After the subjects had eaten the experimental diets for eight weeks, blood levels of the vitamins and homocysteine were measured again, and compared to the levels at the end of the run-in period. The results indicated that, as expected, diet could indeed alter blood levels of the B vitamins and of homocysteine. The magnitude of the effect, however, differed for the different diets and nutrients.

Appel and colleagues reported that blood homocysteine levels decreased with both experimental diets compared to the control diet, but this decrease was statistically significant only for the combined diet — the one that included increased fruits and vegetables as well as low-fat dairy products. Levels of the B vitamins in the subjects’ blood changed too, but in the opposite direction to that of homocysteine. For folic acid and vitamin B-6, both the fruit-and-vegetable diet and the combined diet raised blood levels significantly compared to the control diet. Vitamin B-12 in subjects’ blood also increased with the experimental diets, but the increases were not statistically significant.

The study authors concluded, “Modification of dietary patterns can have substantial effects on fasting levels of serum homocysteine.” They further stated that, of the vitamins examined, dietary folic acid was the one that probably had the greatest effect on homocysteine blood levels, since dietary levels of this vitamin increased progressively across the diets.

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Blood levels of homocysteine, an amino acid that is normally made in the body, may be greatly elevated due to some genetic disorders. Individuals who have very high levels of homocysteine often have advanced cardiovascular disease at early ages. Because of this strong association between very high homocysteine levels and CVD, researchers have looked at factors that may influence the blood levels of this amino acid. In particular, three B vitamins — vitamins B-6, B-12 and folic acid — are important in maintaining normal function of enzymes that produce and break down homocysteine.

In the Circulation study, researchers led by Dr. Lawrence Appel from the Johns Hopkins Medical Institution, looked at the effect of dietary changes on the levels of these vitamins and of homocysteine in the blood of 118 people. For three weeks, the subjects were fed a diet similar to the typical American diet: 37 percent of calories from fat, and 14 percent from saturated fat (the control diet). This diet included fewer servings per day of fruits, vegetables and dairy products than recommended by government nutritional guidelines. At the end of this three-week period (called the “run-in” period), participants’ homocysteine blood levels and the three B vitamins were measured.

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First, researchers found that certain people with heart disease have deficiencies of Co-Q10, an enzyme that occurs naturally in your body. When those people are given a Co-Q10 supplement, they say it dramatically reduces chest discomfort. A study at Harvard found that it might even reverse heart failure.

Guggal is another herb that may help. It’s taken from the Indian Myrrh tree, and it’s been found to decrease LDL, or the so-called “bad” cholesterol, in your body.

The supplement Cholestin may contain the same cholesterol-lowering substance used in some drugs. It may work like a prescription medication but without the side effects.

But there’s been a great deal of debate about this product.

Be sure to check with your doctor before taking any herbs.

Much more research is needed to determine which medicines and which herbs should be used for which conditions. As always, never stop conventional therapy while you try these options. Your doctor knows best.

Some scientists have reasoned that breast-feeding might lower the risk of breast cancer by decreasing a woman’s lifetime exposure to estrogen, a female sex hormone. Long-term or high exposure to estrogen is believed to increase the risk of breast malignancies. Estrogen levels are temporarily lowered while women lactate.

The latest study examined 1,917 patients from two South African hospitals; 446 who had breast cancer and 1,471 who did not. Researchers found that similar proportions (roughly 80 percent) of women in the two groups had breast-fed their children. Breast-feeding was not found to significantly lower the odds of having breast cancer.

If breast-feeding does protect against breast cancer, one would expect to find reductions in breast cancer risk with longer durations of lactation. But the researchers detected no differences in risk between women who had never breast-fed and women who had lactated for up to three years.

For women who had lactated for seven years or more, however, a slight protective effect against breast cancer did seem to exist. But this finding was not statistically significant — meaning that it had a high likelihood of being merely a chance finding.

Researchers also reported that the duration of breast-feeding with the first child, the number of children breast-fed, and a woman’s age at first lactation were not associated with breast cancer risk.

Lead author Patricia Coogan said the work is not the final word on the issue. “I don’t think this is the definitive study,” said Dr. Coogan, of the Slone Epidemiology Unit at Boston University School of Medicine. “But,” she added assessing the total body of research, “the data are inconsistent, which says that there seems to be no big effect of lactation on breast cancer risk.”

Coogan noted that there are multiple explanations for the equivocal findings, some of which do not implicate estrogen at all.

Apart from the possible effects on breast cancer, the researchers pointed out that ultimately “breast-feeding has substantial benefits for infant health and therefore should be encouraged.”

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Make sure your pool is open for business as well, because recreational swimming made it into all of the groups’ top 15 activities (No. 4 for women and youth, No. 10 for men and seniors), as did calisthenics (No. 8 for youth, No. 10 for women, No. 11 for men and No. 13 for seniors). Stretching was another favorite with all four groups, at No. 2 for women, No. 4 for seniors, No. 8 for men and No. 11 for youth.

Exercising with free weights was another popular activity, as free weight exercise with dumbbells and barbells ranked No. 5 and 6, respectively, for men, and exercise with hand weights ranked No. 7 for seniors and No. 9 for women. In other strength-training activity, weight/resistance machines ranked ninth for seniors, 14th for men and 15th for women.

In your cardio area, your treadmills and upright cycles have probably seen the most use, with treadmill exercise ranking No. 3 with seniors and No. 4 with women, and upright cycles at No. 12 with seniors.

If your facility offers sports, basketball, baseball, soccer and golf would be good choices. Basketball made men, women and youth’s top 15 (No. 1 for youth, No. 2 for men and No. 8 for women), while baseball came in at No. 6 for youth and No. 15 for men, and soccer was No. 5 for youth and No. 12 for women. Golf, ranking fifth for seniors and seventh for men, was another popular activity.

I tried to get back on track this week, and I managed to lose a pound. I’m not having to work as much overtime, so the stress level at work has subsided a bit. I felt pretty good overall. My energy level seemed a little higher, and I’ve been waking up feeling more rested.

Sharon, I’m sure you’re right about the extra calories I took in last week. That pint of creamed corn with the barbecue was probably in the neighborhood of 360 to 400 calories, plus another 280 or so for the Coke, along with three or four slices of bread that I forgot to write down. I don’t know what got into me, but I really pigged out that day. This week went a little better in that regard. I still have to think about it a bit, but it’s getting easier to make the right choices.

Armand, I worked in some extra activity here and there during the week, along with my scheduled routine, by doing things like walking down to the mailbox at my apartment complex instead of stopping by when I drive in after work. I’ve definitely been working up a sweat on my walks, even with the cooler weather. As to the other cardio activities, swimming isn’t much of an option because the city where I live does not have any public pools. I do like the idea of bicycling, and I’ve actually been thinking about getting a bike for some time. I just have to work out some way to store one in an already-crowded one bedroom apartment.

Sharon’s Reply
David,

Yes, you seem to have had a well-balanced week. Obviously, stress and time constraints negatively influence your eating. We often use food for comfort and stress reduction, or simply do not have time to shop when we are so busy. I hope this nutrition counseling has been able to show you that it really does not take a lot of time and effort to make better food choices — you just need to be aware of your own behavior and eating patterns. You are naturally eating less fat, and adding more fruits, dairy and vegetables into your diet.

When focusing on fats, it is common to not pay attention to the nonfat calories. Be aware that the lemonade, coke and alcohol can add up and slow your weight loss. You really did not overdo it this week; I’m just making a point. The same goes for fat-free cookies, pretzels, frozen yogurt and sugar candy — they all are really junk foods and, used in excess, will retard weight loss. This is why many people who have been eating low-fat find that they are not losing weight. Calories do count.

Keep up the good work!

Sharon

Armand’s Reply

David,

Another consistent week of exercise. Way to go! Consistency is one of the surest ways to get in great shape and stay there. You certainly seem to be making exercise a priority in your life.

I also like how you integrate functional activities into your lifestyle, such as walking for the mail. Activities like these including walking a dog and taking stairs instead of elevators, and they all increase a person’s total activity level. It can only help your overall health!

I am encouraged that you are getting a good sweat in despite the colder weather. This tells me you are working at an intensity level that produces results.

As far as the bike, you do not need to get a fancy one. I would recommend a mountain bike or a hybrid, which is a cross between a mountain bike and a road bike. You do not need many bells and whistles — just a sturdy frame with some fairly good components. Make sure you always wear a helmet, of course.

Continue to increase your repetitions with your strengthening and toning exercises. Again, your goal is to increase at least one repetition per week.

Keep up the steady work, David. I’m confident you will.

Armand

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Tobacco Company plans to maintain its advertising policy and not follow Philip Morris’ initiative to reduce cigarette ads in magazines with large youth readership.

The magazines Philip Morris targeted for pulling ads under its criteria are a diverse group. Some of the 40 that will no longer carry Philip Morris ads are small circulation publications such as Hot Rod, Hunting and Jet. Others are more well-known and more widely circulated magazines such as Mademoiselle, Self, Elle and Glamour. One wonders, however, why other women’s magazines, such as Redbook, did not meet the same criteria. Similarly, it is curious to learn that Better Homes and Gardens made the list for canceled ads given that it is not a publication one would immediately associate with youth readership.

At least three questions come to mind following Philip Morris’ unprecedented decision to limit advertising:

What prompted this decision?
Will the withdrawal of a substantial number of cigarette ads result in more coverage in these magazines of the adverse health effects of smoking?
What will the net impact be on teen smoking rates?

First, it is clear to anyone following the current tobacco melodrama that the timing of the ad withdrawal is closely tied to a class action trial currently concluding in Miami, Fla. The jury in that trial, known as the “Engle Class Action,” has already held the tobacco industry liable for causing disease and death, awarding substantial compensatory damages. The same jury is now considering punitive damages. It is in the cigarette makers’ interests to convince the jury that they have “cleaned up their act,” and are no longer advertising to children. Pulling these ads bolsters the industry’s case.

Second, we have long known that the presence of cigarette ads in magazines has a chilling effect on the editorial discussion of the dangers of smoking. Editors do not like to criticize their advertiser’s products. So theoretically, we should see more truthful and complete discussions about the role of smoking in disease causation in articles such as “How to Reduce Your Risks of Cancer” or “20 Tips to Increase the Odds of a Long, Healthy Life.” On the other hand, it would be naive to assume that merely pulling cigarette ads will free these publications from the influence of tobacco companies.

Not only are RJR and other tobacco companies still advertising, but Philip Morris also owns vast portions of the food industry, which advertises products in the magazines. Thus, ads for Velveeta and Jell-O still carry editorial clout from the tobacco family.

Third, while a reduction in print ads in magazines read by young people is a step forward, we must not lose sight of the big picture: We have a long way to go before children and adults are free from the influence of cigarette advertising (through sports sponsorship, for example). Thus, there is still a great deal of work to be done to raise the level of awareness about the health hazards of smoking to the point where consumers can make truly informed decisions.

This is especially true for those new to fitness. Regardless of goals and intentions, boredom often leads to an early exit from fitness programs. Motivation is always an important consideration.”

With interactive systems, members can multi-task while exercising, and can use their workout time to check their stocks or catch up on correspondences.

In addition, tracking systems can work in conjunction with entertainment systems to complete the exercise-motivation circle. After working out while watching TV.

Your members can log their exercises and see their results from the days, weeks or months before.

One club member from New Brunswick, N.J., who uses the Asimba (Redwood City, Calif.) Internet-based training and tracking system says, “Before using [the] training program, I had no real direction when working out, and often had to push myself to get to the gym. [Now], I look forward to heading to the gym.”

Another club member in St. George, Utah, says about iFIT.com, a training website that is accessible through the console of NordicTrack (a division of Icon Health and Fitness in Logan, Utah) machines, “[This program] has motivated me to eat healthier and I feel motivated to workout.”

Summary
Maintaining your body’s fluid balance before, during, and after exercise is an important part of your healthy lifestyle habits. Exercising in hot, humid weather conditions requires an increase in fluid intake to replace your body’s water loss. If you are counting calories, select a low-calorie sports beverage. Avoid beverages containing caffeine or alcohol because of their dehydrating effects on the body. If you have a medical condition, talk to your physician about your specific fluid-replacement requirements while exercising. Finally, and most importantly, have fun during your workout and remember to monitor your body’s fluid balance.

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Torrie Allman, general manager at Frog’s Club One iin Solana Beach, Calif., introduced boot camp classes three years ago. Allman says he has seen the interest in this type of class “increase quite markedly over the past year, albeit with some ebbs and flows depending on the weather.” For instance, since they are located in a temperate climate, members can meet outside for a more realistic approach.

Their class attracts 30 to 40 members every Saturday in the club parking lot. After some warm-up stretches, Mike Magira leads his boot camp participants in a half-mile jog to the beach where they engage in an hour and 30 minutes of interval work, with activities such as squat thrusts, sniper crawls and an obstacle course.

While the Frog’s class is coed, Gold’s Gym in Arlington, Va., has been conducting a women’s-only boot camp class since September 1998. According to Kirk Trader, vice president of Fitness & Image Results (consultants who manage the program), “The boot camp classes are extremely popular, averaging 20 participants per class in winter and 25 to 30 women in summer.”