Contamination of Herbal Products

Sere http://www.biomedcentral.com/1741-7015/11/222.

Combination abdominal muscle and inner thigh muscle exercise with block

Kneel on the floor. Place a block between your inner thighs. Place your hands on your heels. Keep your back straight. Lean back so that you feel your abdominal muscles working at a maximum to stabilize you. Hold for ten seconds or as much as you can to get a workout and not collapse. :) Repeat sets until exhausted. 

To stretch, lie on the floor and reach your arms straight over your head and your legs downward, toes pointed.


My third book, Pocket Guide to Fitness, is available on http://www.authorhouse.com and http://www.amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Another Abdominal Crunch

Place your arms over your head so that each is next to an ear. Hold your hands together over your head in a prayer gesture. Keep your back straight. Bend your knees. Rise about two inches over the floor. Do abdominal crunches either several more inches over the floor, halfway up, or bring your chest to your knees. This is the order lowest to highest intensity.  Come back to two inches over the floor. Exhale when you move up and inhale when you move to the starting position. Choose what you can do and that will give you a good workout. Do four sets of ten repetitions.

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Bosu Ball Push Up Variation

Put one hand on the floor an done at the center of a Bosu Ball. Perform four sets of ten repetitions of push-ups. Repeat after switching hands. Varying the angle of your muscles will accelerate the strength and growth of pectoral muscle fibers.

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

New Obliques Exercise

Every time you work out a muscle in a new way, you will feel a burn. You may also up the chances of increasing the amount of muscle fibers and losing weight. Yesterday in Quenia Ribieros's samba class at the Alvin Ailey School of Contemporary Dance in New York City, I remembered a wonderful obliques exercise when she used it in her warmup:

Sit on your left butt cheek. Bend your knees so that your ankles almost touch the back of your thighs. Your ribs and waist should face up. Place your hands behind your head and keep your elbows "open" as if getting ready to do a crunch. Keep your legs off the floor while keeping your back straight and pulsing (indeed as if performing a crunch) toward the ceiling. This will work your right obliques while working your lower abdominal muscles in keeping your legs off the floor. Do four sets of ten repetitions. Repeat for your left oblique muscle by twisting the other way and sitting on your right butt cheek.

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Latest Fast Food Nutrition Statistics

http://blogs.blouinnews.com/blouinbeatsciencehealth/2013/05/07/fast-food-nutrition-not-doing-so-well/

New York University Video on Genetically-Modified Food (GMO)

https://www.youtube.com/watch?v=JVD0J75SATo

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Gut Bacteria Linked to Artherosclerosis via TMAO Levels

I have posted about Dr. Hazen's carnitine study, which I was not too happy about; however, I believe the latest study, published in the New England Journal of Medicine on April 25, is worth mentioning.

Read about it in the other blog I manage:

http://blogs.blouinnews.com/blouinbeatsciencehealth/2013/04/25/gut-bacteria-linked-to-heart-disease/

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Physician Errors

A new study at the Johns Hopkins Medical Center revealed that diagnostic errors, which lead to injury as a result of delay or failure of treatment, are a greater contributor to physician error than treatment error. Their 25-year study of 350,706 paid malpractice claims, amounting to 38.8 billion dollars between 1986 and 2010, showed that diagnostic errors (missed diagnosis, wrong or delayed diagnosis), which accounted for 28.6 percent of total errors,  were more dangerous than errors in other categories.

According to lead study author Dr. David Newman-Toker, an associate professor of neurology at the Johns Hopkins University School of Medicine, “There’s more uncertainty about diagnostic errors than there are about treatment errors. It’s reasonable to say no nurse should ever administer a tenfold dose of chemotherapy or a medication to a patient allergic to that medication.  Those events are easier to keep track of and easier to measure.”

Diagnostic errors often take place when a patient is initially seen. Often, there is no individualized or hospital standardized system or recording diagnosis. If the same patient presents later with an unsolved problem, the error may be noted as a treatment error, instead of healthcare professionals noting that the right diagnosis was not made in the first place.

The study’s authors only studied errors that were found from malpractice suits, but estimated that the annual number of patients how suffer from preventable injury or death in the U.S. are between 80,000 and 160,000.

Dr. Newman-Toker suggested these solutions: Measurement and reporting of diagnostic error should be mandatory. A policy at the federal level to have hospitals report these statistics must be applied. Currently, many hospitals do not report diagnostic errors because of business and legal policies. Most importantly, physicians must more thoroughly record patient appointments. 

Recording should take place both in printed and electronic versions: Paper records may be lost or misplaced and physician writing is often notoriously illegible. Transfer to electronic records would allow the person transferring the records to make sure they are legible, would provide for an easily searchable and comparable records, and would provide a back up system to print records.

The Johns Hopkins study is the latest published study on medical error. Several studies  have shown that medical errors are a leading cause of death in the U.S. One study at Johns Hopkins University, published in 2000 in the Journal of the American Medical Association, showed that medical errors are the third leading cause of death: 2,000 deaths/year from unnecessary surgery; 7000 deaths/year from hospital medication errors; 20,000 deaths/year from other hospital errors; 80,000 deaths/year from infections in hospitals; 106,000 deaths/year from non-error, adverse effects of medications totaling 225,000 deaths per year.

Another study put medical errors at number six of causes of deaths per year in the U.S.: The Institute of Medicine’s (IOM) seminal study of preventable medical errors estimated as many as 98,000 people die every year. In November 2012, CNN medical producer John Bonifield and CNN Senior Medical Correspondent Elizabeth Cohen listed “10 shocking medical mistakes” that include lost patients with dementia, operating on the wrong body part, fake doctors, and leaving surgical equipment inside patients after an operation was complete.

Many may not believe that some of the errors would happen in the U.S., with its network of hospitals and experts, yet Stahel and colleagues from the Department of Orthopedic Surgery, at the University of Colorado School of Medicine reported that a total of 25 wrong-patient and 107 wrong-site procedures were identified during a study period of 5.5 years. Significant harm was noted in 43 events, as was one death. Causes for wrong-patient procedures were errors in diagnosis (56.0%) and errors in communication (100%), while wrong-site procedures were linked to errors in judgment (85.0%) and the lack of performing a "time-out" (72.0%). According to a 2004 Kaiser Family Foundation survey, one in three Americans say that they or a family member has experienced a medical error, and one in five say that a medical error has caused serious health problems or  even death.

As Fox News recently reported, the Accreditation Council for Graduate Medical Education (ACGME) introduced restrictions on intern work hours in 2003 and again in 2011. But even this seemingly simple change did not seem to have beneficial results: Although in a follow-up study weekly hours dropped from 67 to 64, the general sleeping hours, well-being and performance of interns did not improve.  

Dr. Sanjay Desai and colleagues from Johns Hopkins University in Baltimore assigned residents the 2003 and 2011 work shift hours. The more abbreviated 2011 work schedule actually led to a reduced quality of patient care, and did not reduce risk of depression among interns. Many interns reported that they had to accomplish the same amount of work in less hours, which led opt more errors.  Reduced hours led to an increased turnover of care, whereby one physician did not feel (or act) like they were primarily responsible for each patient.  Communication problems in reporting about the patient from one physician to another were increased during turnover. Also, fatigued second-year students often had to fill in the work, which was not much of a solution. Dr. Zachary F. Meisel from the Emergency Room Department at the Perelman School of Medicine at university of Pennsylvania suggested physician naps as one solution to decrease medial errors. He also pointed out that less hours means less training, so a balance has to be struck between too many and too few hours.

Physicians, although they may be trained by the same medical school curriculum, have their own cultural personal and patient history biases. Dr. Brian Goldman, speaking at TED, said that sometimes the most physicians can to is to try their best, be aware of their own biases that affect diagnosis and treatment, and remember any patients that were injured or died due ot medical errors.

According to a 2005 study by the Commonwealth Fund in spite of advances, such as the development of performance standards, an increase in error reporting, integration of information technology, and improved safety systems, the IOM and these recent articles show that more work needs to be done.

According to the 1999 IOM report, more than by individuals, errors are caused by “faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them”. Therefore, workplace organization management and communication systems to computer record-keeping systems must be reassessed and, where necessary, reorganized.  This may involve new practices and technology. The health care sector, according to Harvard University business professor Regina E. Herzlinger, is slow at adapting to innovation. This exits for several reasons, one of which is the different players with varying agendas. Another reason is the huge networks of fragmented care centers and systems of three or less physicians, 5,000 community hospitals and 17,000 nursing care centers.  If a patient is exposed to one of more of these centers, record-keeping and communication of records are of vital importance to prevent mistakes. Last but not least, many physicians and health care centers are committed and comfortable with the status quo.  Studies on what doesn’t work and on new systems that do work may persuade health center administrators and funders to adapt new systems that may decrease physician blunders.

According to  Dr. Herzlinger, hospitals, senior citizen centers, rehabilitation centers, pharmacies and other healthcare systems are not sufficiently linked in information sharing. It is often difficult for physicians seeing a patient for the first time to know the whole, exact patient history, medications taken, etc. that will affect diagnosis and treatment. The push for shared Electronic Health Records (EHR), for instance, is a push for health information sharing that will allow for doctors to know more details about a patient’s history. Add to this that many patients do not know or remember, especially if sick or incapacitated or if they have a language barrier, their own history, including drugs taken, very well. Another problem is that doctors are overworked.

To sum up, solutions may include:

• Government policy to regulate record-keeping;
• Physician checklists of what to ask patients and how to keep records;
• Better, standardized, record-keeping;
• Hospital recording and reporting of physician mistakes and studies into why such mistakes took place;
• A balance between the right amount of training and rest of residents, interns and physicians;
• Information sharing on patient histories and errors between hospital and other care centers for a. better case management and b. insights into why errors take place;
• Patients must be informed of the potential of hospital error and must play a bigger part of their care;
• The repealing of old laws that hinder healthcare innovations; and
• New laws to make healthcare innovation more efficient and lucrative.

This is a complicated issue involving many players. But, with human life on the line and the increasing cost of healthcare, it is an issue that cannot be ignored or put on the sidelines.

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Carnitine: Another Scapegoat?

Dr. Hazen and his colleagues at the Department of Cellular & Molecular Medicine, Cleveland Clinic linked carnitine for red meat to high levels of trimethylamine-N-oxide (TMAO) to heart disease. Days later on April 12, a review of several randomized control trials on carnitine was published in the Mayo Clinic Proceedings. Overwhelmingly, carnitine was found to ameliorate the symptoms of heart disease and peripheral artery disease, and to lead to a significant reduction ventricular arrhythmias and anginal attacks following a heart attack, compared with placebo or control.

Every muscle, including the heart, needs fat for energy and carnitine,  a quaternary ammonium, helps to shuffle fatty acids across the mitochondrial wall, thereby increasing the rate in which they are available to the skeletal or heart muscle. Carnitine thus increases endurance and energy levels for aerobic activity, which uses fat for fuel, and the rate of burning fat. Some studies have shown that carnitine can reduce symptoms of angina, heart failure and peripheral artery disease. Carnitine is present in high levels in many sports drinks, so Hazen's article is also of concern to those who consume them, whether they eat red meat or not.

In Hazen's study, chief of cellular and molecular medicine at the Cleveland Clinic’s Lerner Research Institute, Stanley Hazen, tested the carnitine and TMAO levels of 2,595 patients who were omnivores, vegans and vegetarians. In patients with high TMAO levels, the more carnitine in their blood, the more likely they were to develop cardiovascular disease, heart attacks, stroke and death. The higher TMAO levels were due to the metabolism of carnitine by certain gut bacteria. In 2011, Hazen had shown that TMAO is connected to high levels of cholesterol. Mice bred for artherosclerosis had high levels of TMAO, but not if they were cleared of gut bacteria that metabolize certain molecules to TMAO.

The study had several flaws. The authors claimed that the base levels of TMAO were higher in 30 omnivires than 23 herbivores. They assumed that red meat, more than any other type of food, and high TMAO levels are correlated; TMAO is linked to cholesterol and thus artherosclerosis. The cooking methods for the meat may have led to nitrosamines that are precursors of TMAO. The authors did not control for the effects of antibiotics in meat on the levels of certain gut bacteria that increase TMAO levels. The authors did not write about TMAO being the byproduct of carnitine if legumes or other non-meat sources of carnitine are ingested. A study could be done to find this out. The authors did not publish which gut bacteria increase levels of TMAO. Also, some gut bacteria reduce it, so the problem may be in the type of gut bacteria a person has (or the way meat is prepared or the antibiotics it contains), rather than in eating carnitine. For the animal part of the experiment, mouse and human gut bacteria are not alike.

A recent article in the New York Times highlighted the growing concern about pseudo-journals and pseudo-conferences, where scientists pay to have their studies published or to attend. Contrary to what some may believe, many scientists fall prey to the same ego concerns that, let’s say, actors may have: They want to get their name out there, win rewards – in their cases, grants, and move ahead of their colleagues.Perhaps more rigor and less sensationalism are needed in the study design of scientific articles, and more refrain is needed in declaring and supporting claims that are not sufficiently supported.

Last but not least, nothing can take the place of finding the right diet and exercise program for you. Everyone’s body is different. Balance is key in nutrition. Scapegoating or cutting out one food source is just another quick fix. Find what your body needs, get your nutrients, keep informed by reading a variety of articles about each food source, and use your body – move!

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Orthorexia

Check out my blog post from work as executive science and health editor at Blouin News on Orthorexia:

Some experts use this term to describe those obsessed with eating in a healthy manner such as avoiding fat, carbohydrates, salt and gluten too much or only eating raw or organic food, to the point it causes stress and an inadequate intake of nutrients and/or calories.

http://blogs.blouinnews.com/blouinbeatsciencehealth/2013/03/27/extreme-dieting-is-too-much-of-a-good-thing/

My book Pocket Guide to Fitness is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Oblique Exercise

Lie down on your right side. Cross your ankles. Hold your head up with your left hand. With your left hand, grab a free weight that will give you a workout and with which you can do four sets of 10 repetitions. Keep your left  arm straight while not locking your elbow. Keep the free weight two inches over your hips. Reach to your feet for at least 10 pulses. Rest a few seconds and repeat for three more repetitions. This works your left internal and external  oblique muscles. Repeat while lying down on your left side. This works your right internal and external oblique muscles.

My third book, Pocket Guide to Fitness, is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories.

Marion Nestle's take on sugar, from her blog Food Politics

Here’s another one of those occasional queries from Kerry Trueman.  This one, posted at Huffington, is about FDA regulations for labeling sugars.

Trueman: I’ve just begun to sink my teeth into Michael Moss’s extraordinary food industry exposé, Salt Sugar Fat: How the Food Giants Hooked Us, a book you’ve rightly lauded as a “breathtaking feat of reporting.” As Moss points out, the FDA is happy to give us guidelines on how much salt and fat to include in our daily diets, but–as a glance at any nutritional label shows–they’ve declined to make any recommendation at all about sugar.

Does this mean that:

(a) It’s OK to eat as much sugar as you like, or:

(b) There may be an unsafe level of sugar consumption, but the FDA just doesn’t have the resources to figure out what that level is, or:

(c) The FDA knows how much sugar we can eat without harming our health, but the food industry won’t let them tell us.

How is the average American supposed to interpret this absence of information?

Nestle: Whoa. Slow down. Let’s back up a minute. The FDA sets nutritional standards for food labels, but the Institute of Medicine (IOM) sets nutritional standards for dietary intake. To understand what’s happening with the FDA and food labels, we have to talk about what the IOM used to call the Recommended Dietary Allowances (RDAs) but now calls Dietary Reference Intakes (which, confusingly, include RDAs and other standards, such as Upper Limits).

In 2002, the IOM set standards for total carbohydrates–sugars and starches (which are converted to sugars in the body). In its review of the evidence, the IOM set the RDA for total carbohydrates at 130 grams a day (roughly 4 ounces) to meet the needs of the brain for fuel. This amount is much less than typically consumed by adults.

As for sugars, the IOM noted that the average intake of sugars among adolescent males was 143 grams per day, and that the heaviest users were consuming 208 grams per day–much more than the amount of total carbohydrate needed.

Since sugars are not required nutrients, the IOM could not set an RDA. And although it did not have enough evidence to set an Upper Limit, the IOM suggested that the maximum level of intake of added sugars (as opposed to those naturally present in foods) should be a whopping 25% or less of calories.

Americans typically consume around 20% of calories from added sugars. Taken at face value, the IOM suggestion made it sound as if current intake levels were just fine. The sugar industry happily viewed 25% as a recommendation, not a maximum.

Before the sugar industry got after them, many countries recommended an upper level of sugar intake at 10% of calories. That’s what the U.S. Pyramid did in 1992.

The sugar industry does not like the 10% recommendation. It means, for example, that just one of Mayor Bloomberg’s 16-ounce sodas takes care of recommended sugar intake for the day.

Robert Lustig, who is largely concerned about what too much fructose does to us, thinks that 50 grams of sugar (sucrose or HFCS) is a reasonable Upper Limit for most people. This would provide 25 grams of fructose, which the body can handle with relative ease. What’s interesting about his

Don't work out every day

As I have written in other posts, it is important to rest your muscles, especially major ones, for a day after you work them out. Other muscles, such as abdominal muscles, are used all of the time, so it is important to rest several days a week. Working out four days a week or every other day is ideal. Consult your personal trainer. Write a comment and I can consult you over the Internet for a fee.

It is also good mentally to give it a rest. If you love a certain food or the movies, you don't eat it or go every day. Your body's metabolism will be sped up from working out. How much partially depends on your genetics. But if you work out every day, your metabolism will plateau. Your body will get used to it. So "trick" your body and achieve better results by giving it a rest.

Here is a recent New York Times article on this topic:

http://well.blogs.nytimes.com/2013/02/13/why-four-workouts-a-week-may-be-better-than-six/?ref=health

Should you exercise if you have the cold or flu?

Here is a post from Reuters: http://blouinnews.com/node/47623

According to experts, if you have a fever or pain, take it easy, so as not to elevate your temperature. But if you have a cold or slight flu, it's okay to work out.

Using Bosu Balls for Abdominal Muscles

Place one Bosu ball with the flat surface up and another Bosu ball with the flat surface on the floor a few feet away from the first one, on a vertical line. Place your hands on the handles of the first ball and your toes on the center of the other ball. Keep your arms straight and do not lock your elbows. Do the wedge exercise in this position, keeping your back and hips on a straight line. Hold for 20 seconds. Rest for 10 seconds. Repeat until fatigue.

To make the exercise harder, raise each leg (one at a time)a few inches above your hip level and hold for 20 seconds. Repeat for the other leg. Rest for 10 seconds. Repeat until fatigue.

My third book, Pocket Guide to Fitness, is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

Body Vibration Machine

This Reuters article claims that the body vibration machine increases flexibility and speed for seniors. New York Sports Club on 76th Street and First Avenue in Manhattan ahs one. It reminds me of such machines in cartoons.

http://www.reuters.com/article/2013/01/17/us-body-vibration-elders-idUSBRE90G0Z320130117

Training Insights

Here is a New York times article that adds ot the "evidence" of how important the mind-body connection is, this time in terms of mental distinctions leading to workout shifts that make a difference in fitness and performance.

http://well.blogs.nytimes.com/2013/01/14/training-insights-from-star-athletes/?ref=health

Free Weights on a Bosu Ball

Turn a Bosu Ball "upside down" so that you stand on its flat side. Use free weights for biceps curls and other upper body exercises. You will use your abdominal, leg and glute muscles as stabilizers to balance, and so advance your workout routine.

My third book, Pocket Guide to Fitness, is available on http://www.Authorhouse.com and http://www.Amazon.com. If you look up my name on those Web sites, you will find my other books The Boy in a Wheelchair and Life, Work and Play: Poems and Short Stories. 

New Study on Belly vs Lower Body Fat

Journal of Clinical Endocrinology and Metabolism

"How belly fat differs from thigh fat -- and why it matters
Unlike men, women tend to store more fat on the hips and thighs than in the belly. A study published in the Journal of Clinical Endocrinology and Metabolism helps explain fat distribution differences by determining how belly and thigh fat differ genetically. This research might shift common thinking about fat -- rather than focusing on how to banish belly fat, perhaps we need to tip the balance in favor of heart-friendly fat in the lower body."

http://scienceblog.com/59068/how-belly-fat-differs-from-thigh-fat-and-why-it-matters/

Why?

   Happy New Year everyone! Many of you may have resolutions to get more fit or lose weight. An important question to ask is "Why?", as I was reminded by an article in Boost Your Willpower in the January 2013 issue of Yoga Journal. Yoga teacher and Stanford psychology professor Kelly McGonigal, Ph.D. said that any time you try to change something to fix it, it does not involve accepting what is true now, and does not work.

    

      As I have written in older blog posts, start with loving your body first. Your body gives you so much and allows you to do so much each day. Love and appreciate it. It's beautiful.

      Make the changes you want to make for health. See, by connecting with yourself through exercise, what weight, food, etc. feel best for you. When are you at your healthiest and most energetic? Do not do it to please others.There will always be someone to comment negatively about your fitness level or look anyway, probably projecting their feelings about their own self.

     

      Ask yourself why you want to be stronger or lose weight. The essence of this needs to revolve around a higher level of health, and, a greater quality of life or higher level of living life with vitality and ease.

      Not doing the above will result in not being happy and healthy, at least as much as you can be, and yo-yo dieting or fitness.