By Charrette, Mark N

In its 2002 National Diabetes Fact Sheet,1 the Centers for Disease Control (CDC) cited the following statistics:

* Seventeen million people - 6.2 percent of the population - have diabetes (11.1 million diagnosed, 5.9 million undiagnosed). It is forecasted that 29 million will be diagnosed with diabetes by 2050, with an additional 10 million going undiagnosed.

* The total medical cost of diabetes in the United States is $132 billion (as of 2002).

* Diabetes was the sixth leading cause of death listed on U.S. death certificates in 1999. It is believed that only approximately 35 percent to 40 percent have diabetes listed anywhere on the death certificate, and only about 10 percent to 15 percent have it listed as the underlying cause of death.

* Complications of diabetes include heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease, dental disease, complications of pregnancy, and amputations.

* More than 60 percent of nontraumatic lower-limb amputations in the U.S occur among people with diabetes.

* From 1997 to 1999, about 82,000 nontraumatic lower-limb amputations were performed each year among people with diabetes.

Chiropractic care has much to offer patients who have diabetes. Because of circulatory concerns, these patients often develop extremity problems and symptoms, most commonly of the feet.2,3 As the diabetic process continues, neuropathy can lead to sensory difficulties, which often allows poor shoe fit, excessive pressure and friction, and even injuries, to go undetected.4,6 The eventual result is skin ulcerations, infections (which do not heal readily), and ultimately amputation in some cases.7,8

When treating a diabetic patient, it is the chiropractor’s duty to evaluate the circulatory status in the extremities and to provide advice to help prevent the development of foot ulcers. In most people, the foot is seldom symptomatic. This is particularly true in the case of patients with a history or tendency to be diabetic.

Crucial Care Factors

Nutrition. Dietary modifications and vigilance with respect to food intake are required when dealing with a diabetic condition. Supplementation with vitamins, minerals and other products can be very useful, depending on each patient’s condition and food habits.

Circulation. Circulatory status must be maintained at all costs through proper nutrition, regular exercise and protection from injury. Lower-extremity exercise is critical; just regular walking can stimulate the pumping of blood and fluids through the system, and prevent pooling and stasis. Gentle massage, along with elevation of the legs and compression stockings (when necessary) are useful adjuncts.

Shoe fit. Proper shoe selection can be critical in avoiding excessive frictional stresses to sensitive foot tissues.9 The last on which the shoe is built must match the shape and length of the foot. The vamp and the heel counter need to provide support without being overly restrictive or irritating. The size and shape of the toe box are critical: Prominent seams or stitching can rub and chafe, with disastrous results. Adjustable closures, such as full laces, can adapt to the changes in foot size and shape that occur during the day, and Velcro-type tabs are very helpful for patients who have difficulty lacing and tying knots. Slip-on styles usually are not recommended for patients with diabetes, due to the lack of adjustability and the need for a tight fit.

Shock absorption. An important consideration is preventing damage to the heel pads and absorbing the stresses of walking. The diabetic foot is particularly sensitive to the three to five Gs of force it must endure with every footstep. Normal shocks and stresses can result in damage and injury to sensitive diabetic feet. The sole of the shoe (insole, midsole and outsole) must be made of materials that are comfortable, durable and shock-absorbing.

Breakdown prevention. Custommade, flexible foot orthotics are valuable and should be considered early in the treatment of a patient with diabetes. In the initial stages of the condition, an orthotic that is supportive of normal foot biomechanics is useful, as long as a special, shock-absorbing material is provided. Effective orthotics encourage efficient foot and lower-extremity biomechanics, while at the same time diffusing pressure stresses and preventing tissue breakdown. The ideal orthotic should be designed to be very comfortable and shockabsorbing, while still providing full corrective support for foot alignment and dynamics. This type of orthotic will allow your patient to continue to be active and to exercise regularly.

In the final stages of diabetic foot problems, a purely accommodative orthotic is all that can be tolerated. This type of “compromise” orthotic will absorb shock and prevent pressure sores, but it will not support the arches and biomechanics of the foot. In this case, cutouts and “divots” must be incorporated to allow the broken-down foot to function without excessive pressure on individual areas. It is much better to intervene early in this process and to prevent (or at least slow down) the development of this late stage.

Orthotics: A Valuable Support

The importance of proper shock absorption and shoe fit for the diabetic patient cannot be overstressed. Chiropractors who treat patients with diabetes must consider their need for comfortable, flexible foot orthotics that will provide support and forestall future biomechanical and tissue breakdown.

References

1. Centers for Disease Control. National Diabetes Fact Sheet, 2002.

2. Kosak GP, Hoar CS, et al. Management of Diabetic Foot Problems. Philadelphia: W.B. Saunders, 1984.

3. BiId DE, Selby JV, et al. Lower extremity amputations in people with diabetes. Epidemiology and prevention. Diabetes Care 1989;12(1):24-31.

4. Harkless LB, Dennis KJ. You see what you look for and recognize what you know. Clin Podiatr Med Surg 1987;4(2):331-339.

5. Gibbons GW, Freeman D. Vascular evaluation and treatment of the diabetic. CHn Podiatr Med Surg 1987;4(2):337-381.

6. Huntley A. The skin and diabetes mellitus (photo-essay). Dermatology Online Journal 1995;1(2). http://ma trix.ucdavis.edu/ DOJvollnum2/ diabetes/neuropathy.html, accessed May 10, 2006.

7. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes Care 1990;13(5):513-521.

8. Levin ME, O’Neal MW (eds.) The Diabetic Foot, 3rd ed. St. Louis: C.V. Mosby, 1983.

9. Dyck PJ, Thomas PK, et al. (eds.) Diabetic Neuropathy. Philadelphia: W.B. Saunders, 1987.

Mark N. Charrette, DC, a 1980 graduate of Palmer College of Chiropractic, resides in Las Vegas. For more information, including a brief biography, a printable version of this article and a link to previous articles, please visit his columnist page online: www.chiroweb.com/ columnist/charrette.

Copyright Dynamic Chiropractic Jun 20, 2006

(c) 2006 Dynamic Chiropractic. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Allan Tan

JOGGING is perhaps the most common and practical exercise that anybody can do anywhere and anytime. Statistics show that there are more people jogging or running, than there are going to aerobic classes or visiting the gym.

Do these joggers, however, know that jogging is actually a high- impact exercise which could be unhealthy for their knees?

The knee is a very complex joint. It includes the articulation between the leg and thigh (tibia and femur) and the knee cap (patella). The most common knee problems in jogging relate to what is called the patellofemoral complex, which involves the quadriceps, knee cap and patellar tendon.

What is now called patellofemoral pain syndrome (PFPS) is also known as `runner’s knee’ which, for a long time, was considered to be a breakdown of the cartilage inside the patella.

Symptoms of runner’s knee

When you feel pain around and sometimes behind the knee cap, it’s a signal you that you might be suffering from runner’s knee. As one of the most common injuries among joggers, runner’s knee most often strikes as joggers approach 40 miles per week for the first time.

Even after taking a few days off, the pain seems to come right back, sometimes even more intense, after the first few miles of the next run. The pain often is the worst when running downhill or walking down stairs and the knee is often stiff and aching after sitting down for long periods. You might hear a clicking sound when you bend or extend your knee.

To test if you have runner’s knee

The foolproof test for runner’s knee is to sit down and put your leg out on a chair so that it’s stretched out straight. Have someone squeeze your leg just above the knee while pushing on the kneecap.

He should push from the outside of the leg toward the centre. Meanwhile, tighten your thigh muscle. If this is painful, you’re suffering from runner’s knee.

Early treatments

Runner’s knee can be further aggravated by simple overuse. If you have steeply increased your mileage recently, you might consider holding back a bit.

Stop doing any activity that hurts the knee, and don’t start again until you can do them without any pain. If you really have to exercise, select other forms which will give your knees a lower impact or strain, swimming would be a better and advisable choice.

Use the R.I.C.E. formula

Rest: Avoid giving impact on the painful knee. Most people will temporarily switch to a non-weight bearing activity, such as swimming.

Ice: Apply cold packs or ice wrapped in a towel for short periods of time, several times a day.

Compression: Use an elastic bandage such as a simple knee sleeve with the kneecap cut out or knee guard that fits snugly without causing pain.

Elevation: Keep the knee raised up higher than your heart.

It is always a good idea to look after your feet and legs. If you want them to serve you longer, you need to give them ample rest and attention.

Many people do not know that foot health is as important as the health of their internal organs, and sometimes neglect such symptoms as knee or heel pains.

This could change your lifestyle if not rectified early.

(c) 2006 Malay Mail. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Alison Freehling, Daily Press, Newport News, Va.

Jun. 14–At least 25 percent of Americans suffer from back pain, according to recent national surveys. Many have strained muscles or ligaments. Others have damaged their nerves, bones or discs.

Don’t expect medicine to bail you out after you get hurt, says Daniel A. Shaye, a local chiropractor. Instead, take these steps to stay healthy:

» Lift correctly. Keep objects as close to your body as possible. Bend with your knees and lean slightly forward from the waist (if your back is very straight, your weight might shift too suddenly and strain unprepared muscles). But: Avoid twisting your body - point your feet in the direction you want to go before you lift.

» When moving a heavy object along the ground, push. Don’t pull. » Drink plenty of water. The shock-absorbing discs in your spine are made up mostly of water.

» Maintain a healthy weight. The lower back has to support much of the body’s weight.

» Stay active. Aerobic activities, strength training and balance exercises (think yoga or tai chi) all can decrease pain and strengthen muscles that support the spine.

» Always warm up before heavy exertion. Warm muscles are more flexible and less likely to tear.

» Avoid high heels. Regular use of shoes higher than an inch off the ground likely will cost you.

» Don’t slouch. Bad posture strains muscles in your lower back.

» Help children wear backpacks correctly. Look for models that have wide straps and tell kids to wear straps over both shoulders.

» If back pain lasts several days, call your doctor or a chiropractor. If the pain is severe or you also feel numbness or pain in your legs, call immediately.

Next week: Learn ways to prevent foot pain

By Alison Freehling “How to” is a weekly feature on health, nutrition and fitness. To suggest a topic, call 247-4789 or send e-mail to .

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Copyright (c) 2006, Daily Press, Newport News, Va.

Distributed by Knight Ridder/Tribune Business News.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

 

Former First Lady of the Philippines, Imelda Marcos, was passionate about them.

From winklepickers to wellies, kitten heels to killer heels, people love them.

Now their obsession with shoes is explored in an exhibition at Gateshead’s Shipley Art Gallery.

Shoes: The Agony and the Ecstasy, celebrates footwear from Roman times to the present day and includes shoes by designers such as Manolo Blahnik, Beatrix Ong and Jimmy Choo, as well as showcasing work by up and coming young designers Gil Carvalho and Ellen Sampson.

The exhibition delves into our fixation with shoes, asking why we follow fashion, looking at the shoes of the rich and famous and displaying contemporary artworks inspired by footwear.

Loans from the collections of the V&A and Northampton Museum and Art Gallery can be seen alongside Tyne Wear Museums’ own collection.

Caroline Whitehead, exhibition curator, said: “Shoes are so much more than just what we wear on our feet. We wanted to look into why they are so significant to so many people and also look at some of the more extreme examples of footwear.”

Famed for travelling the world to buy shoes when millions of Filipinos were in poverty, Marcos is probably the best known shoe collector. Hundreds of pairs were found in the presidential palace when she and President Ferdinand Marcos fled when their regime was toppled in 1986.

The show runs until September 3. Free entry.

(c) 2006 Evening Chronicle - Newcastle-upon-Tyne. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Joe Kovac Jr., The Macon Telegraph, Ga.

Jun. 27–The anti-sandal that is the flip-flop is as much a symbol of summer as it is a sound. Especially when one accessorizes with pools, oceans or sprinkler puddles by doing little more than stepping into said bodies of water.

Wet flip-flops not only say summer, they more or less squirt it: thwip-SQUINCH, thwip-SQUINCH.

No matter that the sound is a distant runner-up to, say, the corked thwack of a baseball rocketing off a bat or the muffled fwopp of a baseball popping a glove. A flip-flop can still be a joy of summer. After all, didn’t beach-bum ambassador Jimmy Buffett himself immortalize thonged footwear in the song “Margaritaville”? I blew out my flip-flop / stepped on a pop-top / cut my heel had to cruise on back home.

OK, so flip-flops are prone to blowouts. Still, for the life of us we can’t recall a flip-flop wardrobe malfunction that could not be remedied temporarily by a.) squeezing our toes together, or b.) lashing the soles with duct tape.

Wet or dry, though, flip-flops are the way generations of young people have stepped into summer — not to mention their dormitory showers. Or even the White House.

Last year, members of a women’s college lacrosse team wore flip-flops to meet the president. Etiquette sticklers blasted the team for its toes-exposed transgression, and the flap made flip-flop fashion a news item for days.

A guest on MSNBC’s “Countdown,” irreverent TV personality Mo Rocca, said at the time that the lacrosse players “clearly were making a statement. What they were saying is, ‘Hello, Mr. President, we know that the White House has a pool. Hello! Where is it? And bring us some frothy drinks and beach towels while you’re at it, pool boy.”

A few years back, the Albuquerque Journal noted that “flip-flops have long been the official footwear of the disaffected. … Wearing them says you are more concerned with feeling good than looking good.”

And though wearing old-school flip-flops is pretty much the functional equivalent of rubber-banding a hunk of water-slide mat to your toes, there is something about wearing what are essentially platypus snouts on your feet: folks can hear you coming.

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Copyright (c) 2006, The Macon Telegraph, Ga.

Distributed by Knight Ridder/Tribune Business News.

For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.

 

By Kathryn Wexler

Been feeling a little blah?

You must have been perusing the shoe department. These days, it can feel like making a date with a dream boy who never shows up.

Last summer, our tootsies were swaddled in brilliant hues and ferocious skins. We towered in new-again platforms. We teetered in strappy stilettos.

Out we stepped. Beautiful. Bold.

Oh, what a difference a year can make. Shoe designers seem to have found their summertime inspiration in mud. Or maybe dead leaves.

Most pervasive color? Call it tawny, bronze or cappuccino. It’s brown, people.

Most pervasive shape? Maybe the clodhopper.

There are a few bright spots on the otherwise somber landscape. But generally you’ll have to dig out last year’s lighthearted, color- blasted styles if you want your soles to match the whimsy of your mint juleps.

So here are the trends. Just don’t do anything crazy. Fall isn’t far off.

Brown, brown, brown: Natural, unadorned leather is the material of choice for many designers this season. Never mind that we’ve finally grown accustomed to explosive color, embellishments up the yin yang and lovably mixed-up melanges of prints. Swinging from one extreme to another each year is what sells shoes or we’ll just drag out last year’s pairs.

Where’s Cyndi Lauper when you need her?

Roman sandals: Get ready to feel like an extra in the HBO series Rome. Made of — you guessed it — natural, unadorned leather, these sandals partially cover the arch and have a look reminiscent of, oh, 23 B.C. Some come with heels, others come flat. A few are pinched with small studs. All lack a sense of humor.

Chunky heels: Like those extra six pounds we haven’t, um, had time to shed, heels have grown in girth since last summer. Lithe stilettos have largely gone underground. At least these thickies — unlike us — are unapologetic about their size.

Espadrille overkill: The unofficial Summer of the Espadrille was 2005. But repeats haven’t hurt “Mission: Impossible.” Oh yeah. The newness is gone, and much of the fabulousness. But they’re still as comfy as ever and look delicately right with all those summery dresses.

Ballet flats: In the event you’re suddenly called upon to pirouette. Some of these sparkle. Others pucker. The only way to deal with them effectively is to pair them with jeans, and probably skinny ones at that. If you skip the denim, just don’t go frilly on top or you’ll have as much edge as a jellybean.

Wood, rope, cork: Paper, scissors, rock. Ouch. Plenty of summer shoes are made from real wood, which can make you feel like you’re jackhammering your legs should you step onto pavement (shin splints, anyone?). Others come in faux wood and are meant to look “stacked,” like a bisected tree trunk. There are also plenty of cork heels out there and others with rope glued to their sides.

Resist the urge to buy any navy-theme sandals if the rope falls directly on your skin (rope burn, anyone?)

Orange anything: After neutral leather, orange is the color of choice. Nothing more on this point.

Platforms, wedges: Remember Kork-Ease, the original cork platform sandal introduced in the 1950s that caught fire in the 1970s? Of course you don’t. These sadly harmless shoes have been re-released. Clearly, there’s only so much you can do to hike up a heel.

(c) 2006 Buffalo News. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Associated Press

Why are so many people fat? Scientists have come up with some novel excuses, including air-conditioning, lack of sleep, fewer smokers, and more sex among obese people, which can produce chubby kids.

Twinkies aren’t the only things weighing America down, these researchers contend in a report published to day in the International Journal of Obesity.

“We are facing an epidemic with no tipping point in the near future,” said Dr. Robert Kushner, medical director of the weight management program at Northwestern Memorial Hospital in Chicago, who had no role in the report. “At this point, there are no silly ideas.”

Criticism

Comedy gag? Some critics say the authors’ “Top Ten” list of alternative explanations reads more like material for a David Letterman routine than a scientific study.

Distraction: “I’d put this in the category of ‘calorie distracters’ - ‘Let’s just do anything to get people to stop worrying about having to eat less and move more,’” said Marion Nestle, a nutrition professor at New York University and frequent food industry critic.

The study

Methods: David Allison, a University of Alabama biostatistician, invited 19 other scientists in the United States, Canada and Italy, to work on the report.

The Top 10: They looked at more than 100 studies on potential contributors to obesity besides diet and exercise, and concluded there was at least some support for 10:

Inadequate sleep. (Average sleep amounts have fallen, and many studies tie sleep deprivation to weight gain.)

Endocrine disruptors, which are substances in some foods that may alter fats in the body.

Nice temperatures. (Air-conditioning and heating limit calories burned from sweating and shivering.)

Fewer people smoking. (Less appetite supression.)

Medicines that cause weight gain.

Population changes. (More middle-agers and Hispanics, who have higher obesity rates.)

Older birth moms. (That correlates with heavier children).

Genetic influences during pregnancy.

Darwinian natural selection. (Fat people outsurvive skinny ones).

Assortative mating, or “like mating with like,” as Allison puts it. Translation: fat people procreating with others of the same body type, gradually skewing the population toward the heavy end.

Bottom line

Don’t try at home: Not that people necessarily should try to alter these factors, Allison said. For example, “we would never recommend that people start smoking to reduce their body weight.”

Disclaimer: Allison said no food or beverage makers funded any part of the report, though he does consult for such companies.

Full picture: The point is, there is more to obesity than diet and exercise, he said. “These are 10 reasonable hypotheses, and as scientists, we should be open-minded.”

(c) 2006 Commercial Appeal, The. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Hannah Davies

With celebrity mothers regaining their svelte shape within weeks of giving birth, Hannah Davies asks if it’s sensible to continue exercising while pregnant.

Famouse mums such as Liz Hurley, Kate Moss and Jordan seem to have no problem regaining their figures after giving birth.

Many celebrities attribute this to exercising not only after, but during the pregnancy.

But this is not just a fad indulged in by celebrities desperate to keep their figures.

There is growing evidence keeping active while pregnant is not just vanity but has benefits for mother and baby. Reported health benefits range from lower blood pressure to ease of birth.

Gill Smith, 44, a senior lecturer in midwifery at Northumbria University, has more than 20 years’ experience as a midwife and more than 10 as a lecturer. She says that, with a few exceptions, exercise is beneficial during this period.

“As a general rule, women should exercise during pregnancy. There is solid evidence to say it is a good thing to do to. It does not matter whether you’ve never exercised prior to pregnancy or if you’ve been pretty fit before, as exercises can be tailored to your fitness.

“The golden rule is to consult with your midwife.

“Any midwife can give advice on fitness, but you can also ask to be referred to a midwife who has particular expertise with exercise during pregnancy. There are also a number who also give fitness classes to pregnant mothers. Most areas will at least have someone who has specialist knowledge in this area.

“Aerobic exercises can be done as well as strengthening exercises and it is possible to improve your level of fitness, not just main- tain the level, as long as it is done responsibly.

“It is important to keep your midwife informed, especially as the amount you can do varies depending on how fit you are at the beginning of the pregnancy and also how advanced your pregnancy is.”

Gill says among the advantages are a reduced risk of gestational diabetes and improved circulation.

“Other benefits from exercise include being less likely to suffer from anxiety or depression and it may reduce the length of the actual labour itself and complications during it. There is generally nothing but benefit from exercise ( if it is done properly.”

Pippa Wilson, 29, is expecting her first child in three weeks. As leisure manager at Maften Hall, Northumberland, it is perhaps not surprising she is an advocate of exercising while pregnant.

A passionate swimmer as a child Pippa, originally from Castleside, County Durham, competed with Consett Swimming Club. Fitness is still important to her.

“I worked throughout university teaching swimming and as a lifeguard. I’ve always kept busy and exercise has always been a big part of my life,” she explains.

Pippa met her husband James in 2002 and they married in August last year.

“When I found out I was pregnant I was already about eight weeks gone, so I’d still been exercising in the same way as before. I spoke to my midwife and did some research on the internet to find out if I needed to stop doing things. The advice my midwife gave was as long as I was comfortable and not pushing myself too hard, then I was all right to do it because my body would tell me if I was doing too much.

” After 16 weeks, I eased off a little. I wasn’t running on the treadmill after about 12 weeks and then I stopped teaching my spinning classes [static cycling] at about six-and-a-half months.

“I think how much you do depends on how your pregnancy is going,” she says. “I’ve had a simple pregnancy. The symptoms I’ve had haven’t been too bad. I didn’t suffer from much morning sickness, I haven’t suffered with backache and I definitely feel better for doing exercise.”

Even now, she is doing mild exercise. She says: “I have definitely eased off, particularly in the last week, but I still go walking a couple of times a day and I can still walk up hills ( it just takes longer. I’m also still swimming. That’s excellent exercise if you are pregnant.

“I don’t think I’ll be going into exercises straight away after the baby is born. There will be a few weeks getting used to it, but I definitely plan to get back into an exercise routine.”

Exercising when pregnant does not have to be in the form of classes. Housework and walking are also valuable.

Gill Smith’s advice on exercising while pregnant

* Always consult your doctor or midwife first

* Work out your level of fitness and exercise accordingly

* Make sure you do not overheat.

* Do not over-exert yourself. You should be able to talk easily while exercising.

* Drink plenty of water to avoid overheating.

* Avoid all high-risk sports, anything which has the potential to cause trauma to the baby.

* Do not take part in any contact sports

* Scuba diving is a no-no

* Remember your centre of gravity has moved.

* Aqua natal classes are excellent as they put less stress on the joints and maintain a cool body temperature.

* Yoga and Pilates are great gentle exercises which strengthen the body.

* Adjust your exercise as your pregnancy becomes more advanced.

* Stay in touch with your midwife.

Benefits of exercising

* Reduced risk of high blood pressure.

* Exercise is a mood elevator.

* Can help combat post-natal depression

* Easier to lose baby weight.

* Bigger babies.

Stop exercising if:

* You feel at all faint or dizzy.

* You have become breathless

* There is vaginal discharge or bleeding.

* You feel nauseous.

* You have heart palpitations.

* There are sudden changes in your body temperature.

* Vision is blurred.

Pregnancy exercises

Dynaband shoulder retraction, 10-15reps

Demi Plie squats, 12-15reps

* Start with the feet one-and-a-half hip distance apart.

* Squat or pli, maintaining an upright posture.

* The emphasis here is to keep the knees pressed outwards so they follow the line of the feet.

* Perform these with a slow count of three in both directions, increasing to four with time.

Press ups, 12-15reps

* On all fours go through pelvic tilt to find neutral spine.

* The hands should be one-and-a-half times shoulder distance apart.

* Push the lower body to the ground and press gently up, allowing the elbows to fall out to the side.

* Maintain a neutral spine throughout, including head and neck.

Triceps press, 8-15reps

* As above, except the elbows should not fall out to the side but stay as close to the body as possible.

* This changes the emphasis of the exercise to work the triceps more instead of the pectorals.

Rest into a shell stretch position

* After the above two exercises, slide the arms further in front of you, still in contact with the floor.

* Rest the weight or sit back towards the heels.

* As the pregnancy progresses, take the knees farther apart but keep the feet together at the back. This encourages the muscles of the back to relax and allows the spine to extend while the chest comes towards the floor.

* Breathe in and out deeply for relaxation about six to 10 times.

Pelvic floor contractions x 10 reps each section and 10 together.

* Visualise the three sections of the pelvic area. Back passage/ middle passage/front passage.

Try to connect and contract each area on its own without connecting through to the other parts. So it is an isolated movement.

* This can and should be done at various speeds, both slow and fast.

* Then contract all three sections together. This should be a subtle movement, the pelvic area and hips should not move from its natural alignment so other muscle groups get involved.

* This should be performed on its own and with the abdominal hollow 2-3 sets per day.

* Exercises courtesy of Jo Lewis, a tutor for YMCA Fit and personal trainer. Her website is www.lineafitness.co.uk

(c) 2006 The Journal - Newcastle-upon-Tyne. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Delthia Ricks, Newsday, Melville, N.Y.

Jun. 27–Danish researchers in the early 1970s happened upon a conundrum that has forever changed the way scientists have understood heart function and its relationship to fish consumption.

Studying the Inuit Indians who live in the permafrost regions of North America, the Danes expected to find people encumbered by coronary artery disease due to a diet dominated by fatty fish.

To the Danes’ surprise, explained Dr. Christine Albert, director of the arrhythmia prevention center at Brigham and Women’s Hospital in Boston, they found the opposite: The Inuits were free of coronary artery disease. In time, additional studies revealed that the omega-3 fatty acids in fish also lowered inflammation, reduced clotting factors in the blood and surprisingly lowered the incidence of abnormal heart rhythms.

“That’s how the whole hypothesis got started,” Albert said of the benefits of fish oil. “Cultures like the Inuits’ ate more fish than the Danes and had a lower amount of heart disease. The same was noticed in other cultures with high fish consumption, like the Japanese.”

But new studies suggest that the omega-3 fatty acids in fish oils may not provide protection against abnormal heart rhythms, the potentially deadly activity that causes the heart to quiver chaotically, leading to sudden death.

A long series of smaller studies over the years had produced evidence demonstrating the benefits similar to those of the Inuits.

The latest research, published June 14 in the Journal of the American Medical Association, focuses on people who have an implantable cardioverter defibrillator, an ICD, who consumed fish-oil supplements.

Link to abormal heartbeats

Another study, reported during a heart specialists’ meeting in May, suggests that fish oil obtained through the diet may not provide benefits for healthy men. In this report, researchers suggested that fish oil may even lead to abnormal heart rhythms.

“Our data is observational,” Albert said, referring to the study reported at the meeting of the Heart Rhythm Society last month. “It raises hypotheses,” added Albert, a co-author, who said the investigation lays the groundwork for further research.

The analysis focused on a group of healthy American physicians who ate fish meals five or more times per week. Despite her role in the research, Albert added that people should not change their dietary practices based on the results of a single study.

Omega-3 fatty acids, key chemical components in fish oil, have long held a notable position in the battle against heart disease. For decades, experts have recommended that a sound diet include at least two fish meals per week.

Mackerel, herring, sardines, lake trout and salmon are among the fish ranking high on nutritionists’ lists. Each has an abundance of two kinds of omega-3s: eicosapentaenoic and docosahexaenoic acids.

The American Heart Association underscores that the compounds can help lower blood pressure, reduce arterial plaque - and decrease the risk of cardiac arrhythmias, the electrical miscues that can lead to sudden death.

But prevailing wisdom continues to collide with new research.

Scientists at Wageningen University in the Netherlands reported June 14 that people with ICDs experienced no protection from scary heart rhythms. Dr. Ingeborg Brouwer concluded that fish oil provided no better protection than a placebo.

Brouwer’s analysis involved 546 patients at cardiology clinics across Europe; half swallowed a 2-gram fish oil capsule daily for a year and the other half took the placebo.

The study’s aim was to determine whether fish oil supplementation could stave off ventricular arrhythmia, dangerously stray electrical activity in the heart’s lower chambers. The ventricles are key to heart function: The right ventricle pumps “blue” deoxygenated blood to the lungs; the left ventricle pumps “red” oxygenated blood to the body.

Fish oil was never considered a major source of heart rhythm protection for these patients, researchers said, but an extra measure of insurance, along with the ICD.

But the Dutch study, like one conducted by a team at the Portland Veterans Affairs Medical Center a year ago, could not find a benefit. The Oregon investigation even suggested that fish oil capsules might underlie life-threatening heart rhythms in people with ICDs.

Hopes had been high for these patients because of their greater likelihood of developing dangerous rhythms. The device is capable of sensing when the heart strays, sending an electrical signal that jolts the organ back into its rhythmic lub-dub. Vice President Dick Cheney, who has a long history of heart disease, received an ICD in 2001.

Six months into their investigation, Oregon scientists found that 36 percent of patients on a placebo experienced threatening rhythms that were zapped by their defibrillators, but 46 percent of patients taking fish oil supplements had stray rhythms controlled by the ICD.

Metabolism theory

It is possible, theorized Dr. Marie-Noelle Langan, chief of electrophysiology at Lenox Hill Hospital in Manhattan, that patients who take supplements do not metabolize fish oils efficiently.

“We shouldn’t scratch off fish oil with so few studies,” Langan said. She is embarking on her own analysis of fish oil supplements in patients with cardiac pacemakers, a heart device that differs from the ICD. Fish oils may act differently on the heart’s upper chambers than its lower ones, Langan said.

Albert, meanwhile, said it’s time to end the confusion. “There needs to be a large randomized clinical trial and an improved understanding of the basics of omega-3 fatty acids - an understanding at the level of the cell so that we know in which patients they are most useful.”

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Copyright (c) 2006, Newsday, Melville, N.Y.

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University of Minnesota researchers say they’ve determined drinking decaffeinated coffee may lower a person’s risk for type 2 diabetes.

The study shows postmenopausal women who daily consume more than six cups of coffee — particularly decaffeinated — have a 33 percent lower risk of developing type 2 diabetes than do women who do not drink coffee.

The risk reduction associated with coffee is independent of factors such as weight and physical activity, said Professor Mark Pereira, lead author of the study. There appears to be great potential for coffee to help reduce the risk of diabetes. Identifying the mechanism responsible for this should definitely be the subject of further research.

Coffee is known to contain minerals and antioxidants that may aid in carbohydrate metabolism and insulin sensitivity and possibly delay the onset of type 2 diabetes. Overall caffeine intake did not appear to be related to diabetes risk in the study, further suggesting that another ingredient was responsible for the reduction.

More than 20 million Americans have diabetes, with 6.2 million of those cases being undiagnosed.

The research is reported in the current issue of Archives of Internal Medicine.