need more than the equivalent of 150 minutes of moderate-intensity activity a week to maintain their weight.

Over short periods of time, such as a year, research shows that it is possible to achieve weight stability by doing the equivalent of 150 to 300 minutes (5 hours) a week of moderate-intensity walking at about a 4 mile-an-hour pace. Muscle-strengthening activities may help promote weight maintenance, although not to the same degree as aerobic activity.

People who want to lose a substantial (more than 5 percent of body weight) amount of weight and people who are trying to keep a significant amount of weight off once it has been lost need a high amount of physical activity unless they also reduce their caloric intake. Many people need to do more than 300 minutes of moderate-intensity activity a week to meet weight–control goals.

Regular physical activity also helps control the percentage of body fat in children and adolescents. Exercise training studies with overweight and obese youth have shown that they can reduce their body fatness by participating in physical activity that is at least moderate intensity on 3 to 5 days a week, for 30 to 60 minutes each time.
Musculoskeletal Health

Bones, muscles, and joints support the body and help it move. Healthy bones, joints, and muscles are critical to the ability to do daily activities without physical limitations.

Preserving bone, joint, and muscle health is essential with increasing age. Studies show that the frequent decline in bone density that happens during aging can be slowed with regular physical activity. These effects are seen in people who participate in aerobic, muscle–strengthening, and bone-strengthening physical activity programs of moderate or vigorous intensity. The range of total physical activity for these benefits varies widely. Important changes seem to begin at 90 minutes a week and continue up to 300 minutes a week.

Hip fracture is a serious health condition that can have life-changing negative effects for many older people. Physically active people, especially women, appear to have a lower risk of hip fracture than do inactive people. Research studies on physical activity to prevent hip fracture show that participating in 120 to 300 minutes a week of physical activity that is of at least moderate intensity is associated with a reduced risk. It is unclear, however, whether activity also lowers risk of fractures of the spine or other important areas of the skeleton.

The bottom line is that the health benefits of physical activity far outweigh the risks of adverse events for almost everyone.

Building strong, healthy bones is also important for children and adolescents. Along with having a healthy diet that includes adequate calcium and vitamin D, physical activity is critical for bone development in children and adolescents. Bone-strengthening physical activity done 3 or more days a week increases bone-mineral content and bone density in youth.

Regular physical activity also helps people with arthritis or other rheumatic conditions affecting the joints. Participation in 130 to 150 minutes (2 hours and 10 minutes to 2 hours and 30 minutes) a week of moderate-intensity, low-impact physical activity improves pain management, function, and quality of life. Researchers don't yet know whether participation in physical activity, particularly at low to moderate intensity, reduces the risk of osteoarthritis. Very high levels of physical activity, however, may have extra risks. People who participate in very high levels of physical activity, such as elite or professional athletes, have a higher risk of hip and knee osteoarthritis, mostly due to the risk of injury involved in competing in some sports.

Progressive muscle-strengthening activities increase or preserve muscle mass, strength, and power. Higher amounts (through greater frequency or higher weights) improve muscle function to a greater degree. Improvements occur in younger and older adults. Resistance exercises also improve muscular strength in persons with such conditions as stroke, multiple sclerosis, cerebral palsy, spinal cord injury, and cognitive disability. Though it doesn't increase muscle mass in the same way that muscle-strengthening activities do, aerobic activity may also help slow the loss of muscle with aging.
Functional Ability and Fall Prevention

Functional ability is the capacity of a person to perform tasks or behaviors that enable him or her to carry out everyday activities, such as climbing stairs or walking on a sidewalk. Functional ability is key to a person's ability to fulfill basic life roles, such as personal care, grocery shopping, or playing with the grandchildren. Loss of functional ability is referred to as functional limitation.

Middle-aged and older adults who are physically active have lower risk of functional limitations than do inactive adults. It appears that greater physical activity levels can further reduce risk of functional limitations.

Older adults who already have functional limitations also benefit from regular physical activity. Typically, studies of physical activity in adults with functional limitations tested a combination of aerobic and muscle strengthening activities, making it difficult to assess the relative importance of each type of activity. However, both types of activity appear to provide benefit.

In older adults at risk of falls, strong evidence shows that regular physical activity is safe and reduces this risk. Reduction in falls is seen for participants in programs that include balance and moderate-intensity muscle-strengthening activities for 90 minutes a week plus moderate-intensity walking for about an hour a week. It's not known whether different combinations of type, amount, or frequency of activity can reduce falls to a greater degree. Tai chi exercises also may help prevent falls.
Cancer

Physically active people have a significantly lower risk of colon cancer than do inactive people, and physically active women have a significantly lower risk of breast cancer. Research shows that a wide range of moderate-intensity physical activity—between 210 and 420 minutes a week (3 hours and 30 minutes to 7 hours)—is needed to significantly reduce the risk of colon and breast cancer; currently, 150 minutes a week does not appear to provide a major benefit. It also appears that greater amounts of physical activity lower risks of these cancers even further, although exactly how much lower is not clear.

Although not definitive, some research suggests that the risk of endometrial cancer in women and lung cancers in men and women also may be lower among those who are regularly active compared to those who are inactive.

Finally, cancer survivors have a better quality of life and improved physical fitness if they are physically active, compared to survivors who are inactive.
Mental Health

Physically active adults have lower risk of depression and cognitive decline (declines with aging in thinking, learning, and judgment skills). Physical activity also may improve the quality of sleep. Whether physical activity reduces distress or anxiety is currently unclear.

Mental health benefits have been found in people who do aerobic or a combination of aerobic and muscle– strengthening activities 3 to 5 days a week for 30 to 60 minutes at a time. Some research has shown that even lower levels of physical activity also may provide some benefits.

Regular physical activity appears to reduce symptoms of anxiety and depression for children and adolescents. Whether physical activity improves self-esteem is not clear.
Adverse Events

Some people hesitate to become active or increase their level of physical activity because they fear getting injured or having a heart attack. Studies of generally healthy people clearly show that moderate-intensity physical activity, such as brisk walking, has a low risk of such adverse events.

The risk of musculoskeletal injury increases with the total amount of physical activity. For example, a person who regularly runs 40 miles a week has a higher risk of injury than a person who runs 10 miles each week. However, people who are physically active may have fewer injuries from other causes, such as motor vehicle collisions or work-related injuries. Depending on the type and amount of activity that physically active people do, their overall injury rate may be lower than the overall injury rate for inactive people.

Participation in contact or collision sports, such as soccer or football, has a higher risk of injury than participation in non-contact physical activity, such as swimming or walking. However, when performing the same activity, people who are less fit are more likely to be injured than people who are fitter.

Cardiac events, such as a heart attack or sudden death during physical activity, are rare. However, the risk of such cardiac events does increase when a person suddenly becomes much more active than usual. The greatest risk occurs when an adult who is usually inactive engages in vigorous-intensity activity (such as shoveling snow). People who are regularly physically active have the lowest risk of cardiac events both while being active and overall.

The bottom line is that the health benefits of physical activity far outweigh the risks of adverse events for almost everyone.

Active Children and Adolescents

2008-10-08T09:48:00.001-07:00

Chapter 3: Active Children and Adolescents

Regular physical activity in children and adolescents promotes health and fitness. Compared to those who are inactive, physically active youth have higher levels of cardiorespiratory fitness and stronger muscles. They also typically have lower body fatness. Their bones are stronger, and they may have reduced symptoms of anxiety and depression.

Youth who are regularly active also have a better chance of a healthy adulthood. Children and adolescents don't usually develop chronic diseases, such as heart disease, hypertension, type 2 diabetes, or osteoporosis. However, risk factors for these diseases can begin to develop early in life. Regular physical activity makes it less likely that these risk factors will develop and more likely that children will remain healthy as adults.

Youth can achieve substantial health benefits by doing moderate- and vigorous-intensity physical activity for periods of time that add up to 60 minutes (1 hour) or more each day. This activity should include aerobic activity as well as age-appropriate muscle- and bone–strengthening activities. Although current science is not complete, it appears that, as with adults, the total amount of physical activity is more important for achieving health benefits than is any one component (frequency, intensity, or duration) or specific mix of activities (aerobic, muscle-strengthening, bone strengthening). Even so, bone-strengthening activities remain especially important for children and young adolescents because the greatest gains in bone mass occur during the years just before and during puberty. In addition, the majority of peak bone mass is obtained by the end of adolescence.

This chapter provides physical activity guidance for children and adolescents aged 6 to 17, and focuses on physical activity beyond baseline activity.

Parents and other adults who work with or care for youth should be familiar with the Guidelines in this chapter. These adults should be aware that, as children become adolescents, they typically reduce their physical activity. Adults play an important role in providing age-appropriate opportunities for physical activity. In doing so, they help lay an important foundation for life-long, health-promoting physical activity. Adults need to encourage active play in children and encourage sustained and structured activity as children grow older.
Key Guidelines for Children and Adolescents

* Children and adolescents should do 60 minutes (1 hour) or more of physical activity daily.
o Aerobic: Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity, and should include vigorous-intensity physical activity at least 3 days a week.
o Muscle-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days of the week.
o Bone-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days of the week.
* It is important to encourage young people to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety.

Explaining the Guidelines
Types of Activity

The Guidelines for children and adolescents focus on three types of activity: aerobic, muscle-strengthening, and bone-strengthening. Each type has important health benefits.

* Aerobic activities are those in which young people rhythmically move their large muscles. Running, hopping, skipping, jumping rope, swimming, dancing, and bicycling are all examples of aerobic activities. Aerobic activities increase cardiorespiratory fitness. Children often do activities in short bursts, which may not technically be aerobic activities. However, this document will also use the term aerobic to refer to these brief activities.
For More Information

See Chapter 2—Physical Activity Has Many Health Benefits, for more on overload and progression.
* Muscle-strengthening activities make muscles do more work than usual during activities of daily life. This is called “overload,” and it strengthens the muscles. Muscle-strengthening activities can be unstructured and part of play, such as playing on playground equipment, climbing trees, and playing tug-of-war. Or these activities can be structured, such as lifting weights or working with resistance bands.
* Bone-strengthening activities produce a force on the bones that promotes bone growth and strength. This force is commonly produced by impact with the ground. Running, jumping rope, basketball, tennis, and hopscotch are all examples of bone strengthening activities. As these examples illustrate, bone-strengthening activities can also be aerobic and muscle-strengthening.

How Age Influences Physical Activity in Children and Adolescents

Children and adolescents should meet the Guidelines by doing activity that is appropriate for their age. Their natural patterns of movement differ from those of adults. For example, children are naturally active in an intermittent way, particularly when they do unstructured active play. During recess and in their free play and games, children use basic aerobic and bone-strengthening activities, such as running, hopping, skipping, and jumping, to develop movement patterns and skills. They alternate brief periods of moderate- and vigorous-intensity physical activity with brief periods of rest. Any episode of moderate- or vigorous–intensity physical activity, however brief, counts toward the Guidelines.

Children also commonly increase muscle strength through unstructured activities that involve lifting or moving their body weight or working against resistance. Children don't usually do or need formal muscle-strengthening programs, such as lifting weights.

Regular physical activity in children and adolescents promotes a healthy body weight and body composition.

As children grow into adolescents, their patterns of physical activity change. They are able to play organized games and sports and are able to sustain longer periods of activity. But they still commonly do intermittent activity, and no period of moderate- or vigorous-intensity activity is too short to count toward the Guidelines.

Adolescents may meet the Guidelines by doing free play, structured programs, or both. Structured exercise programs can include aerobic activities, such as playing a sport, and muscle-strengthening activities, such as lifting weights, working with resistance bands, or using body weight for resistance (such as push-ups, pull-ups, and sit-ups). Muscle-strengthening activities count if they involve a moderate to high level of effort and work the major muscle groups of the body: legs, hips, back, abdomen, chest, shoulders, and arms.
Levels of Intensity for Aerobic Activity

Children and adolescents can meet the Guidelines by doing a combination of moderate- and vigorous intensity aerobic physical activities or by doing only vigorous-intensity aerobic physical activities.

Youth should not do only moderate-intensity activity. It's important to include vigorous-intensity activities because they cause more improvement in cardiorespiratory fitness.

The intensity of aerobic physical activity can be defined on either an absolute or a relative scale. Either scale can be used to monitor the intensity of aerobic physical activity:
For More Information

See Appendix 1 for more information on using absolute or relative intensity.

* Absolute intensity is based on the rate of energy expenditure during the activity, without taking into account a person's cardiorespiratory fitness.
* Relative intensity uses a person's level of cardiorespiratory fitness to assess level of effort.

Relative intensity describes a person's level of effort relative to his or her fitness. As a rule of thumb, on a scale of 0 to 10, where sitting is 0 and the highest level of effort possible is 10, moderate-intensity activity is a 5 or 6. Young people doing moderate-intensity activity will notice that their hearts are beating faster than normal and they are breathing harder than normal. Vigorous-intensity activity is at a level of 7 or 8. Youth doing vigorous-intensity activity will feel their heart beating much faster than normal and they will breathe much harder than normal.

When adults supervise children, they generally can't ascertain a child's heart or breathing rate. But they can observe whether a child is doing an activity which, based on absolute energy expenditure, is considered to be either moderate or vigorous. For example, a child walking briskly to school is doing moderate-intensity activity. A child running on the playground is doing vigorous-intensity activity. The table on page 18 includes examples of activities classified by absolute intensity. It shows that the same activity can be moderate or vigorous intensity, depending on factors such as speed (for example bicycling slowly or fast).
Examples of Moderate- and Vigorous-Intensity Aerobic Physical Activities and Muscle- and Bone-Strengthening Activities for Children and Adolescents

Type of Physical Activity

Age Group
Children

Age Group
Adults

Moderate–intensity aerobic

* Active recreation, such as hiking, skateboarding, rollerblading
* Bicycle riding
* Brisk walking

* Active recreation, such as canoeing, hiking, skateboarding, rollerblading
* Brisk walking
* Bicycle riding (stationary or road bike)
* Housework and yard work, such as sweeping or pushing a lawn mower
* Games that require catching and throwing, such as baseball and softball

Vigorous–intensity aerobic

* Active games involving running and chasing, such as tag
* Bicycle riding
* Jumping rope
* Martial arts, such as karate
* Running
* Sports such as soccer, ice or field hockey, basketball, swimming, tennis
* Cross-country skiing

* Active games involving running and chasing, such as flag football
* Bicycle riding
* Jumping rope
* Martial arts, such as karate
* Running
* Sports such as soccer, ice or field hockey, basketball, swimming, tennis
* Vigorous dancing
* Cross-country skiing

Muscle-strengthening

* Games such as tug-of-war
* Modified push-ups (with knees on the floor)
* Resistance exercises using body weight or resistance bands
* Rope or tree climbing
* Sit-ups (curl-ups or crunches)
* Swinging on playground equipment/bars

* Games such as tug-of-war
* Push-ups and pull-ups
* Resistance exercises with exercise bands, weight machines, hand-held weights
* Climbing wall
* Sit-ups (curl-ups or crunches)

Bone-strengthening

* Games such as hopscotch
* Hopping, skipping, jumping
* Jumping rope
* Running
* Sports such as gymnastics, basketball, volleyball, tennis

* Hopping, skipping, jumping
* Jumping rope
* Running
* Sports such as gymnastics, basketball, volleyball, tennis

Note: Some activities, such as bicycling, can be moderate or vigorous intensity, depending upon level of effort
Physical Activity and Healthy Weight

Regular physical activity in children and adolescents promotes a healthy body weight and body composition.

Exercise training in overweight or obese youth can improve body composition by reducing overall levels of fatness as well as abdominal fatness. Research studies report that fatness can be reduced by regular physical activity of moderate to vigorous intensity 3 to 5 times a week, for 30 to 60 minutes.
Meeting the Guidelines

American youth vary in their physical activity participation. Some don't participate at all, others participate in enough activity to meet the Guidelines, and some exceed the Guidelines.

Children and adolescents can meet the Physical Activity Guidelines and become regularly physically active in many ways.

One practical strategy to promote activity in youth is to replace inactivity with activity whenever possible. For example, where appropriate and safe, young people should walk or bicycle to school instead of riding in a car. Rather than just watching sporting events on television, young people should participate in age-appropriate sports or games.

* Children and adolescents who do not meet the Guidelines should slowly increase their activity in small steps and in ways that they enjoy. A gradual increase in the number of days and the time spent being active will help reduce the risk of injury.
* Children and adolescents who meet the Guidelines should continue being active on a daily basis and, if appropriate, become even more active. Evidence suggests that even more than 60 minutes of activity every day may provide additional health benefits.
* Children and adolescents who exceed the Guidelines should maintain their activity level and vary the kinds of activities they do to reduce the risk of overtraining or injury.

Children and adolescents with disabilities are more likely to be inactive than those without disabilities. Youth with disabilities should work with their health-care provider to understand the types and amounts of physical activity appropriate for them. When possible, children and adolescents with disabilities should meet the Guidelines. When young people are not able to participate in appropriate physical activities to meet the Guidelines, they should be as active as possible and avoid being inactive.
Getting and Staying Active: Real-Life Examples

Children and adolescents can meet the Physical Activity Guidelines and become regularly physically active in many ways. Here are just two examples showing how a child and an adolescent can be physically active for at least 60 minutes each day over the course of a week.

These examples illustrate that even though the activity patterns are different, each young person is meeting the Guidelines by getting the equivalent of at least 60 minutes or more of aerobic activity each day that is at least moderate intensity. Both are also doing vigorous-intensity, muscle-strengthening, and bone strengthening activities on at least 3 days a week.
Harold: A 7-Year-Old Child

Harold participates in many types of physical activities in many places. For example, during physical education class, he jumps rope and does gymnastics and sit-ups. During recess, he plays on the playground—often by doing activities that require running and climbing. He also likes to play soccer with his friends and family. When Harold gets home from school, he likes to engage in active play (playing tag) and ride his bicycle with his friends and family.

Harold gets 60 minutes of physical activity each day that is at least moderate intensity. He participates in the following activities each day:

Monday: Walks to and from school (20 minutes), plays actively with family (20 minutes), jumps rope (10 minutes), does gymnastics (10 minutes).

Tuesday: Walks to and from school (20 minutes), plays on playground (25 minutes), climbs on playground equipment (15 minutes).

Wednesday: Walks to and from school (20 minutes), plays actively with friends (25 minutes), jumps rope (10 minutes), runs (5 minutes), does sit-ups (2 minutes).

Thursday: Plays actively with family (30 minutes), plays soccer (30 minutes).

Friday: Walks to and from school (20 minutes), plays actively with friends (25 minutes), bicycles (15 minutes).

Saturday: Plays on playground (30 minutes), climbs on playground equipment (15 minutes), bicycles (15 minutes).

Sunday: Plays on playground (10 minutes), plays soccer (40 minutes), plays tag with family (10 minutes).

Harold meets the Guidelines by doing vigorous–intensity aerobic activities, bone-strengthening activities, and muscle-strengthening activities on at least 3 days of the week:

* Vigorous-intensity aerobic activities 6 times during the week: jumping rope (Monday and Wednesday), running (Wednesday), soccer (Thursday and Sunday), playing tag (Sunday);
* Bone-strengthening activities 6 times during the week: jumping rope (Monday and Wednesday), running (Wednesday), soccer (Thursday and Sunday), playing tag (Sunday); and
* Muscle-strengthening activities 4 times during the week: gymnastics (Monday), climbing on playground equipment (Tuesday and Saturday), sit-ups (Wednesday).

Maria: A 16-Year-Old Adolescent

Maria participates in many types of physical activities in many places. For example, during physical education class, she plays tennis and does sit-ups and push-ups. She also likes to play basketball at the YMCA, do yoga, and go dancing with friends. Maria likes to take her dog on walks and hikes.

Maria gets 60 or more minutes of daily physical activity that is at least moderate intensity. She participates in the following activities each day:

Monday: Walks dog (10 minutes), plays basketball at YMCA (50 minutes).

Tuesday: Walks dog (10 minutes), plays tennis (30 minutes), does sit-ups and push-ups (5 minutes), walks briskly with friends (15 minutes).

Wednesday: Walks dog (10 minutes), plays basketball at YMCA (50 minutes).

Thursday: Walks dog (10 minutes), plays tennis (30 minutes), does sit-ups and push-ups (5 minutes), plays with children at the park while babysitting (15 minutes).

Friday: Plays Frisbee® in park (45 minutes), mows lawn (30 minutes).

Saturday: Goes dancing with friends (60 minutes), does yoga (30 minutes).

Sunday: Hikes (60 minutes).

Maria meets the Guidelines by doing vigorous-intensity aerobic activities, bone-strengthening activities, and muscle-strengthening activities on at least 3 days of the week:

* Vigorous-intensity aerobic activities 4 times during the week: basketball (Monday and Wednesday), dancing (Saturday), hiking (Sunday);
* Bone-strengthening activities 4 times during the week: basketball (Monday and Wednesday), dancing (Saturday), hiking (Sunday); and
* Muscle-strengthening activities 3 times during the week: sit-ups and push-ups (Tuesday and Thursday), yoga (Saturday).

Active Adults

2008-10-08T09:47:00.001-07:00

hapter 4: Active Adults

Adults who are physically active are healthier and less likely to develop many chronic diseases than adults who are inactive. They also have better fitness, including a healthier body size and composition. These benefits are gained by men and women and people of all races and ethnicities who have been studied.

Adults gain most of these health benefits when they do the equivalent of at least 150 minutes of moderate intensity aerobic physical activity (2 hours and 30 minutes) each week. Adults gain additional and more extensive health and fitness benefits with even more physical activity. Muscle-strengthening activities also provide health benefits and are an important part of an adult's overall physical activity plan.

This chapter provides guidance for most men and women aged 18 to 64 years, and focuses on physical activity beyond baseline activity (the usual light or sedentary activities of daily living). Physical activity guidelines for women during pregnancy and the postpartum period and for adults with disabilities and select chronic conditions are discussed in Chapter 7—Additional Considerations for Some Adults.
Explaining the Guidelines

The Guidelines for adults focus on two types of activity: aerobic and muscle-strengthening. Each type provides important health benefits, as explained in Chapter 2—Physical Activity Has Many Health Benefits.
Aerobic Activity

Aerobic activities, also called endurance activities, are physical activities in which people move their large muscles in a rhythmic manner for a sustained period. Running, brisk walking, bicycling, playing basketball, dancing, and swimming are all examples of aerobic activities. Aerobic activity makes a person's heart beat more rapidly to meet the demands of the body's movement. Over time, regular aerobic activity makes the heart and cardiovascular system stronger and fitter.

The purpose of the aerobic activity does not affect whether it counts toward meeting the Guidelines. For example, physically active occupations can count toward meeting the Guidelines, as can active transportation choices (walking or bicycling). All types of aerobic activities can count as long as they are of sufficient intensity and duration. Time spent in muscle strengthening activities does not count toward the aerobic activity guidelines.

When putting the Guidelines into action, it's important to consider the total amount of activity, as well as how often to be active, for how long, and at what intensity.
Key Guidelines for Adults

* All adults should avoid inactivity. Some physical activity is better than none, and adults who participate in any amount of physical activity gain some health benefits.
* For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
* For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount.
* Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

How Much Total Activity a Week?
When adults do the equivalent of 150 minutes of moderate-intensity aerobic activity each week, the benefits are substantial. These benefits include lower risk of premature death, coronary heart disease, stroke, hypertension, type 2 diabetes, and depression.

Not all health benefits of physical activity occur at 150 minutes a week. As a person moves from 150 minutes a week toward 300 minutes (5 hours) a week, he or she gains additional health benefits. Additional benefits include lower risk of colon and breast cancer and prevention of unhealthy weight gain.

Also, as a person moves from 150 minutes a week toward 300 minutes a week, the benefits that occur at 150 minutes a week become more extensive. For example, a person who does 300 minutes a week has an even lower risk of heart disease or diabetes than a person who does 150 minutes a week.

The benefits continue to increase when a person does more than the equivalent of 300 minutes a week of moderate-intensity aerobic activity. For example, a person who does 420 minutes (7 hours) a week has an even lower risk of premature death than a person who does 150 to 300 minutes a week. Current science does not allow identifying an upper limit of total activity above which there are no additional health benefits.

How Many Days a Week and for How Long?
Aerobic physical activity should preferably be spread throughout the week. Research studies consistently show that activity performed on at least 3 days a week produces health benefits. Spreading physical activity across at least 3 days a week may help to reduce the risk of injury and avoid excessive fatigue.

Both moderate- and vigorous-intensity aerobic activity should be performed in episodes of at least 10 minutes. Episodes of this duration are known to improve cardiovascular fitness and some risk factors for heart disease and type 2 diabetes.

How Intense?
The Guidelines for adults focus on two levels of intensity: moderate-intensity activity and vigorous–intensity activity. To meet the Guidelines, adults can do either moderate-intensity or vigorous-intensity aerobic activities, or a combination of both. It takes less time to get the same benefit from vigorous-intensity activities as from moderate-intensity activities. A general rule of thumb is that 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity. For example, 30 minutes of moderate-intensity activity a week is roughly the same as 15 minutes of vigorous-intensity activity.

There are two ways to track the intensity of aerobic activity: absolute intensity and relative intensity.

* Absolute intensity is the amount of energy expended per minute of activity. The energy expenditure of light-intensity activity, for example, is 1.1 to 2.9 times the amount of energy expended when a person is at rest. Moderate-intensity activities expend 3.0 to 5.9 times the amount of energy expended at rest. The energy expenditure of vigorous-intensity activities is 6.0 or more times the energy expended at rest.
* Relative intensity is the level of effort required to do an activity. Less fit people generally require a higher level of effort than fitter people to do the same activity. Relative intensity can be estimated using a scale of 0 to 10, where sitting is 0 and the highest level of effort possible is 10. Moderate intensity activity is a 5 or 6. Vigorous-intensity activity is a 7 or 8.

For More Information

See Appendix 1 for more information on using absolute or relative intensity

The Guidelines for adults refer to absolute intensity because most studies demonstrating lower risks of clinical events (for example, premature death, cardiovascular disease, type 2 diabetes, cancer) have focused on measuring absolute intensity. That is, the Guidelines are based on the absolute amount of energy expended in physical activity that is associated with health benefits. The table lists some examples of activities classified as moderate-intensity or vigorous intensity based on absolute intensity. Either absolute or relative intensity can be used to monitor progress in meeting the Guidelines.

When using relative intensity, people pay attention to how physical activity affects their heart rate and breathing. As a rule of thumb, a person doing moderate-intensity aerobic activity can talk, but not sing, during the activity. A person doing vigorous intensity activity cannot say more than a few words without pausing for a breath.
Examples of Different Aerobic Physical Activities and Intensities

Moderate Intensity

* Walking briskly (3 miles per hour or faster, but not race-walking)
* Water aerobics
* Bicycling slower than 10 miles per hour
* Tennis (doubles)
* Ballroom dancing
* General gardening

Vigorous Intensity

* Racewalking, jogging, or running
* Swimming laps
* Tennis (singles)
* Aerobic dancing
* Bicycling 10 miles per hour or faster
* Jumping rope
* Heavy gardening (continuous digging or hoeing, with heart rate increases)
* Hiking uphill or with a heavy backpack

Note: This table provides several examples of activities classified as moderate-intensity or vigorous-intensity, based on absolute intensity. This list is not all-inclusive. Instead, the examples are meant to help people make choices.
Muscle-Strengthening Activity

Muscle-strengthening activities provide additional benefits not found with aerobic activity. The benefits of muscle-strengthening activity include increased bone strength and muscular fitness. Muscle-strengthening activities can also help maintain muscle mass during a program of weight loss.

Muscle-strengthening activities make muscles do more work than they are accustomed to doing. That is, they overload the muscles. Resistance training, including weight training, is a familiar example of muscle-strengthening activity. Other examples include working with resistance bands, doing calisthenics that use body weight for resistance (such as push-ups, pull-ups, and sit-ups), carrying heavy loads, and heavy gardening (such as digging or hoeing).

Muscle-strengthening activities count if they involve a moderate to high level of intensity or effort and work the major muscle groups of the body: the legs, hips, back, chest, abdomen, shoulders, and arms. muscle strengthening activities for all the major muscle groups should be done at least 2 days a week.

No specific amount of time is recommended for muscle strengthening, but muscle-strengthening exercises should be performed to the point at which it would be difficult to do another repetition without help. When resistance training is used to enhance muscle strength, one set of 8 to 12 repetitions of each exercise is effective, although two or three sets may be more effective. Development of muscle strength and endurance is progressive over time. Increases in the amount of weight or the days a week of exercising will result in stronger muscles.
Meeting the Guidelines

Adults have many options for becoming physically active, increasing their physical activity, and staying active throughout their lives. In deciding how to meet the Guidelines, adults should think about how much physical activity they're already doing and how physically fit they are. Personal health and fitness goals are also important to consider. Examples provided later in the chapter illustrate how to include these goals in decisions to be active.

In general, healthy men and women who plan prudent increases in their weekly amounts of physical activity do not need to consult a health-care provider before becoming active.
Inactive Adults

Inactive adults or those who don't yet do 150 minutes of physical activity a week should work gradually toward this goal. The initial amount of activity should be at a light or moderate intensity, for short periods of time, with the sessions spread throughout the week. The good news is that “some is better than none.”

People gain some health benefits even when they do as little as 60 minutes a week of moderate-intensity aerobic physical activity.

For More Information

See Chapter 6—Safe and Active for more information on how to increase physical activity gradually.

To reduce risk of injury, it is important to increase the amount of physical activity gradually over a period of weeks to months. For example, an inactive person could start with a walking program consisting of 5 minutes of slow walking several times each day, 5 to 6 days a week. The length of time could then gradually be increased to 10 minutes per session, 3 times a day, and the walking speed could be increased slowly.

Muscle-strengthening activities should also be gradually increased over time. Initially, these activities can be done just 1 day a week starting at a light or moderate level of effort. Over time, the number of days a week can be increased to 2, and then possibly to more than 2. Each week, the level of effort (intensity) can be increased slightly until it becomes moderate to high.
Active Adults

Adults who are already active and meet the minimum Guidelines (the equivalent of 150 minutes of moderate-intensity aerobic activity every week) can gain additional and more extensive health and fitness benefits by increasing physical activity above this amount. Most American adults should increase their aerobic activity to exceed the minimum level and move toward 300 minutes a week. Adults should also do muscle-strengthening activities on at least 2 days each week.

One time-efficient way to achieve greater fitness and health goals is to substitute vigorous-intensity aerobic activity for some moderate-intensity activity. Using the 2-to-1 rule of thumb, doing 150 minutes of vigorous-intensity aerobic activity a week provides about the same benefits as 300 minutes of moderate intensity activity.

Adults are encouraged to do a variety of activities, as variety probably reduces risk of injury caused by doing too much of one kind of activity (this is called an overuse injury).
Highly Active Adults

Adults who are highly active should maintain their activity level. These adults are also encouraged to do a variety of activities.
Special Considerations
Flexibility Activities

Flexibility is an important part of physical fitness. Some types of physical activity, such as dancing, require more flexibility than others. Stretching exercises are effective in increasing flexibility, and thereby can allow people to more easily do activities that require greater flexibility. For this reason, flexibility activities are an appropriate part of a physical activity program, even though they have no known health benefits and it is unclear whether they reduce risk of injury. Time spent doing flexibility activities by themselves does not count toward meeting the aerobic or muscle-strengthening Guidelines.
Warm-up and Cool-down

Warm-up and cool-down activities are an acceptable part of a person's physical activity plan. Commonly, the warm-up and cool-down involve doing an activity at a slower speed or lower intensity. A warm-up before moderate- or vigorous-intensity aerobic activity allows a gradual increase in heart rate and breathing at the start of the episode of activity. A cool-down after activity allows a gradual decrease at the end of the episode. Time spent doing warm-up and cool-down may count toward meeting the aerobic activity Guidelines if the activity is at least moderate intensity (for example, walking briskly as a warm-up before jogging). A warm-up for muscle-strengthening activity commonly involves doing exercises with lighter weight.
For More Information

See the Dietary Guidelines for Americans for additional information on weight management and how to determine a healthy weight.
Physical Activity in a Weight-Control Plan

Along with appropriate dietary intake, physical activity is an important part of maintaining healthy weight, losing weight, and keeping extra weight off once it has been lost. Physical activity also helps reduce abdominal fat and preserve muscle during weight loss. Adults should aim for a healthy, stable body weight. The amount of physical activity necessary to achieve this weight varies greatly from person to person.

The first step in achieving or maintaining a healthy weight is to meet the minimum level of physical activity in the Guidelines. For some people this will result in a stable and healthy body weight, but for many it may not.

The health benefits of physical activity are generally independent of body weight. The good news for people needing to lose weight is that regular physical activity provides major health benefits, no matter how their weight changes over time.

Adults should strongly consider walking as one good way to get aerobic physical activity. Many studies show that walking has health benefits and a low risk of injury. It can be done year-round and in many settings.

People who are at a healthy body weight but slowly gaining weight can either gradually increase the level of physical activity (toward the equivalent of 300 minutes a week of moderate-intensity aerobic activity), or reduce caloric intake, or both, until their weight is stable. By regularly checking body weight, people can find the amount of physical activity that works for them.

Many adults will need to do more than the 150 minutes a week of moderate-intensity aerobic physical activity as part of a program to lose weight or keep it off. These adults should do more physical activity and/or further reduce their caloric intake. Some people will need to do the equivalent of 300 or more minutes of moderate-intensity physical activity a week to meet their weight-control goals. Combined with restricting caloric intake, these adults should gradually increase minutes or the intensity of aerobic physical activity per week, to the point at which the physical activity is effective in achieving a healthy weight.

It is important to remember that all activities—both baseline and physical activity—“count” for energy balance. Active choices, such as taking the stairs rather than the elevator or adding short episodes of walking to the day, are examples of activities that can be helpful in weight control.

For weight control, vigorous-intensity activity is far more time-efficient than moderate-intensity activity. For example, an adult who weighs 165 pounds (75 kg) will burn 560 calories from 150 minutes of brisk walking at 4 miles an hour (these calories are in addition to the calories normally burned by a body at rest). That person can burn the same number of additional calories in 50 minutes by running 5 miles at a 10 minutes-per-mile pace.
Getting and Staying Active: Real-Life Examples

Adults can meet the Physical Activity Guidelines in all sorts of ways and with many types of physical activity. The choices of types and amounts of physical activity depend on personal health and fitness goals. Here are three examples.
Jean: An Inactive Middle-Aged Woman

Her goals: Jean sets a goal of doing 1 hour a day of moderate-intensity aerobic activity on 5 days a week (a total of 300 minutes a week). Weighing 220 pounds, Jean is obese and wants to lose about 1 pound of weight each week.

Starting out: Jean cuts back on her caloric intake and starts walking 5 minutes in the morning and 5 minutes in the evening most days of the week. She walks at a 2.5 mile-an-hour pace. Although physical activity tables show this to be light-intensity activity, for her level of fitness and fatness, it is appropriate moderate–intensity activity.

Making good progress: Two months later, Jean is comfortably walking 30 to 40 minutes at moderate intensity to and from her bus stop every day. She then adds variety to her activity by alternating among walking, riding a stationary cycle, and low-impact aerobics. She also begins muscle-strengthening activities, using elastic bands twice each week.

Adults can meet the Physical Activity Guidelines in all sorts of ways and with many types of physical activity.

Reaching her goal: Eventually, Jean works up to 300 minutes a week of moderate-intensity aerobic activity, including her brisk walks to and from the bus stop. She has lost 40 pounds of weight in 1 year, with most of the weight loss occurring the previous 6 months when she mastered her diet and was able to do greater amounts of physical activity.
Douglas: An Active Middle-Aged Man

His goal and current activity pattern: Douglas was a soccer player in his youth. His goal is to get back into shape by becoming a regular recreational runner. In addition to his job operating heavy equipment, he walks 30 to 40 minutes a day on 5 days each week. He also lifts weights 2 days a week.

Starting out: Douglas starts a walk/jog program with a co-worker and plans to gradually replace walking with jogging and then running. The first week he goes out on 5 days, walking for 25 minutes and jogging for 5 minutes.

Making good progress: Each week, Douglas gradually increases the time spent jogging (vigorous-intensity activity) and reduces the time spent walking (moderate–intensity activity). He also continues his weight-lifting program.

Reaching his goal: Eventually, Douglas is running 30 to 45 minutes 4 days a week and lifting weights 2 days a week. He goes for a 1-hour bicycle ride on most weekends.
Anita: A Very Active College-Aged Adult

Her goals and current activity pattern: Anita plays league basketball (vigorous-intensity activity) 4 days each week for 90 minutes each day. She wants to reduce her risk of injury from doing too much of one kind of activity (this is called an overuse injury).

Starting out: Anita starts out by cutting back her basketball playing to 3 days each week. She begins to bicycle to and from campus (30 minutes each way) instead of driving her car. She also joins a yoga class that meets twice each week.

Reaching her goal: Eventually, Anita is bicycling 3 days each week to and from campus in addition to playing basketball. Her yoga class helps her to build and maintain strength and flexibility.
Achieving Target Levels of Physical Activity: The Possibilities Are Endless

These examples show how it's possible to meet the Guidelines by doing moderate-intensity or vigorous-intensity activity or a combination of both. Physical activity at this level provides substantial health benefits.

Ways to get the equivalent of 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic physical activity a week plus muscle-strengthening activities:

* Thirty minutes of brisk walking (moderate intensity) on 5 days, exercising with resistance bands (muscle strengthening) on 2 days;
* Twenty-five minutes of running (vigorous intensity) on 3 days, lifting weights on 2 days (muscle strengthening);
* Thirty minutes of brisk walking on 2 days, 60 minutes (1 hour) of social dancing (moderate intensity) on 1 evening, 30 minutes of mowing the lawn (moderate intensity) on 1 afternoon, heavy gardening (muscle strengthening) on 2 days;
* Thirty minutes of an aerobic dance class on 1 morning (vigorous intensity), 30 minutes of running on 1 day (vigorous intensity), 30 minutes of brisk walking on 1 day (moderate intensity), calisthenics (such as sit-ups, push-ups) on 3 days (muscle strengthening);
* Thirty minutes of biking to and from work on 3 days (moderate intensity), playing softball for 60 minutes on 1 day (moderate intensity), using weight machines on 2 days (muscle-strengthening on 2 days); and
* Forty-five minutes of doubles tennis on 2 days (moderate intensity), lifting weights after work on 1 day (muscle strengthening), hiking vigorously for 30 minutes and rock climbing (muscle strengthening) on 1 day.

Ways to be even more active

For adults who are already doing at least 150 minutes of moderate-intensity physical activity, here are a few ways to do even more. Physical activity at this level has even greater health benefits.

* Forty-five minutes of brisk walking every day, exercising with resistance bands on 2 or 3 days;
* Forty-five minutes of running on 3 or 4 days, circuit weight training in a gym on 2 or 3 days;
* Thirty minutes of running on 2 days, 45 minutes of brisk walking on 1 day, 45 minutes of an aerobics and weights class on 1 day, 90 minutes (1 hour and 30 minutes) of social dancing on 1 evening, 30 minutes of mowing the lawn, plus some heavy garden work on 1 day;
* Ninety minutes of playing soccer on 1 day, brisk walking for 15 minutes on 3 days, lifting weights on 2 days; and
* Forty-five minutes of stationary bicycling on 2 days, 60 minutes of basketball on 2 days, calisthenics on 3 days.

Active Older Adults

2008-10-08T09:46:00.002-07:00

Chapter 5: Active Older Adults

Regular physical activity is essential for healthy aging. Adults aged 65 years and older gain substantial health benefits from regular physical activity, and these benefits continue to occur throughout their lives. Promoting physical activity for older adults is especially important because this population is the least physically active of any age group.

Older adults are a varied group. Most, but not all, have one or more chronic conditions, and these conditions vary in type and severity. All have experienced a loss of physical fitness with age, some more than others. This diversity means that some older adults can run several miles, while others struggle to walk several blocks.

This chapter provides guidance about physical activity for adults aged 65 years and older. The chapter focuses on physical activity beyond baseline activity. The Guidelines seek to help older adults select types and amounts of physical activity appropriate for their abilities. The Guidelines for older adults are also appropriate for adults younger than age 65 who have chronic conditions and those with a low level of fitness.

For adults aged 65 and older who are fit and have no limiting chronic conditions, the guidance in this chapter is essentially the same as that provided in Chapter 4—Active Adults.
Explaining the Guidelines

Like the Guidelines for other adults, those for older adults mainly focus on two types of activity: aerobic and muscle-strengthening. In addition, these Guidelines discuss the addition of balance training for older adults at risk of falls. Each type provides important health benefits, as explained in Chapter 2—Physical Activity Has Many Health Benefits.
Aerobic Activity

People doing aerobic activities move large muscles in a rhythmic manner for a sustained period. Brisk walking, jogging, biking, dancing, and swimming are all examples of aerobic activities. This type of activity is also called endurance activity.

Aerobic activity makes a person's heart beat more rapidly to meet the demands of the body's movement.

Over time, regular aerobic activity makes the heart and cardiovascular system stronger and fitter.

When putting the Guidelines into action, it's important to consider the total amount of activity, as well as how often to be active, for how long, and at what intensity.
Key Guidelines for Older Adults

The following Guidelines are the same for adults and older adults:

* All older adults should avoid inactivity. Some physical activity is better than none, and older adults who participate in any amount of physical activity gain some health benefits.
* For substantial health benefits, older adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
* For additional and more extensive health benefits, older adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount.
* Older adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

The following Guidelines are just for older adults:

* When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.
* Older adults should do exercises that maintain or improve balance if they are at risk of falling.
* Older adults should determine their level of effort for physical activity relative to their level of fitness.
* Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.

How much total activity a week?
Older adults should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity physical activity a week, or an equivalent amount (75 minutes or 1 hour and 15 minutes) of vigorous-intensity activity. Older adults can also do an equivalent amount of activity by combining moderate- and vigorous–intensity activity. As is true for younger people, greater amounts of physical activity provide additional and more extensive health benefits to people aged 65 years and older.

No matter what its purpose—walking the dog, taking a dance or exercise class, or bicycling to the store—aerobic activity of all types counts toward the Guidelines.

How many days a week and for how long?
Aerobic physical activity should be spread throughout the week. Research studies consistently show that activity performed on at least 3 days a week produces health benefits. Spreading physical activity across at least 3 days a week may help to reduce the risk of injury and avoid excessive fatigue.

Episodes of aerobic activity count toward meeting the Guidelines if they last at least 10 minutes and are performed at moderate or vigorous intensity. These episodes can be divided throughout the day or week. For example, a person who takes a brisk 15-minute walk twice a day on every day of the week would easily meet the minimum Guideline for aerobic activity.
Examples of Aerobic and Muscle-Strengthening Physical Activities for Older Adults. The intensity of these activities can be either relatively moderate or relatively vigorous, depending on an older adult's level of fitness.

Aerobic

Muscle-Strengthening

* Walking
* Dancing
* Swimming
* Water aerobics
* Jogging
* Aerobic exercise classes
* Bicycle riding (stationary or on a path)
* Some activities of gardening, such as raking and pushing a lawn mower
* Tennis
* Golf (without a cart)

* Exercises using exercise bands, weight machines, hand-held weights
* Calisthenic exercises (body weight provides resistance to movement)
* Digging, lifting, and carrying as part of gardening
* Carrying groceries
* Some yoga exercises
* Some Tai chi exercises

How intense?
Older adults can meet the Guidelines by doing relatively moderate-intensity activity, relatively vigorous–intensity activity, or a combination of both. Time spent in light activity (such as light housework) and sedentary activities (such as watching TV) do not count.

The relative intensity of aerobic activity is related to a person's level of cardiorespiratory fitness.

* Moderate-intensity activity requires a medium level of effort. On a scale of 0 to 10, where sitting is 0 and the greatest effort possible is 10, moderate-intensity activity is a 5 or 6 and produces noticeable increases in breathing rate and heart rate.
* Vigorous-intensity activity is a 7 or 8 on this scale and produces large increases in a person's breathing and heart rate.

A general rule of thumb is that 2 minutes of moderate–intensity activity count the same as 1 minute of vigorous-intensity activity. For example, 30 minutes of moderate-intensity activity a week is roughly same as 15 minutes of vigorous-intensity activity.
Muscle-Strengthening Activities

At least 2 days a week, older adults should do muscle–strengthening activities that involve all the major muscle groups. These are the muscles of the legs, hips, chest, back, abdomen, shoulders, and arms.

Muscle-strengthening activities make muscles do more work than they are accustomed to during activities of daily life. Examples of muscle-strengthening activities include lifting weights, working with resistance bands, doing calisthenics using body weight for resistance (such as push-ups, pull-ups, and sit-ups), climbing stairs, carrying heavy loads, and heavy gardening.

Muscle-strengthening activities count if they involve a moderate to high level of intensity, or effort, and work the major muscle groups of the body. Whatever the reason for doing it, any muscle-strengthening activity counts toward meeting the Guidelines. For example, muscle-strengthening activity done as part of a therapy or rehabilitation program can count.

No specific amount of time is recommended for muscle strengthening, but muscle-strengthening exercises should be performed to the point at which it would be difficult to do another repetition without help. When resistance training is used to enhance muscle strength, one set of 8 to 12 repetitions of each exercise is effective, although two or three sets may be more effective. Development of muscle strength and endurance is progressive over time. This means that gradual increases in the amount of weight or the days per week of exercise will result in stronger muscles.
Balance Activities for Older Adults at Risk of Falls

Older adults are at increased risk of falls if they have had falls in the recent past or have trouble walking. In older adults at increased risk of falls, strong evidence shows that regular physical activity is safe and reduces the risk of falls. Reduction in falls is seen for participants in programs that include balance and moderate-intensity muscle-strengthening activities for 90 minutes (1 hour and 30 minutes) a week plus moderate-intensity walking for about 1 hour a week. Preferably, older adults at risk of falls should do balance training 3 or more days a week and do standardized exercises from a program demonstrated to reduce falls. Examples of these exercises include backward walking, sideways walking, heel walking, toe walking, and standing from a sitting position. The exercises can increase in difficulty by progressing from holding onto a stable support (like furniture) while doing the exercises to doing them without support. It's not known whether different combinations of type, amount, or frequency of activity can reduce falls to a greater degree. Tai chi exercises also may help prevent falls.
Meeting the Guidelines
For More Information

See Chapter 6—Safe and Active, for details on consulting a health-care provider.

Older adults have many ways to live an active lifestyle that meets the Guidelines. Many factors influence decisions to be active, such as personal goals, current physical activity habits, and health and safety considerations.

Healthy older adults generally do not need to consult a health-care provider before becoming physically active. However, health-care providers can help people attain and maintain regular physical activity by providing advice on appropriate types of activities and ways to progress at a safe and steady pace.

Adults with chronic conditions should talk with their health-care provider to determine whether their conditions limit their ability to do regular physical activity in any way. Such a conversation should also help people learn about appropriate types and amounts of physical activity.
Inactive Older Adults

Older adults should increase their amount of physical activity gradually. It can take months for those with a low level of fitness to gradually meet their activity goals. To reduce injury risk, inactive or insufficiently active adults should avoid vigorous aerobic activity at first. Rather, they should gradually increase the number of days a week and duration of moderate-intensity aerobic activity. Adults with a very low level of fitness can start out with episodes of activity less than 10 minutes and slowly increase the minutes of light-intensity aerobic activity, such as light-intensity walking.

Older adults who are inactive or who don't yet meet the Guidelines should aim for at least 150 minutes a week of relatively moderate-intensity physical activity. Getting at least 30 minutes of relatively moderate–intensity physical activity on 5 or more days each week is a reasonable way to meet these Guidelines. Doing muscle-strengthening activity on 2 or 3 nonconsecutive days each week is also an acceptable and appropriate goal for many older adults.
Active Older Adults

Older adults who are already active and meet the Guidelines can gain additional and more extensive health benefits by moving beyond the 150 minutes a week minimum to 300 or more minutes a week of relatively moderate-intensity aerobic activity. Muscle–strengthening activities should also be done at least 2 days a week.
Older Adults With Chronic Conditions
For More Information

See Chapter 7—Additional Considerations for Some Adults, for more information on chronic conditions.

Older adults who have chronic conditions that prevent them from doing the equivalent of 150 minutes of moderate-intensity aerobic activity a week should set physical activity goals that meet their abilities. They should talk with their health-care provider about setting physical activity goals. They should avoid an inactive lifestyle. Even 60 minutes (1 hour) a week of moderate-intensity aerobic activity provides some health benefits.
Special Considerations
Doing a Variety of Activities, Including Walking

Older adults have many ways to live an active lifestyle that meets the Guidelines.

In working toward meeting the Guidelines, older adults are encouraged to do a variety of activities. This approach can make activity more enjoyable and may reduce the risk of overuse injury.

Older adults also should strongly consider walking as one good way to get aerobic activity. Many studies show that walking has health benefits, and it has a low risk of injury. It can be done year-round and in many settings.
Physical Activity for Older Adults Who Have Functional Limitations

When a person has lost some ability to do a task of everyday life, such as climbing stairs, the person has a functional limitation. In older adults with existing functional limitations, scientific evidence indicates that regular physical activity is safe and helps improve functional ability.
Resuming Activity After an Illness or Injury

Older adults may have to take a break from regular physical activity because of illness or injury, such as the flu or a muscle strain. If these interruptions occur, older adults should resume activity at a lower level and gradually work back up to their former level of activity.
Flexibility, Warm-up, and Cool-down

Older adults should maintain the flexibility necessary for regular physical activity and activities of daily life. When done properly, stretching activities increase flexibility. Although these activities alone have no known health benefits and have not been demonstrated to reduce risk of activity-related injuries, they are an appropriate component of a physical activity program. However, time spent doing flexibility activities by themselves does not count toward meeting aerobic or muscle-strengthening Guidelines.

Research studies of effective exercise programs typically include warm-up and cool-down activities. Warm-up and cool-down activities before and after physical activity can also be included as part of a personal program. A warm-up before moderate- or vigorous-intensity aerobic activity allows a gradual increase in heart rate and breathing at the start of the episode of activity. A cool-down after activity allows a gradual decrease at the end of the episode. Time spent doing warm-up and cool-down may count toward meeting the aerobic activity Guidelines if the activity is at least moderate intensity (for example, walking briskly to warm-up for a jog). A warm-up for muscle-strengthening activity commonly involves doing exercises with less weight than during the strengthening activity.
Physical Activity in a Weight-Control Plan

The amount of physical activity necessary to successfully maintain a healthy body weight depends on caloric intake and varies considerably among older adults. To achieve and maintain a healthy body weight, older adults should first do the equivalent of 150 minutes of moderate-intensity aerobic activity each week. If necessary, older adults should increase their weekly minutes of aerobic physical activity gradually over time and decrease caloric intake to a point where they can achieve energy balance and a healthy weight.

Some older adults will need a higher level of physical activity than others to maintain a healthy body weight. Some may need more than the equivalent of 300 minutes (5 hours) a week of moderate-intensity activity. It is possible to achieve this level of activity by gradually increasing activity over time.

Older adults who are capable of relatively vigorous–intensity activity and need a high level of physical activity to maintain a healthy weight should consider some relatively vigorous-intensity activity as a means of weight control. This approach is more time-efficient than doing only moderate-intensity activity. However, high levels of activity are not feasible for many older adults. These adults should achieve a level of physical activity that is sustainable and safe. If further weight loss is needed, these older adults should achieve energy balance by regulating caloric intake.

It is important to remember that all activities "count" for energy balance. Active choices, such as taking the stairs rather than the elevator or adding short episodes of walking to the day, are examples of activities that can be helpful in weight control.
Getting and Staying Active: Real-Life Examples

The following examples show how different people with different living circumstances and levels of fitness can meet the Guidelines for older adults.
Mary: A 75-Year-Old Woman Living Independently in Her Own Home

Mary gets the equivalent of 180 minutes (3 hours) of moderate-intensity aerobic activity each week, plus muscle-strengthening activity 3 days a week.

* She participates regularly in an exercise class at her local senior center. The class meets Mondays, Wednesdays, and Fridays. It includes 30 minutes of aerobic dance, which she can do at moderate intensity, as well as 20 minutes of strength training, a 5-minute warm-up, a 5-minute cool-down, and some stretching exercises.
* On most Sundays, she visits her favorite park and walks a loop trail with several friends, which takes them about 45 minutes. The trail is hilly, so about 30 minutes of the walk is moderate-intensity walking for her, and about 15 minutes is vigorous intensity (the 15 minutes of vigorous intensity counts as 30 minutes of moderate-intensity walking).
* She adds at least an additional 30 minutes of walking each week in different ways. For example, she walks her grandson to school, she walks to her friends' homes, or she walks at the mall during shopping trips.

Manuel: An 85-Year-Old Man Living in an Assisted-Living Facility

Manuel, who has problems with falls, gets about 70 minutes (1 hour and 10 minutes) of aerobic activity each week and has an individualized strength-training program. He cannot do 150 minutes of moderate intensity physical activity because of his chronic conditions, but he is being as physically active as his condition allows.

* To reduce the risk of falls, a physical therapist has prescribed an individualized exercise program. This program includes 3 days a week (30 minutes each session) of strength- and balance-training exercises. Manueluses ankle weights for lower body muscle strengthening exercises and does a series of balance exercises. He does this program with the assistance of a residential aide.
* Manuel's residence includes a garden with walking paths and benches. He has gradually increased his physical activity to walking about 10 minutes each day. On some days he can walk more than on others, but he tries to walk a little every day. The plan is for him to sustain this level of activity for several weeks.
* After he builds strength and his balance improves, Manuel will consider increasing his level of activity and joining an exercise class specially designed to reduce the risk of falls in older people.

Anthony: A 65-Year-Old Man Living in a Retirement Community

Anthony has been active and fit all his life. He does 180 minutes of relatively vigorous-intensity activity each week, plus muscle-strengthening activities on 3 days.

* Six days a week, Anthony gets up early and runs 3 miles, which takes about 30 minutes.
* With help from staff at his community's fitness facility, Anthony designed a weight-lifting program using weight machines. He does this program on 3 days.

Safe and Active

2008-10-08T09:46:00.001-07:00

Chapter 6: Safe and Active

Although physical activity has many health benefits, injuries and other adverse events do sometimes happen. The most common injuries affect the musculoskeletal system (the bones, joints, muscles, ligaments, and tendons). Other adverse events can also occur during activity, such as overheating and dehydration. On rare occasions, people have heart attacks during activity.

The good news is that scientific evidence strongly shows that physical activity is safe for almost everyone. Moreover, the health benefits of physical activity far outweigh the risks.

Still, people may hesitate to become physically active because of concern they’ll get hurt. For these people, there is even more good news: They can take steps that are proven to reduce their risk of injury and adverse events.

The Guidelines in this chapter provide advice to help people do physical activity safely. Most advice applies to people of all ages. Specific guidance for particular age groups and people with certain conditions is also provided.
Explaining the Guidelines
Physical Activity Is Safe for Almost Everyone

Most people are not likely to be injured when doing moderate-intensity activities in amounts that meet the Physical Activity Guidelines. However, injuries and other adverse events do sometimes happen. The most common problems are musculoskeletal injuries. Even so, studies show that only one such injury occurs for every 1,000 hours of walking for exercise, and fewer than four injuries occur for every 1,000 hours of running.

Both physical fitness and total amount of physical activity affect risk of musculoskeletal injuries. People who are physically fit have a lower risk of injury than people who are not. People who do more activity generally have a higher risk of injury than people who do less activity. So what should people do if they want to be active and safe? The best strategies are to:

* Be regularly physically active to increase physical fitness; and
* Follow the other guidance in this chapter (especially increasing physical activity gradually over time) to minimize the injury risk from doing medium to high amounts of activity.

Following these strategies may reduce overall injury risk. Active people are more likely to have an activity related injury than inactive people. But they appear less likely to have non-activity-related injuries, such as work-related injuries or injuries that occur around the home or from motor vehicle crashes.
Key Guidelines for Safe Physical Activity

To do physical activity safely and reduce risk of injuries and other adverse events, people should:

* Understand the risks and yet be confident that physical activity is safe for almost everyone.
* Choose to do types of physical activity that are appropriate for their current fitness level and health goals, because some activities are safer than others.
* Increase physical activity gradually over time whenever more activity is necessary to meet guidelines or health goals. Inactive people should “start low and go slow” by gradually increasing how often and how long activities are done.
* Protect themselves by using appropriate gear and sports equipment, looking for safe environments, following rules and policies, and making sensible choices about when, where, and how to be active.
* Be under the care of a health-care provider if they have chronic conditions or symptoms. People with chronic conditions and symptoms should consult their health-care provider about the types and amounts of activity appropriate for them.

Choose Appropriate Types and Amounts of Activity

People can reduce their risk of injury by choosing appropriate types of activity. As the table shows, the safest activities are moderate intensity and low impact, and don’t involve purposeful collision or contact.

Walking for exercise, gardening or yard work, bicycling or exercise cycling, dancing, swimming, and golf are activities with the lowest injury rates. In the amounts commonly done by adults, walking (a moderate–intensity and low-impact activity) has a third or less of the injury risk of running (a vigorous-intensity and higher impact activity).

The risk of injury for a type of physical activity can also differ according to the purpose of the activity. For example, recreational bicycling or bicycling for transportation leads to fewer injuries than training for and competing in bicycle races.

People who have had a past injury are at risk of injuring that body part again. The risk of injury can be reduced by performing appropriate amounts of activity and setting appropriate personal goals. Performing a variety of different physical activities may also reduce the risk of overuse injury.

The risk of injury to bones, muscles, and joints is directly related to the gap between a person’s usual level of activity and a new level of activity.
The Continuum of Injury Risk Associated With Different Types of Activity

Injury Risk
Level
(Risk Level from lower to higher)

Activity Type

Examples

Lowest Risk

Commuting

Walking, bicycling

Lower Risk

Lifestyle

Home repair, gardening/yard work

Medium Risk

Recreation/sports
No contact

Walking for exercise, golf, dancing, swimming, running, tennis

Higher Risk

Recreation/sports
Limited contact

Bicycling, aerobics, skiing, volleyball, baseball, softball

Highest Risk

Recreation/sports
Collision/contact

Football, hockey, soccer, basketball

Note: The same activity done for different purposes and with different frequency, intensity, and duration leads to different injury rates. Competitive activities tend to have higher injury rates than non-competitive activities, likely due to different degrees of intensity of participation.
Increase Physical Activity Gradually Over Time

Scientific studies indicate that the risk of injury to bones, muscles, and joints is directly related to the gap between a person’s usual level of activity and a new level of activity. The size of this gap is called the amount of overload. Creating a small overload and waiting for the body to adapt and recover reduces the risk of injury. When amounts of physical activity need to be increased to meet the Guidelines or personal goals, physical activity should be increased gradually over time, no matter what the person’s current level of physical activity.

Scientists have not established a standard for how to gradually increase physical activity over time. The following recommendations give general guidance for inactive people and those with low levels of physical activity on how to increase physical activity:

* Use relative intensity (intensity of the activity relative to a person’s fitness) to guide the level of effort for aerobic activity.
* Generally start with relatively moderate-intensity aerobic activity. Avoid relatively vigorous-intensity activity, such as shoveling snow or running. Adults with a low level of fitness may need to start with light activity, or a mix of light- to moderate-intensity activity.
* First, increase the number of minutes per session (duration), and the number of days per week (frequency) of moderate-intensity activity. Later, if desired, increase the intensity.
* Pay attention to the relative size of the increase in physical activity each week, as this is related to injury risk. For example, a 20-minute increase each week is safer for a person who does 200 minutes a week of walking (a 10 percent increase), than for a person who does 40 minutes a week (a 50 percent increase).

The available scientific evidence suggests that adding a small and comfortable amount of light- to moderate–intensity activity, such as 5 to 15 minutes of walking per session, 2 to 3 times a week, to one’s usual activities has a low risk of musculoskeletal injury and no known risk of severe cardiac events. Because this range is rather wide, people should consider three factors in individualizing their rate of increase: age, level of fitness, and prior experience.

Age
The amount of time required to adapt to a new level of activity probably depends on age. Youth and young adults probably can safely increase activity by small amounts every week or 2. Older adults appear to require more time to adapt to a new level of activity, in the range of 2 to 4 weeks.

Level of Fitness
Less fit adults are at higher risk of injury when doing a given amount of activity, compared to fitter adults. Slower rates of increase over time may reduce injury risk. This guidance applies to overweight and obese adults, as they are commonly less physically fit.

Prior Experience
People can use their experience to learn to increase physical activity over time in ways that minimize the risk of overuse injury. Generally, if an overuse injury occurred in the past with a certain rate of progression, a person should increase activity more slowly the next time.
Take Appropriate Precautions

Taking appropriate precautions means using the right gear and equipment, choosing safe environments in which to be active, following rules and policies, and making sensible choices about how, when, and where to be active.

Use Protective Gear and Appropriate Equipment
Using personal protective gear can reduce the frequency of injury. Personal protective gear is something worn by a person to protect a specific body part. Examples include helmets, eyewear and goggles, shin guards, elbow and knee pads, and mouth guards.

Using appropriate sports equipment can also reduce risk of injury. Sports equipment refers to sport or activity-specific tools, such as balls, bats, sticks, and shoes.
For More Information

See Appendix 2 for a resource chart that provides selected examples of injury prevention strategies for common physical activities.

For the most benefit, protective equipment and gear should be:

* The right equipment for the activity;
* Appropriately fitted;
* Appropriately maintained; and
* Used consistently and correctly.

Be Active in Safe Environments
People can reduce their injury risks by paying attention to the places they choose to be active. To help themselves stay safe, people can look for:

* Physical separation from motor vehicles, such as sidewalks, walking paths, or bike lanes;
* Neighborhoods with traffic-calming measures that slow down traffic;
* Places to be active that are well-lighted, where other people are present, and that are well-maintained (no litter, broken windows);
* Shock-absorbing surfaces on playgrounds;
* Well-maintained playing fields and courts without holes or obstacles;
* Breakaway bases at baseball and softball fields; and
* Padded and anchored goals and goal posts at soccer and football fields.

Follow Rules and Policies That Promote Safety
Rules, policies, legislation, and laws are potentially the most effective and wide-reaching way to reduce activity-related injuries. To get the benefit, individuals should look for and follow these rules, policies, and laws. For example, policies that promote the use of bicycle helmets reduce the risk of head injury among cyclists. Rules against diving into shallow water at swimming pools prevent head and neck injuries.

Make Sensible Choices About How, When, and Where To Be Active
A person’s choices can obviously influence the risk of adverse events. By making sensible choices, injuries and adverse events can be prevented. Consider weather conditions, such as extremes of heat and cold. For example, during very hot and humid weather, people lessen the chances of dehydration and heat stress by:

* Exercising in the cool of early morning as opposed to mid-day heat;
* Switching to indoor activities (playing basketball in the gym rather than on the playground);
* Changing the type of activity (swimming rather than playing soccer);
* Lowering the intensity of activity (walking rather than running); and
* Paying close attention to rest, shade, drinking enough fluids, and other ways to minimize effects of heat.

Inactive people who gradually progress over time to relatively moderate-intensity activity have no known risk of sudden cardiac events, and very low risk of bone, muscle, or joint injuries.

Exposure to air pollution is associated with several adverse health outcomes, including asthma attacks and abnormal heart rhythms. People who can modify the location or time of exercise may wish to reduce these risks by exercising away from heavy traffic and industrial sites, especially during rush hour or times when pollution is known to be high. However, current evidence indicates that the benefits of being active, even in polluted air, outweigh the risk of being inactive.
Advice From Health-Care Providers

The protective value of a medical consultation for persons with or without chronic diseases who are interested in increasing their physical activity level is not established. People without diagnosed chronic conditions (such as diabetes, heart disease, or osteoarthritis) and who do not have symptoms (such as chest pain or pressure, dizziness, or joint pain) do not need to consult a health-care provider about physical activity.

Inactive people who gradually progress over time to relatively moderate-intensity activity have no known risk of sudden cardiac events, and very low risk of bone, muscle, or joint injuries. A person who is habitually active with moderate-intensity activity can gradually increase to vigorous intensity without needing to consult a health-care provider. People who develop new symptoms when increasing their levels of activity should consult a health-care provider.
For More Information

See Chapter 4—Active Adults for guidance and examples of how to gradually increase activity levels.

Health-care providers can provide useful personalized advice on how to reduce risk of injuries. For people who wish to seek the advice of a health-care provider, it is particularly appropriate to do so when contemplating vigorous-intensity activity, because the risks of this activity are higher than the risks of moderate-intensity activity.

The choice of appropriate types and amounts of physical activity can be affected by chronic conditions. People with symptoms or known chronic conditions should be under the regular care of a health-care provider. In consultation with their provider, they can develop a physical activity plan that is appropriate for them. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. However, they may need to take special precautions. For example, people with diabetes need to pay special attention to blood sugar control and proper footwear during activity.

Women who are pregnant and those who’ve recently had a baby should be under the regular care of a health-care provider. Moderate-intensity physical activity is generally safe for women with uncomplicated pregnancies, but women should talk with their provider about how to adjust the amounts and types of activity while they are pregnant and right after the baby’s birth.
For More Information

See Chapter 7—Additional Considerations for Some Adults for more details about physical activity during pregnancy and the postpartum period.

During pregnancy, women should avoid:

* Doing activities that involve lying on their back after the first trimester of pregnancy; and
* Doing activities with high risk of falling or abdominal trauma, including contact or collision sports, such as horseback riding, soccer, basketball, and downhill skiing.

Gradually Increasing Physical Activity Over Time: Real-Life Examples

Here are two examples that show how people at different ages, levels of fitness, and levels of experience can safely become more active over time.
Bill: A Man Who Has Been Inactive for Many Years

Bill wants to work his way up to the equivalent of 180 to 210 minutes (3 hours to 3 hours and 30 minutes) of walking a week. On weekdays he has time for up to 45 minutes of walking, and he plans to do something physically active each weekend. He decides to start with walking because it is moderate intensity and has a low risk of injury.

* The first week, Bill starts at a low level. He walks 10 minutes a day 3 days a week. Sometimes he divides the 10 minutes a day into two sessions. He prefers to alternate rest days and active days. (Total = 30 minutes a week.)
* Between weeks 3 and 8, Bill increases duration by adding 5 minutes a day and continues walking on 3 non-consecutive days each week. The weekly increase is 15 minutes. (Week 3 total = 45 minutes. Week 8 total = 120 minutes or 2 hours.)
* In week 9, Bill adds another day of moderate intensity activity on the weekend, and starts doing a variety of activities, including biking, hiking, and an aerobics class. Gradually increasing the minutes of activity, by week 12 he is doing 60 minutes or more of moderate-intensity activity on the weekend. Reaching his goal: Over 3 months, Bill has increased to a total of 180 moderate-intensity minutes a week.

Kim: An Active Woman

Kim currently does 150 minutes (2 hours and 30 minutes) a week of moderate-intensity activity. She wants to work up to at least the equivalent of 300 minutes (5 hours) of moderate-intensity activity a week. She also wants to shift some of that moderate intensity activity to vigorous-intensity activity. Her current 150 minutes a week includes:

* Thirty minutes of mowing the grass 1 day a week;
* Thirty minutes of brisk walking 4 days a week; and
* Fifteen minutes of muscle-strengthening exercises 2 days a week.

Increasing frequency and duration:

* Over a month, Kim adds walking on another weekday, and she gradually adds 15 minutes of moderate-intensity activity on each of the 5 walking days each week. This provides an additional 105 minutes (1 hour and 45 minutes) of moderate–intensity activity.

Increasing intensity:

* Over the next month, Kim decides to replace some walking with jogging. Instead of walking 45 minutes, she walks for 30 minutes and jogs for 15 minutes on each weekday, providing the equivalent of 300 minutes a week of moderate-intensity physical activity from her walking and jogging.

Reaching her goal: After these increases, Kim is doing a total of 180 minutes of moderate-intensity activity each week (walking and mowing) and also doing 75 minutes (1 hour and 15 minutes) of vigorous–intensity jogging. One minute of vigorous-intensity activity is about the same as 2 minutes of moderate intensity activity, so she is now doing the equivalent of 330 moderate-intensity minutes (5 hours and 30 minutes) a week. She has more than met her goal.

Additional Considerations for Some Adults

2008-10-08T09:45:00.001-07:00

Chapter 7: Additional Considerations for Some Adults

All Americans should be physically active to improve overall health and fitness and to prevent many adverse health outcomes. Most Americans should follow the Guidelines of the child and adolescent, adult, or older adult chapters, depending upon their age. However, some people have conditions that raise special issues about recommended types and amounts of physical activity. This chapter provides guidance on physical activity for healthy women who are pregnant and for people with disabilities. This chapter also affirms and illustrates how physical activity is generally appropriate for adults with chronic conditions by considering three groups of adults:

* Adults with osteoarthritis;
* Adults with type 2 diabetes; and
* Adults who are cancer survivors.

Physical Activity for Women During Pregnancy and the Postpartum Period

Physical activity during pregnancy benefits a woman’s overall health. For example, moderate-intensity physical activity by healthy women during pregnancy maintains or increases cardiorespiratory fitness.

Strong scientific evidence shows that the risks of moderate-intensity activity done by healthy women during pregnancy are very low, and do not increase risk of low birth weight, preterm delivery, or early pregnancy loss. Some evidence suggests that physical activity reduces the risk of pregnancy complications, such as preeclampsia and gestational diabetes, and reduces the length of labor, but this evidence is not conclusive.

During a normal postpartum period, regular physical activity continues to benefit a woman’s overall health. Studies show that moderate-intensity physical activity during the period following the birth of a child increases a woman’s cardiorespiratory fitness and improves her mood. Such activity does not appear to have adverse effects on breast milk volume, breast milk composition, or infant growth.

Physical activity also helps women achieve and maintain a healthy weight during the postpartum period, and when combined with caloric restriction, helps promote weight loss.
Key Guidelines for Women During Pregnancy and the Postpartum Period

* Healthy women who are not already highly active or doing vigorous-intensity activity should get at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity per week during pregnancy and the postpartum period. Preferably, this activity should be spread throughout the week.
* Pregnant women who habitually engage in vigorous-intensity aerobic activity or are highly active can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health-care provider how and when activity should be adjusted over time.

Explaining the Guidelines

Women who are pregnant should be under the care of a health-care provider with whom they can discuss how to adjust amounts of physical activity during pregnancy and the postpartum period. Unless a woman has medical reasons to avoid physical activity during pregnancy, she can begin or continue moderate-intensity aerobic physical activity during her pregnancy and after the baby is born.

When beginning physical activity during pregnancy, women should increase the amount gradually over time. The effects of vigorous-intensity aerobic activity during pregnancy have not been studied carefully, so there is no basis for recommending that women should begin vigorous-intensity activity during pregnancy.

Women who habitually do vigorous-intensity activity or high amounts of activity or strength training should continue to be physically active during pregnancy and after giving birth. They generally do not need to drastically reduce their activity levels, provided that they remain healthy and discuss with their health-care provider how to adjust activity levels during this time.

During pregnancy, women should avoid doing exercises involving lying on their back after the first trimester of pregnancy. They should also avoid doing activities that increase the risk of falling or abdominal trauma, including contact or collision sports, such as horseback riding, downhill skiing, soccer, and basketball.
Physical Activity for People With Disabilities

The benefits of physical activity for people with disabilities have been studied in diverse groups. These groups include stroke victims, people with spinal cord injury, multiple sclerosis, Parkinson’s disease, muscular dystrophy, cerebral palsy, traumatic brain injury, limb amputations, mental illness, intellectual disability, and dementia.
For More Information

See Chapter 2—Physical Activity Has Many Health Benefits, for details.

Overall, the evidence shows that regular physical activity provides important health benefits for people with disabilities. The benefits include improved cardiovascular and muscle fitness, improved mental health, and better ability to do tasks of daily life. Sufficient evidence now exists to recommend that adults with disabilities should get regular physical activity. Physical activity in children and adolescents with disabilities is considered in Chapter 3—Active Children and Adolescents.
Key Guidelines for Adults With Disabilities

* Adults with disabilities, who are able to, should get at least 150 minutes per week (2 hours and 30 minutes) of moderate-intensity, or 75 minutes (1 hour and 15 minutes) per week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
* Adults with disabilities, who are able to, should also do muscle-strengthening activities of moderate or high intensity that involve all major muscle groups on 2 or more days per week as these activities provide additional health benefits.
* When adults with disabilities are not able to meet the above Guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity.
* Adults with disabilities should consult their health-care providers about the amounts and types of physical activity that are appropriate for their abilities.

Explaining the Guidelines

In consultation with their health-care providers, people with disabilities should understand how their disabilities affect their ability to do physical activity. Some may be capable of doing medium to high amounts of physical activity, and they should essentially follow the Guidelines for adults.

Some people with disabilities are not able to follow the Guidelines for adults. These people should adapt their physical activity program to match their abilities, in consultation with their health-care providers. Studies show that physical activity can be done safely when the program is matched to an individual’s abilities.
For More Information

See Chapter 4—Active Adults, for details on these Guidelines and how to meet
Meeting the Guidelines

People with disabilities are encouraged to get advice from professionals with experience in physical activity and disability because matching activity to abilities can require modifying physical activity in many different ways. Some people with disabilities also need help with their exercise program. For example, some people may need supervision when performing muscle-strengthening activities, such as lifting weights.
Physical Activity for People With Chronic Medical Conditions

Adults with chronic conditions should engage in regular physical activity because it can help promote their quality of life and reduce the risk of developing new conditions. The type and amount of physical activity should be determined by a person’s abilities and the severity of the chronic condition. Three examples are provided below to illustrate the benefits of physical activity for persons with chronic conditions.

For many chronic conditions, physical activity provides therapeutic benefits and is part of recommended treatment for the condition. However, this chapter does not discuss therapeutic exercise or rehabilitation.
Key Messages for People With Chronic Medical Conditions

* Adults with chronic conditions obtain important health benefits from regular physical activity.
* When adults with chronic conditions do activity according to their abilities, physical activity is safe.
* Adults with chronic conditions should be under the care of health-care providers. People with chronic conditions and symptoms should consult their health-care providers about the types and amounts of activity appropriate for them.

Example 1. Physical Activity for Adults With Osteoarthritis
For More Information

See Chapter 2—Physical Activity Has Many Health Benefits, for details on these benefits.

Osteoarthritis is a common condition in older adults, and people can live many years with osteoarthritis. People with osteoarthritis are commonly concerned that physical activity can make their condition worse. Osteoarthritis can be painful and cause fatigue, making it hard to begin or maintain regular physical activity. Yet people with this condition should get regular physical activity to lower their risk of getting other chronic diseases, such as heart disease or type 2 diabetes, and to help maintain a healthy body weight.

Strong scientific evidence indicates that both aerobic activity and muscle-strengthening activity provide therapeutic benefits for persons with osteoarthritis. When done safely, physical activity does not make the disease or the pain worse. Studies show that adults with osteoarthritis can expect improvements in pain, physical function, quality of life, and mental health with regular physical activity.

People with osteoarthritis should match the type and amount of physical activity to their abilities and the severity of their condition. Most people can usually do moderate-intensity activity for 150 minutes (2 hours and 30 minutes) a week or more, and may choose to be active 3 to 5 days a week for 30 to 60 minutes per episode. Some people with arthritis can safely do more than 150 minutes of moderate-intensity activity each week and may be able to tolerate equivalent amounts of vigorous-intensity activity. Health-care providers typically counsel people with osteoarthritis to do activities that are low impact, not painful, and have low risk of joint injury. Swimming, walking, and strength-training are good examples of this type of activity.
Example 2. Physical Activity for Adults With Type 2 Diabetes

Physical activity in adults with type 2 diabetes shows how important it can be for people with a chronic disease to be active. Physical activity has important therapeutic effects in people with diabetes, but it is also routinely recommended to reduce risk of other diseases and help promote a healthy body weight.

For example, strong scientific evidence shows that physical activity protects against heart disease in people with diabetes. Moderate-intensity activity for about 150 minutes a week helps to substantially lower the risk of heart disease. A person who moves toward 300 minutes (5 hours) or more of moderate-intensity activity a week gets even greater benefit.

Adults with chronic conditions should work with their health-care providers to adapt physical activity so that it is appropriate for their condition. For example, people with diabetes must be careful to monitor their blood glucose and avoid injury to their feet.
Example 3. Physical Activity for Cancer Survivors

With modern treatments, many people with cancer can either be cured or survive for many years, living long enough to be at risk of other chronic conditions, such as high blood pressure or type 2 diabetes. Some cancer survivors are at risk of recurrence of the original cancer. Some have experienced side effects of the cancer treatment.

Like other adults, cancer survivors should engage in regular physical activity for its preventive benefits. Physical activity in cancer survivors can reduce risk of new chronic diseases. Further, studies suggest physically active adults with breast or colon cancer are less like to die prematurely or have a recurrence of the cancer. Physical activity may also play a role in reducing adverse effects of cancer treatment.

Cancer survivors, like other adults with chronic conditions, should consult their health-care providers to match their physical activity plan to their abilities and health status.

Taking Action: Increasing Physical Activity Levels of Americans

2008-10-08T09:44:00.000-07:00

Chapter 8: Taking Action: Increasing Physical Activity Levels of Americans

The low level of physical activity among Americans is a major contributor to the burden of chronic disease. This burden is costly in terms of quality of life and economic resources needed to provide medical care. Like life in other modern societies around the world, life in the United States requires very little daily physical activity. The amount of physical activity we do is largely a matter of personal choice and the environmental conditions under which we live. So far, little progress has been made in meeting our national health objectives for physical activity.

Based on a careful review of the science, the Physical Activity Guidelines provides essential guidance to help Americans achieve the health benefits of regular physical activity. However, providing guidance by itself is not enough to produce change. Action is necessary. Regular physical activity needs to be made the easy choice for Americans.

To accomplish this goal, public health research suggests the use of a “socio-ecologic” approach. This comprehensive approach involves action at all levels of society: individual, interpersonal, organizational, community, and public policy. Example actions include:
For More Information

See Appendix 3—Federal Web Sites That Promote Physical Activity, for useful resources at all these levels.

* Personal goal setting (individual level);
* Social support and encouragement to be active (interpersonal level);
* Promotion of physical activity as part of worksite health promotion programs (organizational);
* Good access to parks and recreational facilities in neighborhoods (community); and
* Promotion of policies that support families who want their children to walk or bike to school (public policy).

To give a sense of how to make regular physical activity the easy choice, the remainder of this chapter first considers steps individuals can take to adopt an active lifestyle. Then it considers steps society can take to support and facilitate active lifestyles.

The purpose is to illustrate achievable steps that will make a difference, not to address everything that needs to be done.
What Can Adults Do To Get Enough Physical Activity?

Adults can find advice on how to be active from many sources, including fitness professionals, health-care providers, books, and Web sites. Here are three commonly cited steps adults can take to help meet the Guidelines.
Personalize the Benefits of Regular Physical Activity

Adults need to identify benefits of personal value to them. For many people, the health benefits, which are the focus of the Physical Activity Guidelines for Americans, are compelling enough. For others, different reasons are key motivators to be active. For example, physical activity:

* Provides opportunities to enjoy recreational activities, often in a social setting;
* Improves personal appearance;
* Provides a chance to help a spouse lose weight;
* Improves the quality of sleep;
* Reduces feelings of low energy; and
* Gives older adults a greater opportunity to live independently in the community.

Set Personal Goals for Physical Activity

The Guidelines alone don’t provide enough information for individuals to decide the types and amounts of activity that are appropriate for them. Individuals should set goals for activity that allow them to achieve benefits they value. Simple goals are fine. For example, a brisk walk in the neighborhood with friends for 45 minutes 3 days a week and walking to lunch twice a week may be just the right approach for someone who wants to increase both physical activity and social opportunities.

In setting goals, people can consider doing a variety of activities and try both indoor and outdoor activities. In particular, public parks and recreation areas in the United States offer opportunities to experience nature and be physically active at the same time.

The best physical activity is the one that is enjoyable enough to do regularly.
Develop Knowledge To Attain Goals

It is important to learn about the types and amount of activity needed to attain personal goals. For example, if weight loss is a goal, it’s useful to know that vigorous-intensity activity can be much more time-efficient in burning calories than moderate-intensity activity. If running is a goal, it’s important to learn how to reduce risk of running injuries by selecting an appropriate training program and proper shoes. If regular walking is a goal, learning about neighborhood walking trails can help a person attain the goal.
Using a Pedometer To Track Walking

For adults who prefer walking as a form of aerobic activity, pedometers or step counters are useful in tracking progress toward personal goals. Popular advice, such as walking 10,000 steps a day, is not a Guideline per se, but a way people may choose to meet the Guidelines. The key to using a pedometer to meet the Guidelines is to first set a time goal (minutes of walking a day) and then calculate how many steps are needed each day to reach that goal.

Episodes of brisk walking that last at least 10 minutes count toward meeting the Guidelines. However, just counting steps using a pedometer doesn’t ensure that a person will achieve those 10-minute episodes. People generally need to plan episodes of walking if they are to use a pedometer and step goals appropriately.

As a basis for setting step goals, it’s preferable that people know how many steps they take per minute of a brisk walk. A person with a low fitness level, who takes fewer steps per minute than a fit adult, will need fewer steps to achieve the same amount of walking time.

One way to set a step goal is the following:

1. To determine usual daily steps from baseline activity, a person wears a pedometer to observe the number of steps taken on several ordinary days with no episodes of walking for exercise. Suppose the average is about 5,000 steps a day.
2. While wearing the pedometer, the person measures the number of steps taken during 10 minutes of an exercise walk. Suppose this is 1,000 steps. Then, for a goal of 40 minutes of walking for exercise, the total number of steps would be 4,000 (1,000 × 4).
3. To calculate a daily step goal, add the usual daily steps (5,000) to the steps required for a 40-minute walk (4,000), to get the total steps per day (5,000 + 4,000 = 9,000).

Each week the person gradually increases the time walking for exercise until the step goal is reached. Rate of progression should be individualized. Some people who start out at 5,000 steps a day can add 500 steps per day each week. Others, who are less fit and starting out at a lower number of steps, should add a smaller number of steps each week.
How Can We Help Children and Adolescents Get Enough Physical Activity?

Many children and adolescents are naturally physically active, and they need opportunities to be active and to learn skills. They benefit from encouragement from parents and other adults. Adults can promote age-appropriate activity in youth through these steps:

* Provide time for both structured and unstructured physical activity during school and outside of school. Children need time for active play. Through recess, physical activity breaks, physical education classes, after-school programs, and active time with family and friends, youth can learn about physical activity and spend time doing it.
* Provide children and adolescents with positive feedback and good role models. It has been said that if you do not practice what you teach, you are teaching something else. Parents and teachers should model and encourage an active lifestyle for children. Praise, rewards, and encouragement help children to be active. Using physical activity as punishment does not help children to be active.
* Help young people learn skills required to do physical activity safely. As appropriate for their age, youth need to understand how to regulate the intensity of activity, increase physical activity gradually over time, set goals, use protective gear and proper equipment, follow rules, and avoid injuries.
* Promote activities that set the basis for a lifetime of activity. Children and adolescents should be exposed to a variety of activities, including active recreation, team sports, and individual sports. In this way, they can find activities they can do well and enjoy. Include exposure to activities that adults commonly do, such as jogging, bicycling, hiking, and swimming. Young people should experience non-competitive activities and activities that do not require above-average athletic skills.

Communities can provide many opportunities for physical activity, such as walking trails, bicycle lanes on roads, sidewalks, and sports fields.
What Can Communities and Government Do To Help People Be Active?

Actions by communities and government can influence whether regular physical activity is an easy choice. Communities can provide many opportunities for physical activity, such as walking trails, bicycle lanes on roads, sidewalks, and sports fields. Organizations in the community have a role to play as well. Schools, places of worship, worksites, and community centers can provide opportunities and encouragement for physical activity.
Use Evidence-Based Approaches and Tailor Them to the Needs of Individual Communities

To be effective, physical activity promotion efforts should use an “evidence-based” approach. The CDC’s Guide to Community Preventive Services1 has reviewed many community-level approaches to promote physical activity, including these five strongly recommended strategies:

* Community-wide campaigns that combine physical activity messaging (distributed through television, newspapers, radio, and other media) with activities such as physical activity counseling, community health fairs, and the development of walking trails.
* Point-of-decision prompts to encourage stair use. These are signs placed at points where people make the decision either to use the stairs or to use an elevator or escalator. The signs encourage the active option of stair use.
* Physical education classes to increase activity. Physical education classes should use a curriculum that increases the amount of time students are active during class.
* Approaches that increase the reach of individual-level interventions. For example, evidence-based, individual-level interventions can reach more people when they are delivered in group settings or over the telephone.
* Interventions that increase social support for physical activity. These interventions start or enhance social-support networks, and include efforts such as organizing a buddy system (two or more people who set regular times to do physical activity together), walking groups, and community dances.
* Programs to create or enhance access to places to be physically active. This can include building walking trails and providing public access to school gymnasiums, playgrounds, or community centers. This also includes worksite activity programs that provide access to onsite or offsite fitness rooms, walking breaks, or other opportunities to engage in physical activity. Interventions to improve access should also include outreach that increases awareness of the opportunity to be active.

Implementing community-level approaches to physical activity requires collaboration across sectors.
Involve Many Sectors in Promoting Physical Activity

Interventions to improve access should also include outreach that increases awareness of the opportunity to be active.

* Policies and programs that support street-scale design principles and practices that promote physical activity. For example, these types of policies and programs use crosswalks, sidewalks, traffic calming, and other safety measures to make it easier and safer for people to choose active transportation.
* Policies and programs that support community- scale design principles and practices that promote physical activity. Community-scale design includes zoning that facilitates bicycling and walking by allowing schools, housing, and businesses to be built near one another.

The following list identifies relevant sectors and illustrates roles they play in promoting physical activity. The division of functions in the community into the following sectors does not use mutually exclusive categories. These sectors were chosen simply to illustrate how parts of the community have a role to play in promoting physical activity. Some communities may use different names and divisions of functions.

* Parks and recreation. This sector plays a lead role in providing access to places for active recreation, such as playgrounds, hiking and biking trails, basketball courts, sports fields, and swimming pools.
* Law enforcement. Concern about crime can deter people from outdoors recreation. Law enforcement can promote a safe environment that facilitates outdoor activity.
* Urban planning. Urban planning. The Guide to Community Preventive Services recommends both street-scale and community-scale design principles to promote physical activity. Urban planners have a lead role in implementing design principles to promote physical activity.
* Transportation. The transportation sector has a lead role in designing and implementing options that provide areas for safe walking and bicycling. Mass transit systems also promote walking, as people typically walk to and from transit stops. Programs that support safe walking and bicycling to school help children be more physically active.
* Education. The education sector takes a lead role in providing physical education, after-school sports, and public access to school facilities during after-school hours.
* Architecture. Architects and builders can design and construct buildings with active options, such as access to stairs. Campuses should allow pedestrians pleasant and efficient methods of walking within and between buildings.
* Employers and private organizations. Employers and private organizations. Employers can encourage workers to be physically active, facilitate active transportation by supplying showers and secure bicycle storage, and provide other incentives to be active. Private and faith-based organizations can support community physical activity initiatives financially or by providing space for programs. Health and fitness facilities and community programs can provide access to exercise programs and equipment for a broad range of people, including older adults and people with disabilities. Local sports organizations can organize road races and events for the public. Senior centers can provide exercise programs for older adults.
* Health care. Health-care providers can assess, counsel, and advise patients on physical activity and how to do it safely. Health-care providers can model healthy behaviors by being physically active themselves.
* Public health. Public health departments can monitor community progress in providing places and opportunities to be physically active and can track changes in the proportion of the population meeting the Physical Activity Guidelines for Americans. They can also take the lead in setting objectives and coordinating activities among sectors. Public health departments and organizations can disseminate appropriate messages and information to the public about physical activity.

The Physical Activity Guidelines for Americans gives guidance on the amount of physical activity that will provide health benefits for all Americans. Broad, comprehensive strategies are needed to help all Americans meet the Guidelines. Implementing a comprehensive strategy to increase physical activity requires an evidence-based approach that occurs at multiple levels and in all sectors. A comprehensive and coordinated strategy will help Americans take action to ensure that regular physical activity is the easy and accepted choice for everyone

2008 Physical Activity Guidelines for Americans Summary

2008-10-08T09:43:00.000-07:00

2008 Physical Activity Guidelines for Americans Summary

Being physically active is one of the most important steps that Americans of all ages can take to improve their health. The 2008 Physical Activity Guidelines for Americans provides science-based guidance to help Americans aged 6 and older improve their health through appropriate physical activity.

The U.S. Department of Health and Human Services (HHS) issues the Physical Activity Guidelines for Americans. The content of the Physical Activity Guidelines complements the Dietary Guidelines for Americans, a joint effort of HHS and the U.S. Department of Agriculture (USDA). Together, the two documents provide guidance on the importance of being physically active and eating a healthy diet to promote good health and reduce the risk of chronic diseases.

The primary audiences for the Physical Activity Guidelines are policymakers and health professionals. These Guidelines are designed to provide information and guidance on the types and amounts of physical activity that provide substantial health benefits. This information may also be useful to interested members of the public. The main idea behind the Guidelines is that regular physical activity over months and years can produce long-term health benefits. Realizing these benefits requires physical activity each week.
Regular physical activity can produce longterm health benefits.

The steps used to develop the Physical Activity Guidelines for Americans were similar to those used for the Dietary Guidelines for Americans. In 2007, HHS Secretary Mike Leavitt appointed an external scientific advisory committee, called the Physical Activity Guidelines Advisory Committee. The Advisory Committee conducted an extensive analysis of the scientific information on physical activity and health. The Physical Activity Guidelines Advisory Committee Report, 2008 and meeting summaries are available at http://www.health.gov/PAGuidelines/.

HHS primarily used the Advisory Committee’s report but also considered comments from the public and Government agencies when writing the Guidelines. The Guidelines will be widely promoted through various communications strategies, such as materials for the public, Web sites, and partnerships with organizations that promote physical activity.

The Physical Activity Guidelines for Americans describes the major research findings on the health benefits of physical activity:

* Regular physical activity reduces the risk of many adverse health outcomes.
* Some physical activity is better than none.
* For most health outcomes, additional benefits occur as the amount of physical activity increases through higher intensity, greater frequency, and/or longer duration.
* Most health benefits occur with at least 150 minutes (2 hours and 30 minutes) a week of moderate intensity physical activity, such as brisk walking. Additional benefits occur with more physical activity.
* Both aerobic (endurance) and muscle-strengthening (resistance) physical activity are beneficial.
* Health benefits occur for children and adolescents, young and middle-aged adults, older adults, and those in every studied racial and ethnic group.
* The health benefits of physical activity occur for people with disabilities.
* The benefits of physical activity far outweigh the possibility of adverse outcomes.

The following are the key Guidelines included in the Physical Activity Guidelines for Americans:
Key Guidelines for Children and Adolescents

* Children and adolescents should do 60 minutes (1 hour) or more of physical activity daily.
o Aerobic: Most of the 60 or more minutes a day should be either moderate- or vigorous-intensity aerobic physical activity, and should include vigorous-intensity physical activity at least 3 days a week.
o Muscle-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle-strengthening physical activity on at least 3 days of the week.
o Bone-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone-strengthening physical activity on at least 3 days of the week.
* It is important to encourage young people to participate in physical activities that are appropriate for their age, that are enjoyable, and that offer variety.

Key Guidelines for Adults

* All adults should avoid inactivity. Some physical activity is better than none, and adults who participate in any amount of physical activity gain some health benefits.
* For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
* For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate intensity, or 150 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount.
* Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

Key Guidelines for Older Adults

The Key Guidelines for Adults also apply to older adults. In addition, the following Guidelines are just for older adults:

* When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.
* Older adults should do exercises that maintain or improve balance if they are at risk of falling.
* Older adults should determine their level of effort for physical activity relative to their level of fitness.
* Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.

Key Guidelines for Safe Physical Activity

To do physical activity safely and reduce the risk of injuries and other adverse events, people should:

* Understand the risks and yet be confi dent that physical activity is safe for almost everyone.
* Choose to do types of physical activity that are appropriate for their current fitness level and health goals, because some activities are safer than others.
* Increase physical activity gradually over time whenever more activity is necessary to meet guidelines or health goals. Inactive people should “start low and go slow” by gradually increasing how often and how long activities are done.
* Protect themselves by using appropriate gear and sports equipment, looking for safe environments, following rules and policies, and making sensible choices about when, where, and how to be active.
* Be under the care of a health-care provider if they have chronic conditions or symptoms. People with chronic conditions and symptoms should consult their health-care provider about the types and amounts of activity appropriate for them.

Key Guidelines for Women During Pregnancy and the Postpartum Period

* Healthy women who are not already highly active or doing vigorous-intensity activity should get at least 150 minutes of moderate-intensity aerobic activity a week during pregnancy and the postpartum period. Preferably, this activity should be spread throughout the week.
* Pregnant women who habitually engage in vigorous-intensity aerobic activity or who are highly active can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health-care provider how and when activity should be adjusted over time.

Key Guidelines for Adults With Disabilities

* Adults with disabilities, who are able to, should get at least 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
* Adults with disabilities, who are able to, should also do muscle-strengthening activities of moderate or high intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.
* When adults with disabilities are not able to meet the Guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity.
* Adults with disabilities should consult their health-care provider about the amounts and types of physical activity that are appropriate for their abilities.

Key Messages for People With Chronic Medical Conditions

* Adults with chronic conditions obtain important health benefits from regular physical activity.
* When adults with chronic conditions do activity according to their abilities, physical activity is safe.
* Adults with chronic conditions should be under the care of a health-care provider. People with chronic conditions and symptoms should consult their health-care provider about the types and amounts of activity appropriate for them.

whats ur opinion?

2008-10-08T09:37:00.000-07:00

whats ur opinion on second presidential debate ?

Health Costs Senator Obama said health costs were breaking family budgets. “If you’ve got health insurance,” he said, “most of you have seen your premiums double over the last eight years, and your co-payments and deductibles have gone up 30 percent just in the last year alone. And if you’re a small business, it’s a crushing burden.”

Mr. Obama was generally correct in what he said about premiums. Premiums doubled from 1999 to 2007, according to annual surveys conducted jointly by the Kaiser Family Foundation and the Health Research and Educational Trust. The latest report, issued two weeks ago, shows that the average annual premium for employer-sponsored insurance rose 90 percent from 2000 to 2008 for individual coverage, to $4,704 this year, while the average premium for family coverage increased 97 percent, to $12,680.

Deductibles increased significantly last year, but they vary greatly among plans, and Mr. Obama may have overstated the typical increase.

For workers in preferred-provider organizations with deductibles, the average annual deductible for family coverage increased to $1,344 in 2008, from $1,040 in 2007, according to the Kaiser survey. On the other hand, more workers are choosing high-deductible policies, often in combination with savings accounts, and the average deductible for family coverage in these plans was much higher - - about $3,500 this year, as in 2007, according to the Kaiser survey.

Health Care Plans Both candidates mischaracterized elements of their opponent’s health care proposals and may have oversold their own.

Mr. McCain, in arguing that Mr. Obama favors government solutions to the plight of the uninsured, charged that Mr. Obama would “impose mandates” on small businesses to provide coverage for employees and on parents to insure their children. As Mr. Obama pointed out in response, Mr. McCain was only half right.

“If you’re a small businessperson and you don’t insure your employees, Senator Obama will fine you,” Mr. McCain said. “He’ll fine you. That’s remarkable. If you’re a parent and you’re struggling to get health insurance for your children, Senator Obama will fine you.”

Mr. Obama would, in fact, require medium and large employers to either provide coverage to their workers or pay a tax into a fund that would help subsidize coverage for low-income people. But his plan specifically exempts small businesses from the requirement. In fact, Mr. Obama proposes to offer a substantial tax credit to small businesses to encourage them to provide insurance.

Mr. Obama has not said how small a firm would have to be in order to qualify for the exemption, nor has he quantified the size of the penalty.

Mr. Obama has, however, said he would require parents to insure their children. He has not specified a penalty for those who do not. Though Mr. McCain asserted that “every parent I know would acquire health insurance for their children if they could,” studies have shown that more than 1 million low-income children who are eligible for inexpensive government insurance plans remain uninsured.

Mr. Obama was correct that Mr. McCain voted against increasing funding for one of those plans, the Children’s Health Insurance Program. He did so twice last year.

Mr. Obama, meanwhile, charged that Mr. McCain would “strip away the ability of states to provide some of the regulations on insurance companies to make sure you’re not excluded for preexisting conditions or your mammograms are covered or your maternity is covered.”

Mr. McCain has not specifically proposed deregulating the insurance industry by removing coverage requirements. But some economists argue that could be the effect of his plan to allow the sale of insurance policies across state lines. Because some states require insurers to cover more conditions and procedures than others, Mr. Obama contends that insurers would flock to states that impose the least burdensome regulations.

Mr. Obama also repeated his oft-stated assertion that his plan will save the average family $2,500 a year in premium costs. Many health economists question whether he can save that kind of money in a single term, as Mr. Obama promises.

Mr. McCain said that his plan – which would end the exclusion of employer-sponsored health benefits from income taxes and instead give families a $5,000 tax credit – would leave 95 percent of Americans with a net gain. That, too, is in dispute, as the McCain campaign has based its calculation on the average cost of a family health insurance policy. Furthermore, because Mr. McCain’s tax credits would likely not keep up with inflation, many economists believe that more and more consumers will suffer a net loss as time passes.

Getting Bin Laden | 10:26 p.m. When Senator Obama was asked whether he would violate Pakistan’s sovereignty and go over the Pakistan border to pursue the militants who are attacking American forces in Afghanistan he narrowed the question — saying he would go into Pakistan if he had information about the whereabouts of Osama bin Laden. That, of course, has been the Bush administration’s policy since just days after the Sept. 11, 2001 attacks.

The question he sidestepped is more difficult: Whether he would go after the forces attacking Americans — a mix of Taliban, of tribal militants and distant associates of Al Qaeda. That is a far more difficult question than going after Al Qaeda. In July, President Bush reversed himself on this question and issued classified orders permitting American special forces to do just that. Neither Senator Obama nor Senator McCain referred to that decision, or said whether they would continue the policy Mr. Bush adopted over the summer.

Senator McCain talked about cooperating with the Pakistanis, suggesting that it was their responsibility to take action in the Federally Administered Tribal Areas and North and South Waziristan, the safe haven for the militants. But he also, on two occasions, referred to his hero Teddy Roosevelt, citing his famous statement about the need to “speak softly and carry a big stick” — Roosevelt actually said “walk softly and carry a big stick.”

Mr. McCain chastised Senator Obama for speaking too loudly, and the Arizona senator seemed to suggest that if he goes into Pakistan, he will do it quietly and covertly. In the end he never quite said whether he would respect Pakistan’s sovereignty.

Raising Taxes Again the candidates subjected taxes to multiple exaggerations and misstatements. Mr. Obama said he is proposing a tax cut for “95 percent of Americans.” But the Tax Policy Center, a non-partisan organization, did some sophisticated modeling of both candidates’ tax proposals and concluded actually only 81 percent of tax filers would get a tax cut under Mr. Obama’s plan. Some would see their taxes go unchanged. Many at the upper end of the income scale would see tax increases.

As for Mr. McCain, he repeated again his misleading attack that “Senator Obama has voted 94 times to either increase your taxes or against tax cuts.” This comes from a tally that has been pushed by both the campaign and the Republican National Committee, but Factcheck.org, a non-partisan group, conducted an analysis and found most of the votes were actually on non-binding budget measures or motions. Others would have actually increased taxes but only on those making more than $1 million a year. A handful would have actually lowered taxes for most but increased them for some corporations or wealthy individuals.

Humanitarian Intervention On the subject of humanitarian intervention to prevent genocide, Mr. Obama made some assertions about policy and history that at best are fuzzy and which many historians would probably question.

“If we could have intervened effectively in the Holocaust, who among us would say that we had a moral obligation not to go in?” he asked. “If we could have stopped Rwanda, surely if we had the ability that would be something that we would have to strongly consider and act.”

But according to Bill Clinton, who was president at the time of the Rwanda genocide, the question was not one of “ability” so much as political will. In two visits to Rwanda, the last in 2005, he has apologized for not having taken steps to use American power to prevent the slaughter that took place in 1994, killing hundreds of thousands of people in a three month period.

“I was the government of the United States in 1994″ and did not act, Mr. Clinton said during a visit to a museum in the Rwandan capital in July 2005. “”I express regret for my personal failure,” he added.

The reasons for that failure are complicated and still being debated. But one factor was clearly a desire to avoid a repetition of what had happened in nearby Somalia in 1993, where a humanitarian intervention by American troops led to the political disaster depicted in the film “Black Hawk Down.”

Last December, campaigning for his wife in Iowa, Mr. Clinton went so far as to say that she had urged him to use American power to prevent the Rwandan genocide. Had he heeded her advice, he acknowledged, history might have changed.

“I believe that if I had moved, we might have saved at least a third of those lives,” he said. “I think she clearly would have done that.”

On the Holocaust, the historical record is even more complicated. But in July 1943, Roosevelt was told of the Nazis’ systematic mass slaughter of Jews by Jan Karski, a courier for the Polish underground who had been smuggled into both the Warsaw Ghetto and a concentration camp in order to document what was going on.

Some historians and Jewish scholars argue that the United States and Great Britain could in fact have “intervened effectively” to stop or at least slow down the Holocaust by bombing rail and other links and supporting efforts to resettle refugees. But that would have required diverting resources, they argue, that both countries felt were better employed in the war effort.

Small Businesses and Taxes | 10:19 p.m. Mr. McCain said, “Senator Obama’s secret that you don’t know is that his tax increases will increase taxes on 50 percent of small business revenue. Small businesses across America will have to cut jobs and will have their taxes increase and won’t be able to hire because of Senator Obama’s tax policies.”

The Republican nominee’s claim is based on Mr. Obama’s proposal to let the 2001 and 2003 Bush tax cuts expire on schedule after 2010 for couples with more than $250,000 income a year or individuals making more than $200,000. Many small businesses pay income taxes as individuals rather than as corporations. But as Mr. Obama stated, a small percentage of small business owners have taxable income above the cut-off.

Factcheck.org cited a projection by the nonpartisan Tax Policy Center, a joint project of the Brookings Institution and Urban Institute think tanks, that 663,608 taxpayers with business income would fall into the top two tax brackets in 2009. Not all of these, however, would be considered “small business owners;” some are individuals who get income from real-estate partnerships or other investment arrangements.

Nuclear Power | 10:14 p.m. Senator John McCain said of global warming, “The best way of fixing it? Nuclear power.”

He’s right that, once built, a nuclear power plant emits no carbon dioxide, the main human-generated greenhouse gas linked to recent warming of the global climate.

But many energy experts have run the numbers on just how many nuclear power plants would have to be constructed between now and 2050 just to avert even a tenth or so of the projected increase in emissions of carbon dioxide coming from expanding use of coal in that span.

According to analysis by Professors Stephen Pacala and Robert Socolow of Princeton University, the world, in the end, would need to build about 880 nuclear plants – twice the number operating worldwide today – by 2050 just to avoid that small fraction of projected emissions.

So nuclear power, even in a best case, is only likely to be a small fraction of the long-term effort to curb emissions of carbon dioxide.

Debt and Deficits | 10:10 p.m. Senator Obama said: “When George Bush came into office, we had surpluses. And now we have a half-a-trillion-dollar deficit annually. When George Bush came into office, our debt, national debt, was around 5 trillion. It’s now over $10 trillion. We’ve almost doubled it.”

The figures are not precisely right, but the point is valid.

When President Bush took office, the federal budget had a surplus ($128 billion in 2001). The latest estimate from the Congressional Budget Office is that there was a $438 billion deficit in the fiscal year that ended last month.

In speaking of the debt, Senator Obama was probably referring to the federal debt limit, set by Congress. Economists prefer to use a different measure - - federal debt held by the public, which rose from $3.3 trillion in 2001 to more than $5.4 trillion this year, and is expected to rise higher because of the current economic slump and recent federal efforts to bail out financial institutions.

On a related issue, Senator Obama was roughly correct in saying that earmarks account for $18 billion of the budget. That is less than 1 percent of federal spending, which exceeded $2.7 trillion in the fiscal year just ended. But Mr. McCain and other Republicans contend that earmarks are a kind of “gateway drug” that leads to excessive spending.

Earmarks | 10 p.m. As in the last debate, Mr. McCain continued to hit Mr. Obama on the issue of earmarks. “He voted for nearly $1 billion in pork barrel earmark projects,” Mr. McCain said. “Including, by the way, $3 million for an overhead projector at a planetarium in Chicago, Illinois.”

Mr. McCain was referring to an earmark in 2007 that Mr. Obama disclosed in a news release.

Among the requested earmarks Mr. Obama listed for fiscal year 2008: “Adler Planetarium, to support replacement of its projector and related equipment, $3,000,000.”

“One of its most popular attractions and teaching tools at the Adler Planetarium is the Sky Theater,” the statement continued. “The projection equipment in this theater is 40 years old, and is no longer supported with parts or service by the manufacturer. It has begun to fail, leaving the theater dark and groups of school students and other interested museum-goers without this very valuable and exciting learning experience.”

The Adler, founded in 1930, was the first planetarium in the Western hemisphere. On its Web site, it is described as “a recognized leader in science education, with a focus on inspiring young people, particularly women and minorities, to pursue careers in science.”

According to an article in The Chicago Tribune in October, it would only be the second time the projector is replaced since the Adler opened in 1930.

“The Zeiss optical projector in Adler Planetarium and Astronomy Museum’s Sky Theater has been showing the night sky and celestial objects on the theater dome’s inner surface since 1970,” the article said.

The project has already received a $500,000 grant from the Polk Bros. foundation.

Oil Dependence | 9:58 p.m. Senator Obama said, “Our goal should be, in 10 years’ time, we are free of dependence on Middle Eastern oil, and we can do it.” And Senator McCain said that America should drill offshore because that would lower the price of oil. “It will reduce the price of a barrel of oil, because when people know there’s a greater supply, then the cost of that will go down,” he said.

But both statements ignore the fact that oil is traded in a global market. If the United States imports no Middle Eastern oil but supply form that region is interrupted, the global shortage will affect the United States as well, according to oil market experts. And the oil that could be produced from offshore areas would have an effect, but would be a small increment to the global market and thus its price impact would be small.

Fannie and Freddie | 9:35 p.m. On the role of Fannie Mae and Freddie Mac in starting the crisis that has engulfed the American economy, Mr. McCain said “with the encouragement of Senator Obama and his cronies and friends,” Congress failed to pass legislation that could have reined in lending abuses at the two government-chartered companies. He also said that “some of us stood up two years ago” to try to stop the irregularities.

Economists say that the causes of the crisis are many and are certainly not limited to loan practices at Fannie Mae and Freddie Mac. But even beyond that, Mr. McCain’s statements oversimplify the situation in Congress and mischaracterize the role played by Mr. Obama, who had just entered the Senate.

Mr. McCain was referring to the Federal Housing Enterprise Regulatory Reform Act, which Democrats did oppose when it was introduced in 2005. But the White House also opposed the legislation, arguing that “it fails to include key elements that are essential to protect the safety and soundness of the housing finance system and the broader financial system at large” and complaining that it would set up a system that “is considerably weaker than that which governs other large, complex financial institutions.”

At the time, Republicans controlled the Senate, not Democrats. At least in part because of the Bush Administration’s complaints that the bill was too weak, it never came to a vote in the Senate. As a result, Mr. Obama never had an opportunity to vote against the proposal. So it is an exaggeration to shift blame for the bill’s failure exclusively to him and other Democrats.

Mr. McCain also overstated his own role in efforts to rein in the two federally-chartered companies. The bill was introduced in January 2005 by Senator Chuck Hagel of Nebraska and two co-sponsors. Mr. McCain signed on May 2006, after a fusillade of criticism directed at the two entities in an official report, and was not one of its original sponsors.

Mr. McCain was correct, however, in saying that Mr. Obama “was the second highest recipient of Fannie Mae and Freddie Mac money in history.” According to calculations by the Center for Responsive Politics, a monitoring group, Mr. Obama has received $126,349 in campaign contributions from political action committees and individuals associated with the two companies, second only to Senator Christopher Dodd.

But Mr. McCain neglected to say that some of his closest advisers and campaign staff members have also benefited from the largesse of Fannie Mae and Freddie Mac. Over a five year period, for example, campaign manager Rick Davis was paid nearly $2 million by the mortgage giants to help defend them against stricter regulations.

Most Liberal | 9:15 p.m.Senator John McCain suggested that Senator Barack Obama had the “most liberal big spending record in the United States Senate.” A moment later, Mr. McCain said that his Democratic rival has proposed “$860 billion in new spending.”

This is the same assertion that Mr. McCain has been making in recent weeks on the campaign trail. Where does he get that figure? The McCain campaign said it is based on adding up all of the programs that Mr. Obama has proposed, more than 40 initiatives throughout the course of the campaign.

But it does not factor in any of the money that an Obama administration would save through cutbacks in other programs.

Late last month, the nonpartisan Committee for a Responsible Federal Budget has called Mr. McCain’s $860 billion assertion “a misleading figure taken out of context.”

Senator McCain suggested that voters “go to some of these organizations that are the watchdogs of what we do, like the Citizens Against Government Waste or the National Taxpayers Union” and look at Senator Obama’s record. “And you know what you’ll find? This is the most liberal, big-spending record in the United States Senate.”

It’s certainly true that Mr. Obama is not rated favorably by either group, but neither one ranks him as its “most liberal” spender in the Senate. The National Taxpayers Union gave Mr. Obama an “F” grade for each of his first three years in the Senate, but also ranked four senators lower than him in 2005, 31 lower than him in 2006 and 12 lower than him in 2007.

Citizens Against Government Waste concluded that Mr. Obama voted right just 10 percent of the time in 2007 and 18 percent of the time during his entire Senate career. But it concluded that there were 47 senators who were even worse by its standards last year (including Mr. McCain’s close friend and ally, Joseph I. Lieberman of Connecticut) and 30 who have been worse over their Senate careers plus four others tied with Mr. Obama.

Every sunrise is a "BEAUTIFUL MESSAGE FROM GOD"

2008-10-05T20:08:00.001-07:00

Funny quotes

2008-10-05T20:07:00.001-07:00

Beautiful message of the week

2008-10-05T19:44:00.000-07:00

To realize
The value of a sister
Ask someone
Who doesn't have one.

To realize
The value of ten years:
Ask a newly
Divorced couple.

To realize
The value of four years:
Ask a graduate.

To realize
The value of one year:
Ask a student who
Has failed a final exam.

To realize
The value of nine months:
Ask a mother who gave birth to a still born.

To realize
The value of one month:
Ask a mother
who has given birth to
A premature baby.

To realize
The value of one week:
Ask an editor of a weekly newspaper.

To realize
The value of one hour:
Ask the lovers who are waiting to Meet.

To realize
The value of one minute:
Ask a person
Who has missed the train, bus or plane.

To realize
The value of one-second:
Ask a person
Who has survived an accident...

To! realize
The value of one millisecond:
Ask the person who has won a silver medal in the Olympics

Time waits for no one.

Treasure every moment you have.
You will treasure it even more when

you can share it with someone special.

To realize the value of a friend:
Lose one.

Nice weekend!!!

regards
nagu

LRRK2 gene in Sergey brin

2008-10-03T08:10:00.000-07:00

This post was recently posted by sergey brin the google founder in his blogspot, u can visit that here http://too.blogspot.com ,he said that he is affected with parkinsons gene in him. so thought it will be useful for everyone to know about this disease and its gene. Its on rise in usa now....Hoping that he gets away with that gene in him.....

For more than 20 years, my mother has worked with computers at NASA. So, when she developed a pain in her hands the diagnosis seemed easy -- Repetitive Stress Injury. Except that it wasn't so easy. As her mysterious symptoms progressed it varied -- RSI, fibromyalgia (unexplained pain), Lyme Disease, and so forth. It was only after visits to many specialists over a number of years that the diagnosis settled -- Parkinson's Disease. Since there is no clear test for Parkinson's -- it is defined by its symptoms -- we only grew certain as those symptoms developed and as her medications began to alleviate them.

My mother had always been haunted by Parkinson's because her aunt had suffered from it. I had often reasoned with her that since Parkinson's is not hereditary (there is not a strong correlation of Parkinson's incidence among close relatives), she had little to fear.

In 2004, my wife, Anne, introduced me to her future cofounders in 23andMe as they were studying the genetics of Parkinson's Disease. As with my mother's fear, I was skeptical about the study. I reasoned that if there was much to be learned about Parkinson's in the genome, there would have to be a high percentage of inherited cases. In fact, I appeared to be right in that this particular study did not bear immediate fruit.

Nonetheless, there are some cases of familial Parkinson's but they are quite rare. Over the past few years researchers have been honing in on the genes that are responsible for those cases. One gene that stands out in those studies is LRRK2. There is one particular mutation of the LRRK2 gene -- known as G2019S -- that, while rare even among people with the disease, accounts, in some ethnic groups, for a substantial proportion of familial Parkinson's.

As a customer of 23andMe, I have always been excited about the product. I have found what pieces of DNA I share with various relatives. I checked whether other Brins were related. I explored my various gene journals -- learning, for instance, that I have one copy of the fast twitch muscle fiber. I also looked over the health related entries and found that my genetic risk for most diseases is modestly lower than average but for a few diseases it is modestly higher.

Because there are only a small number of genes which are known to have a very substantial effect on health (e.g. 10 times the average risk), I felt the possibility of discovering something very important to my health was just a hypothetical exercise. So, when my wife asked me to look up G2019S in my raw data (23andMe scientists had had the forethought to include it on their chip), I viewed it mostly as entertainment.

But, of course, I learned something very important to me -- I carry the G2019S mutation and when my mother checked her account, she saw she carries it too.

The exact implications of this are not entirely clear. Early studies tend to have small samples with various selection biases. Nonetheless it is clear that I have a markedly higher chance of developing Parkinson's in my lifetime than the average person. In fact, it is somewhere between 20% to 80% depending on the study and how you measure. At the same time, research into LRRK2 looks intriguing (both for LRRK2 carriers and potentially for others).

This leaves me in a rather unique position. I know early in my life something I am substantially predisposed to. I now have the opportunity to adjust my life to reduce those odds (e.g. there is evidence that exercise may be protective against Parkinson's). I also have the opportunity to perform and support research into this disease long before it may affect me. And, regardless of my own health it can help my family members as well as others.

I feel fortunate to be in this position. Until the fountain of youth is discovered, all of us will have some conditions in our old age only we don't know what they will be. I have a better guess than almost anyone else for what ills may be mine -- and I have decades to prepare for it.

For more information on Parkinson's Disease see these organizations I have supported and worked with: Michael J. Fox Foundation, The Parkinson's Institute
Posted by Sergey Brin at 12:01 PM

STEVE JOBS - INSPIRING SPEECH

2008-07-01T08:15:00.000-07:00

hi
i found this article very inspiring delivered by Steve jobs in stanford university. More importantly i liked the way he concluded his speech quoting " stay hungry and stay foolish".

You've got to find what you love,' Jobs says

This is the text of the Commencement address by Steve Jobs, CEO of Apple Computer and of Pixar Animation Studios, delivered on June 12, 2005.

I am honored to be with you today at your commencement from one of the finest universities in the world. I never graduated from college. Truth be told, this is the closest I've ever gotten to a college graduation. Today I want to tell you three stories from my life. That's it. No big deal. Just three stories.

The first story is about connecting the dots.

I dropped out of Reed College after the first 6 months, but then stayed around as a drop-in for another 18 months or so before I really quit. So why did I drop out?

It started before I was born. My biological mother was a young, unwed college graduate student, and she decided to put me up for adoption. She felt very strongly that I should be adopted by college graduates, so everything was all set for me to be adopted at birth by a lawyer and his wife. Except that when I popped out they decided at the last minute that they really wanted a girl. So my parents, who were on a waiting list, got a call in the middle of the night asking: "We have an unexpected baby boy; do you want him?" They said: "Of course." My biological mother later found out that my mother had never graduated from college and that my father had never graduated from high school. She refused to sign the final adoption papers. She only relented a few months later when my parents promised that I would someday go to college.

And 17 years later I did go to college. But I naively chose a college that was almost as expensive as Stanford, and all of my working-class parents' savings were being spent on my college tuition. After six months, I couldn't see the value in it. I had no idea what I wanted to do with my life and no idea how college was going to help me figure it out. And here I was spending all of the money my parents had saved their entire life. So I decided to drop out and trust that it would all work out OK. It was pretty scary at the time, but looking back it was one of the best decisions I ever made. The minute I dropped out I could stop taking the required classes that didn't interest me, and begin dropping in on the ones that looked interesting.

It wasn't all romantic. I didn't have a dorm room, so I slept on the floor in friends' rooms, I returned coke bottles for the 5¢ deposits to buy food with, and I would walk the 7 miles across town every Sunday night to get one good meal a week at the Hare Krishna temple. I loved it. And much of what I stumbled into by following my curiosity and intuition turned out to be priceless later on. Let me give you one example:

Reed College at that time offered perhaps the best calligraphy instruction in the country. Throughout the campus every poster, every label on every drawer, was beautifully hand calligraphed. Because I had dropped out and didn't have to take the normal classes, I decided to take a calligraphy class to learn how to do this. I learned about serif and san serif typefaces, about varying the amount of space between different letter combinations, about what makes great typography great. It was beautiful, historical, artistically subtle in a way that science can't capture, and I found it fascinating.

None of this had even a hope of any practical application in my life. But ten years later, when we were designing the first Macintosh computer, it all came back to me. And we designed it all into the Mac. It was the first computer with beautiful typography. If I had never dropped in on that single course in college, the Mac would have never had multiple typefaces or proportionally spaced fonts. And since Windows just copied the Mac, its likely that no personal computer would have them. If I had never dropped out, I would have never dropped in on this calligraphy class, and personal computers might not have the wonderful typography that they do. Of course it was impossible to connect the dots looking forward when I was in college. But it was very, very clear looking backwards ten years later.

Again, you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.

My second story is about love and loss.

I was lucky — I found what I loved to do early in life. Woz and I started Apple in my parents garage when I was 20. We worked hard, and in 10 years Apple had grown from just the two of us in a garage into a $2 billion company with over 4000 employees. We had just released our finest creation — the Macintosh — a year earlier, and I had just turned 30. And then I got fired. How can you get fired from a company you started? Well, as Apple grew we hired someone who I thought was very talented to run the company with me, and for the first year or so things went well. But then our visions of the future began to diverge and eventually we had a falling out. When we did, our Board of Directors sided with him. So at 30 I was out. And very publicly out. What had been the focus of my entire adult life was gone, and it was devastating.

I really didn't know what to do for a few months. I felt that I had let the previous generation of entrepreneurs down - that I had dropped the baton as it was being passed to me. I met with David Packard and Bob Noyce and tried to apologize for screwing up so badly. I was a very public failure, and I even thought about running away from the valley. But something slowly began to dawn on me — I still loved what I did. The turn of events at Apple had not changed that one bit. I had been rejected, but I was still in love. And so I decided to start over.

I didn't see it then, but it turned out that getting fired from Apple was the best thing that could have ever happened to me. The heaviness of being successful was replaced by the lightness of being a beginner again, less sure about everything. It freed me to enter one of the most creative periods of my life.

During the next five years, I started a company named NeXT, another company named Pixar, and fell in love with an amazing woman who would become my wife. Pixar went on to create the worlds first computer animated feature film, Toy Story, and is now the most successful animation studio in the world. In a remarkable turn of events, Apple bought NeXT, I returned to Apple, and the technology we developed at NeXT is at the heart of Apple's current renaissance. And Laurene and I have a wonderful family together.

I'm pretty sure none of this would have happened if I hadn't been fired from Apple. It was awful tasting medicine, but I guess the patient needed it. Sometimes life hits you in the head with a brick. Don't lose faith. I'm convinced that the only thing that kept me going was that I loved what I did. You've got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don't settle.

My third story is about death.

When I was 17, I read a quote that went something like: "If you live each day as if it was your last, someday you'll most certainly be right." It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: "If today were the last day of my life, would I want to do what I am about to do today?" And whenever the answer has been "No" for too many days in a row, I know I need to change something.

Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the morning, and it clearly showed a tumor on my pancreas. I didn't even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor's code for prepare to die. It means to try to tell your kids everything you thought you'd have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.

I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my pancreas and got a few cells from the tumor. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I'm fine now.

This was the closest I've been to facing death, and I hope its the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept:

No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life's change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.

Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma — which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.

When I was young, there was an amazing publication called The Whole Earth Catalog, which was one of the bibles of my generation. It was created by a fellow named Stewart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch. This was in the late 1960's, before personal computers and desktop publishing, so it was all made with typewriters, scissors, and polaroid cameras. It was sort of like Google in paperback form, 35 years before Google came along: it was idealistic, and overflowing with neat tools and great notions.

Stewart and his team put out several issues of The Whole Earth Catalog, and then when it had run its course, they put out a final issue. It was the mid-1970s, and I was your age. On the back cover of their final issue was a photograph of an early morning country road, the kind you might find yourself hitchhiking on if you were so adventurous. Beneath it were the words: "Stay Hungry. Stay Foolish." It was their farewell message as they signed off. Stay Hungry. Stay Foolish. And I have always wished that for myself. And now, as you graduate to begin anew, I wish that for you.

Stay Hungry. Stay Foolish.

ABS EXERCISES

2008-05-15T20:30:00.000-07:00

ABS EXERCISES

Traditional Crunch

Lie on your back with your knees bent and your hands behind your ears. Slowly crunch up, bringing your shoulder blades off the ground. 12 - 15 repetitions, 1 set

Bent-Leg Knee Raise

Lie on your back with your head and neck relaxed and your hands on the floor near your butt. Your feet should be flat on the floor. Use your lower abdominal muscles to raise your knees up toward your rib cage, then slowly lower your feet back to the starting position. As your feet lightly touch the floor, repeat. 12 reps, 1 set

Oblique V-Up

Lie on your side with your body in a straight line. Fold your arms across your chest. Keeping your legs together, lift them off the floor as you raise your top elbow toward your hip. The range of motion is short, but you should feel an intense contraction in your obliques. 10 reps each side, 1 set

Bridge

Start to get in a Pushup position, but bend your elbows and rest your weight on your forearms instead of your hands. Your body should form a straight line from your shoulders to your ankles. Pull your abdominals in; imagine you're trying to move your belly button back to your spine. Hold for 20 seconds, breathing steadily. As you build endurance, you can do one 60-second set. 1 - 2 reps, 1 set

Standing Crunch

Attach a rope handle to a high cable pulley. Stand with your back to the weight stack, and hold the ends of the rope behind your head. Crunch down. 12 - 15 reps, 1 set

Pulse Up

Lie with your hands underneath your tailbone and your legs raised and pointed straight up toward the ceiling, perpendicular to your torso. Pull your navel inward, and flex your glutes as you lift your hips just a few inches off the floor. Then lower your hips. 12 reps, 1 set

Saxon Side Bend

Hold a pair of lightweight dumbbells over your head, in line with your shoulders, with your elbows slightly bent. Keep your back straight, and slowly bend directly to your left side as far as possible without twisting your upper body. Pause, return to an upright position, then bend to your right side as far as possible. 6 - 10 reps on each side, no rest between sets

Side Bridge

Lie on your nondominant side. Support your weight with that forearm and the outside edge of that foot. Your body should form a straight line from head to ankles. Pull your abs in as far as you can, and hold this position for 10 to 30 seconds, breathing steadily. Relax. If you can do 30 seconds, do one repetition. If not, try for any combination of reps that gets you up to 30 seconds. Repeat on your other side.
1–2 repetitions on each side

Back Extension

Position yourself in a back extension station, and hook your feet under the leg anchor. Hold your arms straight out in front of you. Your body should form a straight line from your hands to your hips. Lower your torso, allowing your lower back to round, until it's just short of perpendicular to the floor. Raise your upper body until it's slightly above parallel to the floor. At this point, you should have a slight arch in your back, and your shoulder blades should be pulled together. Pause for a second, then repeat. 12 - 15 reps, 1 set

CORE EXERCISES
Squat

Hold a barbell with an overhand grip so that it rests comfortably on your upper back. Set your feet shoulder-width apart, and keep your knees slightly bent, back straight, and eyes focused straight ahead. Slowly lower your body as if you were sitting back into a chair, keeping your back in its natural alignment and your lower legs nearly perpendicular to the floor. When your thighs are parallel to the floor, pause, then return to the starting position.

Home variation:

Same, but with one dumbbell in each hand, your palms facing your outer thighs. 10 - 12 reps

Bench Press

Lie on your back on a flat bench with your feet on the floor. Grab the barbell with an overhand grip, your hands just beyond shoulder-width apart. Lift the bar off the uprights, and hold it at arm's length over your chest. Slowly lower the bar to your chest. Pause, then push the bar back to the starting position.

Home variation:

Just do standard pushups: Get in a Pushup position with your hands about shoulder-width apart. Bend at the elbows while keeping your back straight, until your chin almost touches the floor, then push back up. 10 reps

Pulldown

Stand facing a lat pulldown machine. Reach up and grasp the bar with an overhand grip that's 4 to 6 inches wider than your shoulders. Sit on the seat, letting the resistance of the bar extend your arms above your head. When you're in position, pull the bar down until it touches your upper chest. Hold this position for a second, then return to the starting position.

Home variation:

Bent-Over Row: Stand with your knees slightly bent and shoulder-width apart. Bend over so that your back is almost parallel to the floor. Holding a dumbbell in each hand, let your arms hang toward the floor. With your palms facing in, pull the dumbbells toward you until they touch the outside of your chest. Pause, then return to the starting position. 10 reps

Military Press

Sitting on an exercise bench, hold a barbell at shoulder height with your hands shoulder-width apart. Press the weight straight overhead so that your arms are almost fully extended, hold for a count of one, then bring it down to the front of your shoulders. Repeat.

Home variation:
Sitting on a sturdy chair instead of a bench, hold one dumbbell in each hand, about level with your ears. Push the dumbbells straight overhead so that your arms are almost fully extended, hold for a count of one, then return to the starting position. Repeat. 10 reps

Upright Row

Grab a barbell with an overhand grip, and stand with your feet shoulder-width apart and your knees slightly bent. Let the barbell hang at arm's length on top of your thighs, thumbs pointed toward each other. Bending your elbows, lift your upper arms straight out to the sides, and pull the barbell straight up until your upper arms are parallel to the floor and the bar is just below chin level. Pause, then return to the starting position.

Home variation:

Same, using one dumbbell in each hand. 10 reps

Abs Diet Weekly Workout Schedule

2008-05-15T20:27:00.000-07:00

Abs Diet Weekly Workout Schedule

When you construct your schedule, make sure to: Leave at least 48 hours between weight workouts of the same body parts. Your muscles need time to recover and repair themselves after a workout. Take 1 day each week to rest with no formal exercise. Warm up for 5 minutes before starting to exercise, either through a light jog, riding on a stationary bike, jumping rope, or doing slow jumping jacks.
The three components of your weekly schedule
1. Strength training: Three times a week. Below are total-body workouts with one workout that puts extra emphasis on your legs.

2. Additional cardiovascular exercise: Optional, on non-strength-training days. Examples are cycling, running, swimming, walking, and using cardio machines. An interval workout is recommended for 1 day a week, and light cardiovascular exercise like walking is recommended for 2 of your 3 off days.

3. Abs exercises; Twice a week. I recommend doing them before your strength training or interval workouts.

Your Weekly Workout Schedule
Here, you're going to do circuit training to optimize your muscle-building potential. That is, you'll perform one set of an exercise and then move immediately to the next exercise, with just 30 seconds of rest. Follow the order of the exercises; that will allow you to work different body parts from set to set.
By alternating between body parts, you'll keep your body in constant work mode and be able to perform the movements back-to-back without rest. Here's why circuit training works so well: You'll save time because you'll cut the amount of rest you need when you alternate muscle groups. More important, you'll keep your heart rate elevated throughout the workout, so you'll burn even more fat while you're exercising -- whether it's in the gym or in your own living room.

In the first 2 weeks of the program, do the circuit twice. Move from exercise to exercise with no more than 30 seconds of rest in between. When you complete one circuit, rest for 1 to 2 minutes, then complete the second circuit. After the first 2 weeks, when you've become comfortable doing two complete circuits during a workout, increase your workload to three circuits per workout. In every exercise, use a weight that you can handle comfortably for the number of repetitions noted. When that becomes too easy, increase the weight on each set by 10 percent or less. Here's a sample schedule of how you might arrange your workouts.

Monday:
Total-Body Strength Training Workout with Ab Emphasis
Complete one set of each ab exercise*, then complete the rest of the circuit twice.

Exercise Repetitions Rest Sets
Traditional Crunch* 12–15 none 1
Bent-Leg Knee Raise* 12–15 none 1
Oblique V-Up* 10 each side none 1
Bridge* 1 or 2 none 1
Back Extensions* 12–15 none 1
Squat 10–12 30 seconds 2
Bench Press 10 30 seconds 2
Pulldown 10 30 seconds 2
Military Press 10 30 seconds 2
Upright Row 10 30 seconds 2
Triceps Pushdown 10–12 30 seconds 2
Leg Extension 10–12 30 seconds 2
Biceps Curl 10 30 seconds 2
Leg Curl 10–12 30 seconds 2

Tuesday (Optional):
Light Cardiovascular Exercise Such as Walking
(Try for 30 Minutes at a Brisk Pace)

Wednesday:
Total-Body Strength Training Workout with Ab Emphasis
Complete one set of each ab exercise* once, then complete rest of circuit twice.

Exercise Repetitions Rest Sets
Traditional Crunch* 12–15 none 1
Pulse Up* 12 none 1
Saxon Side Bend* 6-10 each side none 1
Side Bridge* 1 or 2 each side none 1
Back Extensions* 12–15 none 1
Squat 10–12 30 seconds 2
Bench Press 10 30 seconds 2
Pulldown 10 30 seconds 2
Military Press 10 30 seconds 2
Upright Row 10 30 seconds 2
Triceps Pushdown 10–12 30 seconds 2
Leg Extension 10–12 30 seconds 2
Biceps Curl 10 30 seconds 2
Leg Curl 10–12 30 seconds 2

Thursday (Optional):
Light Cardiovascular Exercise Such as Walking
(Try for 30–45 Minutes at a Brisk Pace)

Friday:
Total-Body Strength Training Workout, with Leg Emphasis
Repeat entire circuit twice.

Exercise Repetitions Rest Sets
Squat 10–12 30 seconds 2
Bench Press 10 30 seconds 2
Pulldown 10 30 seconds 2
Traveling Lunge 10–12 each leg 30 seconds 2
Military Press 10 30 seconds 2
Upright Row 10 30 seconds 2
Step-Up 10–12 each leg 30 seconds 2
Triceps Pushdown 10–12 30 seconds 2
Leg Extension 10–12 30 seconds 2
Biceps Curl 10 30 seconds 2
Leg Curl 10–12 30 seconds 2

Saturday (Optional):
Abs Workout Plus Interval Workout
Complete one set of each ab exercise, then choose one interval workout from our selection.

Exercise Repetitions Rest Sets
Traditional Crunch 12–15 None 1
Bent-Leg Knee Raise 12 None 1
Oblique V-Up 6–10 each side None 1
Bridge 1–2 None 1
Back Extension 12–15 None 1

Sunday: Off

ABS EXERCISES
Traditional Crunch

Lie on your back with your knees bent and your hands behind your ears. Slowly crunch up, bringing your shoulder blades off the ground. 12 - 15 repetitions, 1 set

Bent-Leg Knee Raise

Lie on your back with your head and neck relaxed and your hands on the floor near your butt. Your feet should be flat on the floor. Use your lower abdominal muscles to raise your knees up toward your rib cage, then slowly lower your feet back to the starting position. As your feet lightly touch the floor, repeat. 12 reps, 1 set

Oblique V-Up

Lie on your side with your body in a straight line. Fold your arms across your chest. Keeping your legs together, lift them off the floor as you raise your top elbow toward your hip. The range of motion is short, but you should feel an intense contraction in your obliques. 10 reps each side, 1 set

Bridge

Start to get in a Pushup position, but bend your elbows and rest your weight on your forearms instead of your hands. Your body should form a straight line from your shoulders to your ankles. Pull your abdominals in; imagine you're trying to move your belly button back to your spine. Hold for 20 seconds, breathing steadily. As you build endurance, you can do one 60-second set. 1 - 2 reps, 1 set

Standing Crunch

Attach a rope handle to a high cable pulley. Stand with your back to the weight stack, and hold the ends of the rope behind your head. Crunch down. 12 - 15 reps, 1 set

Pulse Up

Lie with your hands underneath your tailbone and your legs raised and pointed straight up toward the ceiling, perpendicular to your torso. Pull your navel inward, and flex your glutes as you lift your hips just a few inches off the floor. Then lower your hips. 12 reps, 1 set

Saxon Side Bend

Hold a pair of lightweight dumbbells over your head, in line with your shoulders, with your elbows slightly bent. Keep your back straight, and slowly bend directly to your left side as far as possible without twisting your upper body. Pause, return to an upright position, then bend to your right side as far as possible. 6 - 10 reps on each side, no rest between sets

Side Bridge

Lie on your nondominant side. Support your weight with that forearm and the outside edge of that foot. Your body should form a straight line from head to ankles. Pull your abs in as far as you can, and hold this position for 10 to 30 seconds, breathing steadily. Relax. If you can do 30 seconds, do one repetition. If not, try for any combination of reps that gets you up to 30 seconds. Repeat on your other side.
1–2 repetitions on each side

Back Extension

Position yourself in a back extension station, and hook your feet under the leg anchor. Hold your arms straight out in front of you. Your body should form a straight line from your hands to your hips. Lower your torso, allowing your lower back to round, until it's just short of perpendicular to the floor. Raise your upper body until it's slightly above parallel to the floor. At this point, you should have a slight arch in your back, and your shoulder blades should be pulled together. Pause for a second, then repeat. 12 - 15 reps, 1 set

CORE EXERCISES
Squat

Hold a barbell with an overhand grip so that it rests comfortably on your upper back. Set your feet shoulder-width apart, and keep your knees slightly bent, back straight, and eyes focused straight ahead. Slowly lower your body as if you were sitting back into a chair, keeping your back in its natural alignment and your lower legs nearly perpendicular to the floor. When your thighs are parallel to the floor, pause, then return to the starting position.

Home variation:

Same, but with one dumbbell in each hand, your palms facing your outer thighs. 10 - 12 reps

Bench Press

Lie on your back on a flat bench with your feet on the floor. Grab the barbell with an overhand grip, your hands just beyond shoulder-width apart. Lift the bar off the uprights, and hold it at arm's length over your chest. Slowly lower the bar to your chest. Pause, then push the bar back to the starting position.

Home variation:

Just do standard pushups: Get in a Pushup position with your hands about shoulder-width apart. Bend at the elbows while keeping your back straight, until your chin almost touches the floor, then push back up. 10 reps

Pulldown

Stand facing a lat pulldown machine. Reach up and grasp the bar with an overhand grip that's 4 to 6 inches wider than your shoulders. Sit on the seat, letting the resistance of the bar extend your arms above your head. When you're in position, pull the bar down until it touches your upper chest. Hold this position for a second, then return to the starting position.

Home variation:

Bent-Over Row: Stand with your knees slightly bent and shoulder-width apart. Bend over so that your back is almost parallel to the floor. Holding a dumbbell in each hand, let your arms hang toward the floor. With your palms facing in, pull the dumbbells toward you until they touch the outside of your chest. Pause, then return to the starting position. 10 reps

Military Press

Sitting on an exercise bench, hold a barbell at shoulder height with your hands shoulder-width apart. Press the weight straight overhead so that your arms are almost fully extended, hold for a count of one, then bring it down to the front of your shoulders. Repeat.

Home variation:
Sitting on a sturdy chair instead of a bench, hold one dumbbell in each hand, about level with your ears. Push the dumbbells straight overhead so that your arms are almost fully extended, hold for a count of one, then return to the starting position. Repeat. 10 reps

Upright Row

Grab a barbell with an overhand grip, and stand with your feet shoulder-width apart and your knees slightly bent. Let the barbell hang at arm's length on top of your thighs, thumbs pointed toward each other. Bending your elbows, lift your upper arms straight out to the sides, and pull the barbell straight up until your upper arms are parallel to the floor and the bar is just below chin level. Pause, then return to the starting position.

Home variation:

Same, using one dumbbell in each hand. 10 reps
Triceps Pushdown

While standing, grip a bar attached to a high pulley cable or lat machine with your hands about 6 inches apart. With your elbows tucked against your sides, bring the bar down until it is directly in front of you. With your forearms parallel to the floor (the starting position), push the bar down until your arms are extended straight down with the bar near your thighs. Don't lock your elbows. Return to the starting position.

Home variation: Triceps Kickback

Stand with your knees slightly bent and shoulder-width apart. Bend over so that your back is almost parallel to the ground. Bend your elbows to about 90-degree angles, raising them to just above the level of your back. This is the starting position. Extend your forearms backward, keeping your upper arms stationary. When they're fully extended, your arms should be parallel to the ground. Pause, then return to the starting position. 10 - 12 reps

Leg Extension

Sitting on a leg extension machine with your feet under the footpads, lean back slightly, and lift the pads with your feet until your legs are extended.

Home variation:

Squat Against the Wall. Stand with your back flat against a wall. Squat down so that your thighs are parallel to the ground. Hold that position for as long as you can. That consists of one set. Aim for 20 seconds to start, and work your way up to 45 seconds. 10 - 12 reps

Biceps Curl

Stand while holding a barbell in front of you, palms facing out, with your hands shoulder-width apart and your arms hanging in front of you. Curl the weight toward your shoulders, hold for a second, then return to the starting position.

Home variation: Same, only use a set of dumbbells instead. 10 reps

Leg Curl

Lie facedown on a leg curl machine, and hook your ankles under the padded bar. Keeping your stomach and pelvis against the bench, slowly raise your feet toward your butt, curling up the weight. Come up so that your feet nearly touch your butt, and slowly return to the starting position.

Home variation:

Lie down with your stomach on the floor. Put a light dumbbell between your feet (so that the top end of the dumbbell rests on the bottom of your feet). Squeeze your feet together, and curl them up toward your butt. 10 - 12 reps
Diet meal plan for abs

Unlike most diet plans, which are laden with complex, hard-to-follow rules and verboten foods you love but have to live without, the Abs Diet lets you eat the foods you love, keeps your cravings at bay, and helps you control stress -- all at the same time. Here's an example of how you can structure a week of eating. It's not written in stone, by any means: Mix up the meals. Substitute whenever you want. Heck, I don't care if you eat the same thing every day for a week. The purpose of this chart is simply to show you how to follow the principles of the Abs Diet. So enjoy!

(Learn more about Powerfoods and the Power 12 from the Related Articles on the right. For a complete listing of Abs Diet Recipes, click here.)

Monday
Breakfast
One tall glass (8 to 12 ounces) Abs Diet Ultimate Power Smoothie; make extra for later

Abs Diet Ultimate Power Smoothie (number of Powerfoods: 5)
1 cup 1% milk
2 tablespoons low-fat vanilla yogurt
¾ cup instant oatmeal, nuked in water
2 teaspoons peanut butter
2 teaspoons chocolate whey powder
6 ice cubes, crushed

Makes 2 8-ounce servings

Per serving: 220 calories, 12 g protein, 29 g carbohydrates, 4 g fat (1.5 g saturated), 3 g fiber, 118 mg sodium

Snack #1
2 teaspoons peanut butter, raw vegetables (as much as you want)

Lunch
Turkey or roast beef sandwich on whole-grain bread, 1 cup 1% or fat-free milk, 1 apple

Snack #2
1 ounce almonds, 1½ cups berries

Dinner
Mas Macho Meatballs (number of Powerfoods: 3)
1 pound extra-lean ground beef
½ cup crushed saltine crackers
1 large onion, diced
1 clove garlic, minced
1 tablespoon ground flaxseed or whey powder
1 jar (16 ounces) tomato sauce
4 whole-wheat hoagie rolls
½ cup reduced-fat mozzarella cheese, shredded

1. Mix the beef, crackers, onion, garlic, and flaxseed or whey powder into golf ball-size meatballs.

2. In a nonstick skillet over medium heat, cook the meatballs until browned all the way around. Drain the fat from the skillet, and add the tomato sauce.

3. While the mixture is warming, use a fork to scoop out some of the bread in the rolls to form shallow trenches. Spoon the meatballs and sauce into each trench, and sprinkle with shredded mozzarella, and top with the top half of the roll.

Makes 4 servings

Per serving: 569 calories, 38 g protein, 65 g carbohydrates, 19 g fat (6 g saturated), 10 g fiber, 1,341 mg sodium

Snack #3
8 to 12 ounces Abs Diet Ultimate Power Smoothie
Tuesday
Breakfast
Eggs Beneficial Sandwich (number of Powerfoods: 5)
1 large whole egg
3 large egg whites
1 teaspoon ground flaxseed
2 slices whole-wheat bread, toasted
1 slice Canadian bacon
1 tomato, sliced, or 1 green bell pepper, sliced
½ cup orange juice

1. Scramble the whole egg and egg whites in a bowl. Add ground flaxseed to the mixture.

2. Fry in a nonstick skillet spritzed with vegetable oil spray, and dump onto the toast.

3. Add bacon and tomatoes, peppers, or other vegetables of your choice.

Makes 1 serving

Per serving: 399 calories, 31 g protein, 46 g carbohydrates, 11 g fat (3 g saturated), 6 g fiber, 900 mg sodium

Snack #1
2 teaspoons peanut butter, 1 bowl oatmeal or high-fiber cereal

Lunch
The I-Am-Not-Eating-Salad Salad (number of Powerfoods: 4)
2 ounces grilled chicken
1 cup romaine lettuce
1 tomato, chopped
1 small green bell pepper, chopped
1 medium carrot, chopped
3 tablespoons Italian 94% fat-free Italian dressing or
1 teaspoon of olive oil
1 tablespoon grated Parmesan cheese
1 tablespoon ground flaxseed

1. Chop the chicken into small pieces.

2. Mix all the ingredients together, and store in the fridge. Eat on multigrain bread or by itself.

Makes 1 serving

Per serving: 248 calories, 16 g protein, 33 g carbohydrates, 8 g fat (2 g saturated), 10 g

Snack #2
3 slices deli turkey, 1 large orange

Dinner
Bodacious Brazilian Chicken (number of Powerfoods: 2)
1 lemon
1 lime
1 tablespoon ground flaxseed
1 can (8 ounces) tomato sauce
1 can (6 ounces) frozen orange juice concentrate
1½ cloves garlic, minced
1 teaspoon dried Italian seasoning
4 boneless, skinless chicken breast halves
1 teaspoon hot pepper salsa
½ cup chunky salsa

1. Grate the zest of the lemon and lime into a resealable bag. Squeeze the juice from both fruits into the bag, and throw out the pulp and the seeds.

2. Mix in everything else except the chicken and salsa.

3. Drop in the chicken, reseal the bag, and refrigrate for a few hours.

4. Grill the chicken, turning and basting with marinade a few times, for 10 to 15 minutes or until the center is no longer pink. Serve with salsa.

Makes 4 servings

Per serving: 205 calories, 29 g protein, 18 g carbohydrates, 2 g fat (3 g saturated), 3 g fiber, 726 mg sodium

Snack #3
1 ounce almonds, 4 ounces cantaloupe
Wednesday
Breakfast
One tall glass (8 to 12 ounces) Strawberry Field Marshall Smoothie, make extra for later

Strawberry Field Marshall Smoothie (number of Powerfoods: 5)
½ cup low-fat vanilla yogurt
1 cup 1% milk
2 teaspoons peanut butter
1 cup frozen strawberries
2 teaspoons whey powder
6 ice cubes, crushed

Makes 2 8-ounce servings

Per serving: 186 calories, 11 g protein, 26 g carbohydrates, 5 g fat (2 g saturated), 3 g fiber, 151 mg sodium

Snack #1
1 ounce almonds, 1 ounce raisins

Lunch
Guac and Roll (number of Powerfoods: 4)
1 can (6 ounces) light oil-packed tuna
2/3 cup guacamole
¼ cup chopped tomatoes
1 teaspoon lemon juice
1 tablespoon light mayonnaise
1 teaspoon ground flaxseed
2 6-inch whole-wheat hoagie rolls

1. Combine the first six ingredients in a bowl and blend thoroughly with a fork.

2. Split the rolls in half, and fill each half with ¼ cup of the mixture.

Makes 2 servings

Per serving: 606 calories, 36 g protein, 58 g carbohydrates, 28 g fat (5 g saturated), 13 g fiber, 942 mg sodium

Snack #2
1 stick string cheese, raw vegetables (as much as you want)

Dinner
Chile-Peppered Steak (number of Powerfoods: 4)
1 tablespoon olive oil
2 carrots, sliced
1 cup chopped broccoli
2 jalapeño peppers, sliced
2 cayenne peppers, sliced
12 ounces lean sirloin steak, sliced thin
¼ cup Hunan stir-fry sauce
4 cups cooked brown rice

1. Heat the oil in a nonstick skillet over high heat. Toss in the carrots and broccoli, and cook until tender.

2. Add the peppers and beef, and continue cooking until meat is done.

3. Add sauce, and serve over rice.

Makes 4 servings

Per serving: 485 calories, 32 g protein, 57 g carbohydrates, 14 g fat (3.5 g saturated), 6 g fiber, 224 mg sodium

Snack #3
8 to 12 ounces Strawberry Field Marshall Smoothie
Thursday
Breakfast
1 slice whole-grain bread with 1 tablespoon peanut butter, 1 medium orange, 1 cup All-Bran cereal with 1 cup 1% or fat-free milk, 1 cup berries

Snack #1
8 ounces low-fat yogurt, 1 can low-sodium V8 juice

Lunch
Guilt-Free BLT (number of Powerfoods: 3)
¾ tablespoon fat-free mayonnaise
1 whole-wheat tortilla
2 slices turkey bacon, cooked
2 ounces roasted turkey breast, diced
2 slices tomato
2 leaves lettuce

1. Smear the mayo on the tortilla.

2. Line the middle of the tortilla with the bacon and top with turkey breast, tomato, and lettuce.

3. Roll it tightly into a tube.

Makes 1 serving

Per serving: 206 calories, 17 g protein, 26 g carbohydrates, 7 g fat (2 g saturated), 3 g fiber, 1,270 mg sodium

Snack #2
3 slices deli roast beef, 1 large orange

Dinner
Philadelphia Fryers (number of Powerfoods: 3)
1 medium onion, sliced
1 small red bell pepper, sliced
1 small green bell pepper, sliced
2/3 cup medium or hot salsa
4 multigrain hoagie rolls
¾ pound roast beef, thinly sliced
½ cup grated reduced-fat Cheddar cheese

1. In a nonstick skillet over medium heat, cook the onion and peppers until tender. Add the salsa and heat until warm.

2. Construct the sandwiches with the buns, roast beef, onions, peppers, and cheese, then warm them in the microwave for 1 to 2 minutes on high, until the cheese starts to melt.

Makes 4 sandwiches

Per sandwich: 558 calories, 35 g protein, 40 g carbohydrates, 28 g fat (12.5 g saturated), 4 g fiber, 653 mg sodium

Snack #3
2 teaspoons peanut butter, 1 cup low-fat ice cream
Friday
Breakfast
One tall glass (8 to 12 ounces) Banana Split Smoothie; make extra for later

Banana Split Smoothie (number of Powerfoods: 3)
1 banana
½ cup low-fat vanilla yogurt
1/8 cup frozen orange juice concentrate
½ cup 1% milk
2 teaspoons whey powder
6 ice cubes, crushed

Makes 2 8-ounce servings

Per serving: 171 calories, 8 g protein, 33 g carbohydrates, 2 g fat (1 g saturated), 2 g fiber,

Snack #1
1 ounce almonds, 4 ounces cantaloupe

Lunch
Hot Tuna (number of Powerfoods: 4)
½ cup chopped celery
1 onion, chopped
½ cup shredded, reduced-fat mozzarella cheese
½ cup reduced-fat cottage cheese
1 can (6 ounces) water-packed tuna, drained and flaked
¼ cup reduced-fat mayonnaise
1 tablespoon lemon juice
3 whole-wheat English muffins, split in half

1. Preheat your oven to 350°F. In a large nonstick skillet over low heat, cook the celery and onion until softened. Add the cheeses, tuna, mayo, and lemon juice to the skillet, and cook the mixture just long enough to warm it up.

2. Spread one-sixth of the mixture on each English muffin half. Put the muffin halves on a baking sheet, and bake for 10 minutes.

Makes 2 servings

Per serving: 628 calories, 50 g protein, 54 g carbohydrates, 24 g fat (6 g saturated), 8 g fiber, 1,300 mg sodium

Snack #2
3 slices deli roast beef, 1 large orange

Dinner
Chili Con Turkey (number of Powerfoods: 4)
1 pound ground turkey
1 can (14 ounces) Mexican-style diced tomatoes
1 can (15 ounces) black beans, rinsed and drained
1 can (14 ounces) whole-kernel sweet corn, drained
1 package (1 ½ ounces) dried chili mix
1 tablespoon ground flaxseed
¼ cup water
1 cup cooked rice

1. In a large nonstick skillet over medium-high heat, brown the turkey.

2. Add everything else but the rice, and cook over low heat for 10 minutes. Serve over rice.

Makes 4 servings

Per serving: 407 calories, 30 g protein, 52 g carbohydrates, 11 g fat (3 g saturated), 9 g fiber, 1,578 mg sodium

Snack #3
8 to 12 ounces Banana Split Smoothie
Saturday
Breakfast
One tall glass (8 to 12 ounces) Halle Berries Smoothie; make extra for later

Halle Berries Smoothie (number of Powerfoods: 4)
¾ cup instant oatmeal, nuked in water or fat-free milk
¾ cup fat-free milk
¾ cup mixed frozen blueberries, strawberries, and raspberries
2 teaspoons whey powder
3 ice cubes, crushed

Makes 2 8-ounce servings

Per serving: 144 calories, 7 g protein, 27 g carbohydrates, 1 g fat (0 g saturated), 4 g fiber, 109 mg sodium

Snack #1
1 bowl high-fiber cereal, 1 cup low-fat yogurt

Lunch
Leftover Chili Con Turkey

Snack #2
2 teaspoons peanut butter, 1 or 2 slices whole-grain bread

Dinner
Cheat meal! Have whatever you've been craving this week: beer and wings, beer and pizza, beer and bratwurst -- anything you can dream of.

Snack #3
8 to 12 ounces Halle Berries Smoothi
Sunday
Breakfast
The I-Haven't-Had-My-Coffee-Yet Sandwich (number of Powerfoods: 3)
1 ½ teaspoons low-fat cream cheese
1 whole-wheat pita, halved to make 2 pockets
2 slices turkey or ham
Lettuce or green vegetable

1. Spread cream cheese in the pockets of the pita.

2. Stuff with meat and vegetables.

3. Put in mouth. Chew and swallow.

Makes 1 serving

Per serving: 225 calories, 10 g protein, 42 g carbohydrates, 3 g fat (1 g saturated), 6 g fiber, 430 mg sodium

Snack #1
2 teaspoons peanut butter, 1 can low-sodium V8 juice

Brunch (Relax -- it's Sunday)
2 scrambled eggs, 2 slices whole-grain toast, 1 banana, 1 cup 1% or fat-free milk

Snack #2
3 slices deli roast beef, 1 slice fat-free cheese

Dinner
BBQ King (number of Powerfoods: 5)
5 ounces smoked turkey kielbasa, diced
1 small onion, chopped
1 can (3 ounces) sliced mushrooms
1 clove garlic, minced
1 can (16 ounces) baked beans
1 can (8 ounces) navy beans, drained
1 can (14 ½ ounces) puréed tomatoes
¼ cup seasoned bread crumbs
¾ tablespoon ground flaxseed
¾ tablespoon olive oil

1. Preheat your oven to 350°F. Put the kielbasa in a 2-quart baking dish, and bake until browned (about 5 minutes). Drain the fat and set the dish aside.

2. In a nonstick skillet over medium-high heat, cook the onion, mushrooms, and garlic for 5 to 7 minutes. Transfer to the baking dish, then add the beans and tomatoes, plus salt and pepper to taste.

3. Bake for 20 minutes or until the edges bubble.

4. In a small bowl, mix the bread crumbs and flaxseed with the oil. Sprinkle over the sausage mixture, and broil 4 to 5 inches from the heat until the top is golden (about 3 minutes).

Makes 4 servings

Per serving: 348 calories, 20 g protein, 53 g carbohydrates, 8.5 g fat (2 g saturated), 13 g fiber, 1,463 mg sodium

Snack #3
1 ounce almonds, 1 cup low-fat ice cream

Cardio VS Weight Training,

2008-05-15T15:08:00.000-07:00

Cardio VS Weight Training

It's hard to believe that exercise, which seems to be a relatively simple topic, can cause so much debate. However, when assessing the efficacy of weight training vs. cardiovascular exercise, there are plenty of conflicting opinions on which is better — and this debate may never get resolved. Therefore, the staff at BioFit and Wellness decided to compare the benefits and risks of the two forms of exercise so you can make an educated choice as to how to approach either type of workout. (Note: For the sake of simplification, we will use the term aerobic and cardiovascular interchangeably.)

Cardiovascular Exercise
The No. 1 benefit of following an aerobic exercise plan is the change in your cardiovascular fitness that results from this kind of training regimen. Regular aerobic exercise causes your lungs to process more oxygen with less effort; your heart to pump more blood with fewer beats; and the blood supply directed to your muscles to increase. As a result, by performing cardiovascular exercises, you are increasing your body's endurance and efficiency.

Additional Benefits
In addition to the cardiovascular benefits, other benefits of aerobic exercise include:

* Weight loss.
Combined with a healthy diet and appropriate strength training, aerobic exercise will help you lose weight.
* Improved mental health.
Regular aerobic exercise releases endorphins, your body's natural painkillers. Endorphins also reduce stress, depression and anxiety.
* Improved immune system.
People who exercise regularly are less susceptible to minor viral illnesses such as colds and flu. It is possible that aerobic exercise helps activate your immune system and prepares it to fight off infection.
* Increased stamina.
Exercise may make you tired in the short term, i.e., during and right after the activity, but over the long term it will increase your stamina and reduce fatigue.
* Disease reduction.
Extra weight is a contributing factor to conditions such as heart disease, high blood pressure, stroke, diabetes and some forms of cancer. As you lose weight, your risk of developing these diseases decreases. In addition, weight-bearing aerobic exercise, such as walking, can reduce your risk of osteoporosis and its complications. Low-impact aerobic exercises, such as swimming, cycling and pool exercises, can help keep you fit if you have arthritis, without putting excessive stress on your joints.
* Increased life span.
The Harvard Alumni Health Study (1986), published in the New England Journal of Medicine, scientifically linked exercise with increased life spans for the first time. Since then, additional research has supported this finding.
* Improved muscle health.
Aerobic exercise stimulates the growth of tiny blood vessels (capillaries) in your muscles. This helps your body more efficiently deliver oxygen to your muscles and remove from them irritating metabolic waste products such as lactic acid. This can lessen your discomfort if you have chronic muscle pain or chronic low-back pain.

Common Risks Associated With Cardiovascular Exercise

Stress fractures.
Probably the most common type of injury to aerobics instructors, stress fractures are caused by poor shoe selection, hard surfaces and overuse. Women are more likely to develop stress fractures, usually in the lesser metatarsal bones, than men. When swelling and pain arise, be sure to see a podiatrist as soon as possible. X-ray evaluation and early treatment can prevent a disabling injury.

Plantar fasciitis.
More prevalently known as arch pain, plantar fasciitis is often caused by frequent stress on the plantar aspect, or bottom of the foot, in an aerobics routine. When the plantar fascia, a supportive fibrous band of tissue running from the heel to the ball of the foot, becomes inflamed, pain on the bottom of the foot results. Forefoot and rearfoot instability with excessive pronation may result in plantar fasciitis. Shoes with proper support in the arch often prevent plantar fasciitis; if not, see your podiatrist for a custom orthotic device or a recommendation for another shoe.

Dehydration.
Dehydration is a condition in which the body, or certain body tissues, suffer from lack of water. The results are discomfort and sometimes cracking of the skin unless it is protected by natural lubrication or lotions and increased susceptibility of the respiratory system to infections.

Heel spurs.
Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by a proper warm-up that includes stretching the band of tissue on the bottom of the foot.

Shin splints.
Aside from ankle sprains, shin splints are perhaps the most common injury to the lower body, as the muscles attached to the shin bone bring the foot up and down. The pain is usually associated with inflammation of the shin muscle and tendon due to stress factors. Treat shin pain with cold compresses immediately after working out to reduce swelling. Proper stretching before the workout should prevent the onset of shin splints. Strengthening the lower leg muscles also helps reduce shin splints.

Achilles tendon and calf pain.
The frequent rising on the toes that occurs during an aerobics routine often creates pain and tightness in the large muscles in the back of the legs, which can create pain and tightness in the calf and inflammation of the Achilles tendon. Again, stretching the calf muscles gently and gradually before and after the workout will ordinarily help alleviate the pain and stiffness.

What Should I Do If I Become Injured?

If you experience any of these injuries, see a physician (a podiatrist can treat most of them) who will prescribe treatments to alleviate the pain, and make recommendations to prevent recurrence of any discomfort. As foot specialists trained in all aspects of foot care, podiatrists are also qualified to perform surgery if the condition requires it.

Remember: there are good aerobics programs and bad ones. Use discretion in choosing classes to attend and/or home videos that are right for you. Always pace yourself and stop if you feel pain. Remember, foot pain is not normal so don't ignore it. Chances are a successful aerobics regimen may bring out the bodily changes you desire, both physically and mentally.

Weight Training
Improving or maintaining health should be the primary goal of any exercise program. Health not only refers to the absence of disease or illness but may include the way a person feels about their body, their confidence about participating in a variety of activities and their overall attitude toward life. For many people feeling physically fit and strong is part of being a well-rounded and confident person. Resistance training (weight training) can play an important role in the development of self-confidence and body satisfaction by increasing strength, toning muscles and increasing muscular endurance. It can also help maintain lean body mass (important for individuals attempting weight loss), decrease the risk of osteoporosis, develop coordination and balance, and prevent injuries resulting from weak muscles.

By using free weights, a person will achieve greater overall muscle mass as compared to aerobic exercise. Free weights use your natural range of motion and strengthen the stabilizer muscles. If you switch from machine weights to free weights, you will notice that your muscles will shake a lot when performing the exercises. Once you become adjusted to the feel of free weights, your stabilizer muscles will get stronger and you won't shake as much, if at all.

Performing strength training exercises with machine weights gives a person the ability to tone with the freedom of working out alone. Machine weights are nice to use when a person wants to use lighter weights and perform high numbers of repetitions. However, free weights build mass faster than machine exercises. You can only get so strong using machine weights because there is a maximum amount of weight that can be lifted. For instance, most machine exercises can only go up to roughly 200 pounds, whereas free weights can go to whatever the lifter can handle. If you can lift 500 pounds, there is no machine exercise that would be heavy enough for you.

The Advantages of Free Weights

* A wide variety of exercises can be performed.
* Results are fast and noticeable.
* The equipment is often inexpensive, and is portable.
* Free weights are suitable for all shapes and sizes.
* It creates a more natural movement compared to machines.
* Exercises that use free weights are often good for the rehabilitation of injuries.

Risks of Weight Training

* More supervision is required as the risk of injury is greater.
* Certain exercises, such as lunges or incline bench press, can be difficult to perform, .
* There is a need for lower back support, or strong back and abdominal muscles, when performing certain free weight exercises such as squats and or any standing overhead barbell presses.
* There is a lot more to remember about how to do each exercise safely and correctly.
* Free weights can seem intimidating.

The Bottom Line
The bottom line when undertaking an aerobic or a weight training exercise program is that you must be careful and responsible. Both may provide the type of vigorous workout that you require. So listen to your body and exercise your common sense as well as your muscles.

by
Jenson Varghese

Delay The Effects Of Aging - Men's Health

2008-05-15T15:04:00.000-07:00

Delay The Effects Of Aging - Men's Health

Grow, Show and Go: Your 20s
"Nature doesn't give a damn whether you live beyond the age of 25," says Leonard Hayflick, Ph.D., a professor emeritus at UCSF and
author of How and Why We Age. "Nature's only concern is that we live long enough to raise offspring to independence." That's why for
most of human history, the average life expectancy has been about 20 years. Of course, we've found ways to live longer, primarily by
eradicating diseases. But the surest way to cheat death is to stack the game early. Think of your 20s as a decade of pregame practice.
Invest a couple of hours of effort every week now, and it will save you a decades-long decline later.
Change #1 - Hormonal Chaos
Your body is pumping out tons of human growth hormone (HGH) and testosterone, which leads to a peak in muscle mass sometime
between ages 18 and 25, says Walter Thompson, Ph.D., a professor of kinesiology, health, and nutrition at Georgia State University in
Atlanta. The bad part: It's only temporary.
The Fix
Feast on the flood. By the time you're 22 or 23, HGH production begins to decrease, dropping 2 to 5 percent each decade after that,
silently stealing your strength. Build as much as you can now, and when you're 40 you can just maintain the brawn.
Change #2 - Creaky Knees
Researchers at Johns Hopkins University followed 1,321 former medical students and found that those who injured their knees as
young adults were more than twice as likely to develop arthritis as they grew older.
The Fix
Stretch your hamstrings. Lack of flexibility in the hamstrings causes many knee problems. Avoid them with this hamstring stretch: Sit
on the floor with your legs straight and spread a few feet apart. Bend your right leg and bring the foot to your left knee. Then try to
touch both hands to your left foot. Hold the stretch for 20 to 30 seconds, then switch legs. Repeat three times every day. Ease up on
the cardio. Pounding the pavement too hard, too often can wear down the cartilage in your joints. So limit your running to no more
than 4 days a week. Instead, try a sport like basketball, in which you start and stop often. It's actually better for your cartilage than the
repetitive pounding of jogging. Strength training can also strengthen cartilage, says Thompson.
Change #3 - The Fat Tide
During college, most guys eat like sumo wrestlers but burn off the extra calories playing sports, walking to class, chasing skirts, and
just being generally active. After graduation, the feast continues--but without the physical activity. "From the day of graduation, most
men start gaining weight," says Thompson. "Before long, you're sitting at your desk and you're 25 pounds overweight."
The Fix
Travel east for healthy eats. Restaurants tend to serve large portions, and the food can be high in fat. Plus, there's often a limited
choice of vegetables. "Picking the type of restaurant wisely can help," says Hope Warshaw, R.D., author of Eat Out, Eat Right.
Warshaw says that Asian cuisine--Chinese, Thai, and Vietnamese--generally includes more vegetables. Play hide-and-seek. Put the
beer and sodas in your refrigerator's vegetable drawer and leave the carrots out in plain sight so you'll remember to eat them, says
Nancy Clark, M.S., R.D., senior sports nutritionist at Boston-based Healthworks Fitness Center.
Change #4 - The Buff Factor
Looking good can help you land a better job and a better mate. In a recent study, researchers at Yale University found that a significant
bias against overweight people--stereotyping them as lazy, less valuable, and less intelligent--exists even among health professionals
whose careers emphasize obesity research. So imagine what that Fortune 500 HR specialist thinks.
The Fix
Build your show muscles. Pay particular attention to your chest, shoulders, and biceps--the muscles people are most apt to notice
first. To build maximum muscle in these areas, Tom Seabourne, Ph.D., C.S.C.S., an exercise physiologist at Northeastern Texas
Community College, designed an exclusive strength-training routine (below) for men in their 20s. It includes explosive power moves,
like the bench-press throw, that take advantage of your increased hormonal activity to develop muscle faster. Check out some of the
upper body workouts at Men' s Health Personal Trainer . The muscle you build now will help to sustain you through the decades to come.

by
matthew foreman