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HEALTHY HEART

Eating for a healthy heart

Your heart is the most important muscle in the body, so it pays to look after this vital organ by watching what you eat. Diet plays an important role in helping to keep coronary heart disease (CHD) at bay. CHD is the nation's biggest killer. More than one in five men and one in six women in the UK currently die from CHD, according to research conducted by the British Heart Foundation, but we can all do a lot to reduce our risk.

What's CHD? CHD is caused by atherosclerosis - the furring up and narrowing of the small arteries that supply blood to the heart. This can restrict the flow of blood, causing pain known as 'angina'. If a blood clot forms within the narrowed arteries, it can block the flow of blood to the heart and cause a heart attack. CHD affects both men and women, and while it mainly affects older people, those as young as 25 can develop it. CHD tends to run in families and the risk is also increased by smoking, an unhealthy diet, high cholesterol levels, diabetes, high blood pressure, obesity and lack of exercise A healthy, balanced diet which includes cutting saturated fat to help keep cholesterol levels under control is one of the most important ways to reduce risk.

What's cholesterol? Cholesterol is a soft, waxy substance that's manufactured largely by the liver and is then circulated within the blood. We all need cholesterol if our bodies are to function efficiently, but if we have too much in our blood it increases the risk of heart disease. A healthy cholesterol level is less than 5.0mmol/litre. The amount of cholesterol circulating in your blood depends on your genes and also what you eat, in particular the amount and types of fat and fibre-rich foods that you eat. There are two main types of cholesterol in the blood: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Atherosclerosis (which leads to heart disease) can develop if there's too much LDL circulating in the blood, which then undergoes a process called 'oxidation', making it more easily deposited in the walls of the small arteries in the heart. HDL, however, which is often referred to as 'good cholesterol', actually helps to remove LDL from the blood, and so appears to protect against heart disease. So the ideal aim is to have a low level of LDL and a high level of HDL. If you have a high LDL level, it's vital that you watch what you eat to help you to keep your LDL level within healthy limits. However, some people need extra help from medication, so do have regular check-ups with your doctor. The following nutrition tips will help you to look after your heart in many ways, such as regulating cholesterol levels and blood pressure, helping the heart to beat in a smooth rhythm and provide heart-protective nutrients like antioxidants (to combat 'oxidation').

Eat lots of heart-protective food, such as fish, garlic, fruit and vegetables, along with wholegrains, pulses, nuts and seeds.
Boost your intake of oily fish, such as salmon, mackerel, sardines, herrings and fresh tuna. The omega-3 fatty acids that they contain help the heart to beat regularly, prevent blood clots from forming and protect the arteries in the heart from damage. Therefore, health experts advise everyone to enjoy one portion of oily fish every week. However, oily fish contains very small amounts of dioxins and polychlorinated biphenyls, more commonly known as PCBs. The Food Standards Authority now recommends limits: girls and women who might have a child one day, and women who are pregnant or breastfeeding, can have up to two portions of oily fish a week. Other women, men and boys can have up to four portions of oily fish a week.
Increase your intake of soluble fibre, found in oats, pulses, fruit and vegetables.
Don't eat too many saturated fats. These encourage the liver to manufacture LDL. Saturated fat is generally usually from animal sources. The white fat you can see on red meat and underneath poultry skin is rich in saturated fat. It's also found in lard, butter, fatty meat, full-fat dairy foods, hard margarine, cakes, chocolate, biscuits, sausages, pies, fried fast food and pastries.
Replacing some saturated fats with small amounts of unsaturated fats will help to improve the ratio of 'good' HDL cholesterol to 'bad' LDL cholesterol in your blood. The best food to choose is types rich in monounsaturated fats such as olive oil, rapeseed oil, nuts and avocados).
Also reduce your intake of processed foods that contain trans-fats (usually only indicated on food labels as 'hydrogenated vegetable oil' in ingredients lists). Like saturated fats they can also raise cholesterol levels and are mainly found in hard margarine, biscuits, cakes, pastries and fast food.
Eat some soya-based products (such as soya yogurt, milk). Soya protein can help to lower cholesterol levels, but for a good effect you need 25g (1oz) of soya protein every day. One 250ml (9fl oz) glass of soya milk provides about 9g (1/4oz) soya protein
Enjoy an alcoholic drink but be aware that too much booze can damage the heart muscle, increase blood pressure and make it harder to keep to a healthy weight. However, moderate drinking (between one and two units of alcohol a day) can help to protect the heart in men aged over 40, and women who've gone through the menopause.

Rules of thumb

The following rules of thumb will help you to maintain a healthy heart:

Eat at least five portions of fruit and vegetables a day.
Eat fish at least twice a week. Ensure one portion is oily fish such as mackerel, salmon or pilchards. Fresh, canned and smoked types all count.
Cut saturated and trans-fats. Cutting back on these fats and replacing some with small amounts of unsaturated fats will help to improve the ratio of 'good' HDL cholesterol to 'bad' LDL cholesterol.
Eat wholegrains daily. Diets with three or more daily servings of nutrient-rich wholegrains, such as wholemeal bread, wholemeal cereals, rye crackers and brown rice, could reduce the risk of CHD by up to 30 per cent.
Keep to a healthy weight. If you're overweight, reducing your weight will reduce the workload of your heart and help to keep your blood pressure down.
Limit salt. Aim for less than 6g a day (about a teaspoon full) - it may also help to keep your blood pressure down.

Eating out

If you only eat out now and again and the rest of the time you eat a well balanced diet, you don't need to worry about the effect of the occasional indulgence. But knowing how to make healthy choices from menus is vital. However, at a conservative estimate, most people eat out for about 25 per cent of their meals, which means we need to be more careful about the choices we make from menus. The trend towards eating food outside the home is increasing, so even if it doesn't apply to you now, it soon will. Research shows that people who eat out the most have a higher body mass index than those who eat mainly home-prepared and cooked food. That's because food on sale outside the home, whether fast food or haute cuisine, is mainly high in fat, sugar or salt. Added to which, offers such as buy-one-get-one free pizzas or discounts on super-size chips or burger all deposit a load of lard in your arteries and on to your waist. If you want to make the best choices for your waistline and health be prepared to ask questions. And if the waiter doesn't know the answers, patiently and politely ask him or her to find out from the kitchen.

Lower calorie tips

Ask for a medium or small size portion, shunning the double helpings and 'all you can eat' offers.
Alcohol is not calorie-free. A small glass of dry white wine contains 80 calories. These are getting harder to come by as most pubs and bars serve large glasses, which have about 150 calories.
Aperitifs, beer, spirits and digestifs all take their calorie toll, so for general health and to avoid weight gain, stick to a low intake.
Be wary of aperitifs which come with nibbles such as crisps and nuts that are very high in calories.
Alcohol also lowers eating inhibitions - so you eat more if you drink with meals.
Order wine by the glass, not the bottle, or share half a bottle between two.

Before you go out

You don't have to eat three courses at a meal. Eat just two (decide beforehand or when you see the menu), or share a starter and pudding with your companion, or have two starters instead of a starter and main course. Get to know places that cook low-fat food or will cook or serve dishes as you wish. Have an apple and a glass of water half an hour before you go out to reduce your appetite.

Checklist to print

Starters
Avoid pate, rilettes, meat or fish mousses, goujons, antipasto plates of salami and other fatty meats and creamy soups. Choose Thai-style broths, vegetable soups and fish soups, or ones like bouillabaisse. Smoked salmon and gravad lax with wholegrain breads are good choices, as are salads. Ask for the dressing on the side (also for main course salads), not added or tossed into the dish. Bread - it's better to fill up on breadsticks and wholegrain bread (no butter) than eating a starter.

Main courses
Avoid food with added fat: that's fried, deep-fried, sauteed, pan-fried, meuniere (swimming in butter), breaded, crumbed, battered and goujons. Choose dishes that are low fat, stir-fried, chargrilled, grilled, steamed, poached or en papillote. Roast may be with or without added fat - enquire. Avoid fatty meat such as duck or goose, meat pies (or any pastry - en croute), burgers and sausages. Choose lean meat, game, poultry or fish grilled, poached or steamed. Remove any visible fat from meat. Avoid sauces such as mayonnaise, salad dressing, tartare, bearnaise or mornay, or any others made with cream or butter. If the menu doesn't fully describe what's in the sauce, ask the waiter to find out. If you're not sure ask for the sauce in a dish on the side. Choose wine or stock-based sauces or vegetable sauces such as salsas. Avoid pasta in creamy sauces and lasagne or other dishes made with fatty mince. Choose tomato-based pasta sauces rather than cream-based sauces or marinara (seafood) sauce. Avoid all fondues whether they're the type that dips raw ingredients into boiling fat, melted cheese or chocolate sauce. Avoid pizza toppings such as salami, pepperoni, other fatty meat and cheese. Choose vegetable and seafood toppings with extra vegetables and without cheese.

Cheese course
Say no, unless you haven't had a pudding and starter. Even then choose small amounts. If you eat it with biscuits don't have butter. Eat cheese with fruit (pears, grapes, apricots) or celery instead of biscuits and bread.

Pudding
Avoid pastries, cheesecakes, souffle, mousses, creme brulee, creme caramel, trifle, ice cream - just about everything! Choose sorbet instead of ice cream. Eat fresh fruit, such as raspberries, strawberries or oranges, without the cream or sauces. Or have a coffee and petit fours or a chocolate mint instead of pudding.

Coffee (in addition to pudding)
Avoid calorie-laden coffee, such as cappuccino, latte, with cream, with liqueur. Choose espresso, an Americano or black filter coffee.

If you're eating out at a restaurant chain you may be able to visit its website in advance and check the nutritional information to find the lowest calorie choices on the menu. Decide what you're going to eat before you go, and stick to it.

Fitness: Exercise can add 3 years to life expectancy, study finds

CHICAGO - People who exercise can add three years to their life, and their hearts reap benefits from something as simple as brisk walking a half-hour a day, two studies suggest. "Three years of extra life: It's a very clear message that makes it easy to grasp what might be the consequences of a sedentary lifestyle," said Dr. Oscar Franco, co-author of one of the studies and a researcher at Erasmus Medical Center in Rotterdam, Netherlands. In the Rotterdam study, researchers analyzed more than four decades of data from the Framingham Heart Study, a long-running health analysis of suburban Boston residents.

The researchers grouped 4,121 people into three levels of physical activity: low, medium and high. The volunteers, who had kept track of how long they spent doing various activities each day, received scores based on the estimated oxygen consumed for their activities. Life expectancy at age 50 for the medium activity group was 1.5 years longer than for the low activity group. The high activity group lived 3.5 years longer. The extra years were lived mostly free from heart disease. The study didn't give details quantifying high, medium or low activity. In the second, smaller study, researchers examined what type of real-world walking program would improve heart health. They found several routines worked: Walking for 30 minutes five or more days a week, either moderately or briskly, improved cardio respiratory fitness. It worked just as well to walk briskly three to four days a week. Only fast-paced walking on five or more days a week also led to short-term progress in cholesterol levels.

The study of 492 sedentary adults was not conducted in an exercise lab, but in the real world where demands on people's time and energy got in the way of their walking goals, said lead investigator Michael Perri of the University of Florida. That led to one of the study's most important findings, Perri said: People who were supposed to walk 150 minutes a week actually were walking only 90 minutes a week - and still achieving health benefits. Doctors should consider prescribing daily walking, just to get people to walk a few days a week, Perri said. "If you aim for exercising every day, you'll probably do four or five days," Perri said. "If you aim for three or four days, you're likely to get maybe two days done." The studies appeared in Monday's Archives of Internal Medicine. Dr. Martha Gulati, a cardiologist and fitness researcher at Northwestern University, said both studies are significant and should guide doctors' advice to patients and public spending on health. "We need to know how to prescribe this and how to implement this," Gulati said. "If we don't, we're never going to get to the point where we do prevention. We're always going to be treating chronic disease."

LOOKING GOOD AND FEELING GOOD

HEALTH BY MAXIMILLIEN DE LAFAYETTE

Men's Health

Body maintenance

Whether it's getting yourself into shape, pampering your skin, giving up smoking, or getting a good night's sleep - look after your body, it's with you for life!

Men have lagged behind women in taking care of their health, but it's time to catch up. If you're worried about a health matter, going to the doctor is the best way to deal with it. What holds men back? When it comes to their health, men are notoriously bad at seeking help. Sometimes embarrassment gets in the way. Often, though, it's because of outdated attitudes such as "Men don't get ill" or "Pull yourself together" - which don't help men at all. Of course, another common reason why men delay seeking help is the false belief that if you ignore something, it will go away. In fact, most health problems are simply and easily treated, but the longer they're left, the less this is true. Not only does early treatment mean it's more likely to be successful, but it means less worry, fewer sleepless nights, and so on. Unlike women, men often don't ask each other for advice about health problems, but they should, because it may save a lot of unnecessary worry.

Fearing the worst: The big fear is that a symptom will turn out to be a life-threatening illness such as cancer. Actually, most health problems are far less serious. Take, for example, the urinary symptoms that one in three men over the age of 65 suffer: getting up at night to urinate, having to urinate more frequently during the day, feeling the need to urgently go then passing only a weak dribble. The most likely cause is benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate, which can be successfully treated.

Overcoming embarrassment: Another reason why men find it difficult to go and see the doctor is that they're frightened they'll stick out like a sore thumb. Traditionally, women are used to talking and asking about their health because they've had to go to the doctor for a variety of reasons: taking their child for immunisations, attending for family planning advice, antenatal care, cervical screening, and so on. Many men, on the other hand, aren't used to experiencing a doctor's surgery. They may be terrified that, even if they haven't got a problem that's located below the belly button and above the knees, everyone will think they have and know why they're there. Nowadays, men are pleasantly surprised when they go to the doctor. There will be other men in the waiting room - men who are there because of lung problems, heart problems, joint problems, rashes, in fact anything at all.

Exercise: More men than ever before are spending their working lives as well as their leisure time sitting down, making it more important than ever to take some exercise on a regular basis. Exercise makes your body stronger, fitter and more flexible. It protects your heart and bones, keeps your weight at an ideal level, helps to reduce stress and makes you feel good too.

Ways to stay fit

It doesn't matter what you do or where you do it - activity on a regular basis is what's important. Experts recommend that every man gets active for at least 20 to 30 minutes on at least five days of the week. You'll know if you're doing enough because you'll feel yourself breathing a little bit harder and faster, and your pulse will be faster than usual .It doesn't have to be the gym, either. Walking, cycling, swimming and running, are all simple, accessible and convenient ways to get a daily dose of exercise. Pick something that you enjoy. If it's going to feel like a chore then you're not going to do it.

Three types of exercise

Aerobic (also known as cardiovascular). Used to build up cardiovascular fitness and endurance, and to improve the absorption of oxygen by the lungs and its delivery around the body by the heart and circulation. Running, rowing and cycling are examples of good aerobic exercises.
Anaerobic. Used to build up strength. Exercises are performed against resistance, for instance weightlifting.
Stretching. Vital for developing the flexibility that protects muscles from injury.

Safe routine

Always warm up by doing five to ten minutes of light aerobic exercise such as running on the spot.
Stretch once the muscles are warmed up for about five minutes.
Perform your chosen exercise.
Cool down by doing light aerobic exercise again for five to ten minutes and performing a few stretches.
Drink water to replace any lost during your workout.

Body shapes

There are many different body types around, and regrettably many are 'round'. But underneath all the padding and designer wear we can put each body into one of three categories.

The three main types:

ectomorphs - thin and wispy
mesomorphs - athletic and muscular
endomorphs - generously rounded or 'stout'

Your basic body type is greatly outside of your control - more to do with DNA, and your childhood lifestyle than anything else. So if you are over 18 and reading this, you are what you are, although you can fine tune what you already have.

Changing your body type

If you're looking to change the shape of your body the basic groundwork is the same.

eat fresh, low fat and healthy food
avoid large amounts of toxins such as alcohol and caffeine
take regular exercise which should include elements of stamina (puffing), strength (grunting) and suppleness (bending)

If you have reached this state of physical nemesis you may wish to be more specific in adapting your training in order to develop characteristics of the body type which you favour.

Try adapting your training along the following lines:

If you want to be ectomorphic (long and thin):

Do more aerobic exercise, running and biking and ensure you work at a steady state (70 per cent max heart rate). Avoid explosive activity.
Use exercises that allow full range of movement - swimming, isokenetics or yoga and take more time to fully stretch each muscle.
Concentrate on eating complex carbohydrates such as pasta and potatoes and drink plenty of tepid water.

If you want to be mesomorphic (athletic and muscular):

Work on short bursts of explosive, dynamic and intense aerobic activity near to maximum effort - short sprints, jumping and punching.
Do more weight-bearing exercise - pump iron. Use heavy weights, up to 90 per cent of your maximum capability and complete at least three sets of each exercise with no more than seven repetitions per set. Ideally isolate one muscle group at a time and work it until exhausted.
You must have plenty of rest between each workout to allow the muscle to grow.

If you want to be endomorphic (rounded and stout):

Buy a video, some beer, order a takeaway, sit back and enjoy.

GROOMING

It's easy to take the skin for granted and not take care of it, and men are much more likely to do this than women. But the skin needs regular care and attention - particularly the areas that are exposed to the elements, such as the face. Late nights, stress, an unhealthy diet and too much sun all take their toll on the skin. It dries out, becomes flaky and cracked and looses its vitality. What's missing from most people's diet, that the skin needs in abundance, is water. A least two litres a day is essential, more in hot and humid weather. To remain healthy the skin also needs vitamin C and this is readily available from citrus fruits, fortified breakfast cereals, and fortified bread. Potatoes are also a good source of vitamin C too and since the vitamin C is found just below the skin having a baked potato means the vitamin C doesn't end up in the waste bin lost in the peelings. Moisturise regularly too, using a cream that contains vitamin E and UV protection. Many men regularly have facials nowadays to help revitalise their skin.

How to boost your immunity:

get enough rest
don't smoke
drink alcohol within safe levels
eat plenty of fresh fruit and vegetables
drink at least eight glasses of water a day
take time to relax and unwind

Cold sores

Something else that the skin needs to keep it healthy is zinc. This, and vitamin C, also helps to boost our immune system and keep it strong so that it can protect the body from infection. Stress, infection, being overtired, cold winds, and hot weather can all be responsible for waking up a cold sore when you would rather it remained asleep. It's possible to avoid cold sores by getting enough rest, eating plenty of fresh fruit and vegetables, not smoking, and keeping alcohol to a minimum. Be sure to also apply a UV protection lip-balm a few times each day to protect against the effects of cold winds and bright sunlight. Tea-tree oil cream or aciclovir cream both have anti-viral properties and can shorten the duration and the severity of cold sores. Keep a tube of one or the other at home should the telltale tingle come your way.

Spots

If it's not cold sores then it's spots that appear at the wrong time and in the wrong place. Once again these are more likely to occur if you've become run-down. Try to avoid them - the same rules apply. Don't pick them. This won't make them disappear and will only serve to make them look worse, and more obvious. Topical treatments from the pharmacist or tea-tree oil gel or cream will help to dry spots up. Now you may wish to sit down for this next bit of advice. To hide the spot that appears on the day use a blemish or cover-up stick - which looks like a pencil. These are available from the make-up counter in large department stores, for example. Make-up specifically designed for men is available.

Skin cancer

The number of cases of skin cancer is increasing.

Malignant melanoma is the most dangerous form of skin cancer and is:

most common in younger people (age 20 to 35)
caused by excess UV radiation exposure causing sunburn
common among people who work indoors (because their skin is more easily damaged when they're exposed to the sun)

Everyone is at risk of skin cancer. Those most at risk are men with:

fair skin
freckles
ginger hair
lots of moles

If you notice any changes with your moles get them checked by your doctor. Look out for:

increase in size
change in shape
change in color
change in sensation - itchy, painful
new redness or inflammation
bleeding

Protect your skin

stay in the shade between 11am and 3pm
take care not to burn
cover up with sleeves, caps, and shades
apply sun protection cream regularly every two hours throughout the day using at least SPF 15
don't use sunbeds
if you need a tan then fake it

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NEWS

Vatican studying ethics of genetic testing at human genome conference

VATICAN CITY- The Vatican is studying the ethics of new advances in genetic testing in a bid to provide answers to what one cardinal said Tuesday were "some of the most anguishing questions" facing humanity. The Vatican's health care office is hosting a three-day conference this week on The Human Genome, drawing together experts from 17 countries to discuss issues such as genetic aspects of fetal medicine and the ethics of medical counseling in the field. "We wanted to create an interdisciplinary dialogue at the highest level, where we can find answers to some of the most anguishing questions of the contemporary world," said Javier Cardinal Lozano Barragan, who heads the Vatican health care office. Symposium participants told a press conference that advances in genetic testing offered tremendous possibilities in terms of creating therapies to treat or cure genetic diseases. But they said the ethical implications behind the medicine must remain at the forefront, and stressed that human embryos must never be used for genetic experimentation. "Ethics must precede the act itself," said Maria Louisa Di Pietro, associate professor of bioethics at the Sacred Heart Catholic University in Rome. The conference, which is gathering geneticists, biologists, theologians and bioethics experts, will also cover the way human genetics is seen in different religions, such as Judaism, Islam, Hinduism and Buddhism. Barragan said a representative from the Russian Orthodox Church would attend the conference, and said his presence marked an important development in ecumenical relations.

Top UN official: countries need to test pandemic plans, not just write them

Photo: Staff members of Harbin Animal Husbandry and Veterinary Station check the samples taken from the vaccinated chickens in Harbin, capital city of northeast China's Heilongjiang Province, on Monday.

GENEVA, Switzerland- Nearly 60 per cent of the world's countries now have pandemic influenza response plans - but plans need to be practised if paper strategies are to be effective in emergency situations, officials of the World Health Organization and the United Nations warned Monday. The number of countries that have worked out plans has risen sharply in the past six months, Dr. Michael Ryan, director of the WHO's epidemic and pandemic alert and response, told a major international meeting on avian and pandemic influenza. But while as many as 120 countries now have some form of pandemic plan, such strategies need to be run through their paces before countries can have confidence they will mitigate difficulties when a pandemic occurs, Ryan told the opening session of the three-day meeting. "A piece of paper is like a statement of intent: a very, very good thing. You need to write down what you want to do." he said. "The problem is, that's all it is until you actually put it into practice. And that's where the costs come in. It's cheap to write a plan." Roughly 600 delegates from about 100 countries are attending the meeting, which is being co-hosted by the WHO, the UN's Food and Agriculture Organization, the World Bank and World Organization for Animal Health, commonly known as the OIE.

Dr. David Nabarro, the UN's systems co-ordinator for avian and pandemic influenza, said he will be urging countries to run tabletop exercises and live simulations to test the effectiveness of their plans. "The quicker people get into simulation the better," he said at a news conference following the opening session. "I think we all know if you've got plans on paper, it's quite easy for people not to think through the implications of those plans." The benefits of running them through, he said, is "you get to find out where things are not working." The meeting was designed to follow twin tracks of discussions - trying to lower the risk a flu pandemic and gearing up the readiness of countries around the globe should those efforts fail. Leaders of the animal health sector have been urging the investment of about $170 million US to finance measures to tamp down concentrations of the dangerous H5N1 avian flu virus in Southeast Asia. H5N1 has ignited large and widespread flu outbreaks in domestic poultry in a number of countries there for most of the past two years and has recently been found in migratory birds in parts of Europe. It has occasionally jumped the species barrier to infect humans; 124 human cases have been confirmed and 63 of those people have died, Dr. Lee Jong-wook, director-general of the World Health Organization, told the gathering. The money would go towards beefing up disease surveillance in affected countries, improving hygiene in Asian "wet" markets where stacked cages of live animals breed disease, and by putting in place compensation schemes that would encourage farmers to report and cull infected poultry, not hid, eat or sell it.

While officials of the FAO and OIE expressed confidence these measures could lower the risk of a human pandemic, there were cautionary words from a member of the delegation from Thailand. Until recent weeks, that country was the poster child for success in controlling avian influenza. But after a period of a year where no human cases were recorded, the country is again fighting widespread poultry outbreaks and three human cases, including one death, have also recently been recorded. The assembly was warned that the cost of failure would be enormous. An official of the World Bank said that using the SARS outbreak of 2003 as a model, the bank projects at least $800 billion could be lost in the first year of a pandemic. And if the eventual pandemic were more severe than SARS - which knocked two per cent from the gross domestic product of Asian countries for the second quarter of 2003 - the losses could be significantly higher, said Milan Brahmbhatt, lead economist for the World Bank's East Asia and Pacific Region.

A little preparation can make joining a gym less intimidating

The Greatest Vitamin In The World endorsed by the NBCCA Walking or riding a bike may have been enough to keep weight gain at bay during the summer. But with colder weather and the holiday season on the horizon, other fitness arrangements could be in order. Before plunking down a good chunk of change on the first gym you walk into, there are a few things a would-be fitness enthusiast should know to make the process a little less intimidating. Wendy Grosso, a 33-year-old marketing manager for a software company, decided a few weeks ago it was time to join a gym. Over the years she has belonged to a number of fitness clubs, but had a hard time committing to a workout. "For some reason I just stopped going. Got lazy ... I had a young 20s body, whatever, right?" said Grosso. "Now ... I don't feel fit anymore." With her busy schedule, she felt the best time for her to work out was during her lunch hour. So the gym she chose was close to her work. Location may be an important consideration when joining a fitness club, but there are other, more subtle, aspects that can make - or break - a fitness regime. "From a lifestyle perspective, looking at whether the gym, including the location, the hours it is open and the types of programs the gym offers fits the individual's lifestyle rather than trying to shift everything in the individual's life to fit the gym," said Jennifer Irwin, professor in health sciences at the University of Western Ontario. "It's all about making the healthier choice, the easier choice," said Irwin, who is a life coach. As for other considerations about the club's location, the International Council on Active Aging suggests checking to make sure the facility is well lit on the outside, especially if the time you'll be using the gym is after work.

The council's checklist (available on its website Http://www.icaa.cc/) is aimed at seniors; however, many of the suggestions are helpful for anyone looking to hook up with a fitness club. These include: Do you feel comfortable in the facility's atmosphere? Is the music acceptable and at a reasonable volume? Are the locker rooms clean and frequently monitored by staff? While checking out the facilities, sometimes even when you simply walk in the door, a staff member will encourage you to sign on with the gym. Brent Braeder, co-author of The All Inclusive Fitness Guide, said fitness clubs are highly competitive. As a result, there is wiggle room when it comes to signing a one-year contract. Some gyms will forgo a contract, especially in B.C., where - between walking the Stanley Park Seawall in Vancouver or skiing in Whistler - there are many ways to stay fit outside the confines of a gym, he said. It is worth asking if the facility will give you some free passes, so you can give the gym a try before giving them your banking information, said Braeder, a personal trainer in Vancouver. During that trial, you can monitor how many times you use the facility, if anyone was available to take you on an orientation and show you how the equipment works, and how comfortable you feel in the club. For Grosso, atmosphere was very important. "I used to belong to (a gym) where all the ladies are wearing makeup and lipstick," she said. But the gym she belongs to now is very laid back. "I feel very comfortable there... I can just go in my grubbies and do the work I have to do." She also likes the fact that her gym has a wet sauna, a chiropractor, a massage therapist and a nutritionist on site. And, unlike other gyms, she doesn't have to wait in line for machines. She also makes use of the staff who are always on hand to answer questions. Once you have decided on a club, you may feel relieved, but Braeder said that the hard part is just starting. "It's really tough for people ... who rarely do physical activity, because pain and discomfort sets in and it is hard to get past," Braeder said. "You have to challenge yourself to look past that. "Fitness is really hard because you won't see results right away. It takes about eight weeks to see any muscle development," he said, adding it is a point he and his partner, Rob Lacheur, emphasize in their book as well as on their website, www.yourbodyinfocus.com. It's helpful to have a long-term goal in mind, such as losing 25 pounds, for example, but also to have short-term goals. He suggests trying something small, such as working towards doing 10 push-ups. That way after two weeks, you may not have lost any weight but maybe you can do seven push-ups - well on the way to your mini goal. Little successes keep people motivated to continue going to the gym, as does keeping a journal and finding a workout buddy who will motivate you, he said. For Grosso, while she is still very interested in her gym, she hasn't been keeping her lunchtime fitness dates. She just entered a busy season at work and she can't leave her phone for an hour at a time. So now, after the facility called to find out why she wasn't coming in as often, she's making an effort to exercise after work.

Stop bird flu at source, UN directors urges

Not enough being done to wipe out virus among wild birds and poultry

Photo: Britain is considering banning live birds since an imported parrot died of the avian flu. These birds were confiscated from an illegal business in Nicaragua.

The world should temper its obsession with a possible human flu pandemic and focus more on wiping out the bird flu, UN officials urged yesterday. Canada and many other nations have been scrambling to stockpile limited supplies of anti-viral drugs and take other measures to combat a pandemic if and when it arrives. But as an international pandemic conference started here, UN agriculture and animal health directors warned too little is being done to combat the avian flu among poultry and wild birds. Incentives such as compensation for destroyed chickens are needed to encourage high-risk countries to keep watch for the virulent H5N1 flu and take swift action to try to stamp out the animal epidemic, they said.

Countries should also avoid punishing trade measures against nations that have been transparent in identifying cases of the bug, said Dr. Alejandro Thiermann of the world organization for animal health standards. While millions are spent on buying up supplies of the drug Tamiflu, rich nations have been slow to pay for increased efforts by agriculture officials, said Jacques Diouf, head of the UN Food and Agriculture Organization. "If I could leave only one message with you today, it would be to double and redouble your efforts to stop avian flu at its source, in animals, before it affects humans and before it further decimates rural communities," he said. "As the world takes prudent measures to prepare for a major human pandemic, greater measures must be taken to stop this disease in its tracks, at its source, in animals. This is very possible. It can be done." There were also calls at the meeting's opening for the industrial world to help poorer countries fight the avian flu and any future human pandemic. Representatives of 30 countries from Australia to Russia and Brazil converged in Ottawa for the session. Fears that a flu pandemic is imminent have grown with the spread of the H5N1 strain among birds, first in east Asia and now on the eastern edges of Europe. About 120 people have been infected, mainly through contact with infected birds, and about half have died. The virus cannot spread easily between humans now. But if it mutates into a form that can transmit readily from person to person, a pandemic with a potentially devastating human and economic toll would be afoot." Once the flu has gone pandemic, it will be too late to prepare," Dr. Lee Jong-Wook, director-general of the World Health Organization, told the conference yesterday. "Then we can only react." Dr. Thiermann said the world has "under-invested" in the agriculture infrastructure needed to contain the virus at the bird level. He suggested offering various incentives to developing countries to find and openly report cases, including compensation for culled flocks, money to build safer enclosures and an end to "excessive" trade restrictions against nations that have admitted they have H5N1 cases. Dr. Margaret Chan, the WHO's infectious disease czar, warned that the early-warning system for a pandemic is weak in east Asia, where avian flu is most prevalent. She cited poor surveillance, a shortage of high-security labs, late or missed cases and the risk that whole clusters of cases could be missed. Delegates from Thailand, Vietnam and Nigeria urged the industrialized world to offer financial help to developing nations to buy anti-viral drugs and vaccine and help combat avian flu now, a suggestion that was endorsed by Ujjal Dosanjh, the Canadian Health Minster. "If the wealthier nations solve this in their countries, and the disease is spreading elsewhere, it doesn't solve it," said Helen Udoakha Esuene, Nigeria's Minister of State for Health. A vaccine against any future pandemic can only be developed once the pandemic has begun and the nature of the strain is identified. Once that happens, the world will need "billions" of doses, many times the amount of regular flu vaccine produced now, Dr. Lee said. He said the production capacity for vaccine must be expanded.

FDA decision-making on emergency contraception 'unusual,' report says

WASHINGTON, D.C.- Federal health officials didn't follow normal procedures in rejecting over-the-counter sales of the morning-after pill - and some documents suggest the decision was made even before scientists finished reviewing the evidence, congressional investigators reported Monday. Politics trumped science, immediately charged long-suspicious members of Congress who had requested the independent audit. "We are deeply opposed to this subversion of science," California Democrat Henry Waxman and 17 other legislators wrote Health and Human Services Secretary Mike Leavitt. They urged that Leavitt, who oversees FDA, intervene to assure that a pending reconsideration of the pill's status "is based on the best available science instead of ideology." The morning-after pill is a high dose of regular birth control that, taken within 72 hours of unprotected sex, can lower the risk of pregnancy by up to 89 per cent. The sooner it's taken, the better it works, but it can be difficult for women to get a prescription in time. In December 2003, FDA's scientific advisers overwhelmingly backed over-the-counter sales for all ages, citing assessments that easier access could halve the three million annual unintended pregnancies in the United States. But the following May, FDA leaders rejected that recommendation, citing concern about young teens' use of the pills without a doctor's guidance. The maker reapplied, seeking to sell Plan B without a prescription to women 16 or older while younger teens continue to get a doctor's note, much like the age restrictions that govern cigarette sales. In August, FDA's then-commissioner postponed that decision indefinitely, saying it wasn't clear how the FDA could enforce an age limit. The independent Government Accountability Office reviewed FDA's first rejection, uncovering what they called "unusual" decision-making. Among the findings: -Conflicting accounts of whether the decision was made months before scientific reviews were completed. -Unusual involvement from high-ranking agency officials. -Three FDA directors who normally would have been responsible for signing off on the decision did not do so because they disagreed with it. Health Canada approved the sale of levonorgestrel, known as the Plan B morning-after birth control pill, without a prescription in April. The drug is distributed in Canada by Paladin. Health Canada's decision was supported by leading Canadian medical authorities, including the Society of Obstetricians and Gynecologists of Canada, the Canadian Medical Association and Planned Parenthood Federation of Canada.

British man says his body has rid itself of AIDS virus; doctors want more tests

LONDON- AIDS experts called for more tests on a British man who claims his body has rid itself of the virus that causes AIDS. Andrew Stimpson, 25, told two British newspapers that he tested positive for HIV in August 2002, but that tests 14 months later came back negative. He told the Mail on Sunday, "I can't help wondering if I hold the cure for AIDS." Stimpson also was interviewed by News of the World, which said it paid for the story - a common practice in Britain - but declined to disclose how much. The Mail on Sunday could not immediately be reached for comment. The Chelsea and Westminster Healthcare Trust, which conducted Stimpson's HIV tests, confirmed he had had a positive test followed by a negative one, but would not say this meant he was cured. "This is a rare and complex case," the hospital said in a statement. "When we became aware of Mr. Stimpson's HIV negative test results we offered him further tests to help us investigate and find an explanation for the different results. "So far Mr. Stimpson has declined this offer." Stimpson told the Mail on Sunday he was happy to submit to further tests. "This appears to be a highly unusual case and without further tests it really is impossible to draw any conclusions for people living with HIV," said Deborah Jack, chief executive of the National AIDS Trust.

Contributors: Tom Blackell, John Beal, Loraine Anthony, Ashley Hener, Linda Constain, Bob Hicks, Karlo Johnson, Helene Bransell.

Anti-aging products: do they really work?

There are many products on the market today that claim to reverse the signs of aging. It can be quite frustrating to wade through these products to figure out if any of them do what they claim. What makes one product different from the next? Read on to find out what active ingredients are commonly used to reduce the signs of aging.

Tretinoin is a vitamin A analog. It has been shown to reduce wrinkles, lessen discolorations, and result in smoother skin over a period of 6 to 12 months. Over-the-counter products with tretinoin are not as effective as the prescription products. Tretinoin can irritate the skin, so start off with a lower concentration and increase gradually. It's most effective if you use it at night. It may be less suitable for people with sensitive skin, and it greatly increases the skin's sensitivity to sun, so using a sunscreen every day is an absolute must.

Alpha-hydroxy acids (AHAs) and beta-hydroxy acids (salicylic acid) stimulate dead cells in the skin's top layer to slough off more easily (exfoliate), and may reduce fine lines. AHAs are known to "irritate" the skin, so if you want to try a product, discuss your choices with a dermatologist and always follow the instructions for use. Freshly exfoliated skin is much more sensitive to sunlight, so use a good sunscreen daily.

Topical anti-oxidants, especially vitamins C and E and Coenzyme Q10, may temporarily improve the appearance of fine lines and wrinkles caused by sunlight and smoking. However, more research is needed to determine whether they can prevent sun damage or treat wrinkles. Vitamin E (alpha tocopherol) may help, as it acts as a moisturizer and as a mild sunscreen.

Collagen and elastin are proteins that occur naturally in the skin, giving it strength and elasticity. In cosmetics, their molecules are too large to penetrate the skin, but they're added as a moisturizer to help make the skin feel smoother by absorbing water.

Hydroquinone is a depigmenting agent used to reduce solar lentigenes (age, liver or sun spots) and other discolorations. It is often combined with a sunscreen, because sunlight reverses its bleaching effects.

HEALTH AND CONSUMERS' CONCERNS

George W. Bush signs bill to regulate colored contact lenses

People who use colored contact lenses will have to get them from eye-care professionals under a bill that President George W. Bush signed into law Wednesday. The new law gives the Food and Drug Administration authority to regulate cosmetic and novelty contact lenses, even if the products do not correct poor vision. The legislation would require people to see an eye-care professional to get fitted for the lenses and to be instructed in their use and care. Customers could purchase the lenses from their eye-care professionals or through online vendors. The lenses, which come in various colors and designs, have been sold without prescription in beauty salons, flea markets, convenience stores, beach shops and online, according to the FDA. Optometrists have warned that misuse or sharing of contacts lenses can lead to infections, abrasions, allergic reaction or blindness.

Guidant releases product information in face of product recalls

Under fire for recalling thousands of its pacemakers and defibrillators, Guidant Corp. released a massive product report card Wednesday in an effort to allay concerns about its implantable devices. The 153-page document includes product-by-product lists that detail the longevity and failure rates for heart devices made by the Indianapolis-based company. The report came two days after Guidant said its third-quarter earnings dropped 57 per cent because of months of safety advisories and recalls that sent its stock price spiralling and put its acquisition by Johnson & Johnson in jeopardy. "This is related to the folks out there that are customers asking for more information," said Renold Russie, Guidant's director of product performance reporting. "It certainly provides a window into our quality system. Anybody can take a look at what we're seeing, and we think that will be confidence building." For years, the medical device industry has tracked its products, but Guidant's report is among the first to include details such as the number of devices that remain implanted in patients, failure information and whether those failures compromised patient therapy. "Trust in Guidant, for the time being, has declined," said Samin Sharma, a cardiologist with Mt. Sinai Medical Center in New York. "The report that has come out is a very good practice for them." Russie said the report will be updated quarterly. Separate versions written in patient-friendly language and highlighting an individual product may also be offered. Guidant's recalls, along with warnings from its competitors, have focused attention on the lack of standards for disclosing problems with medical devices to patients and doctors. Since June, Guidant has recalled or issued warnings about 88,000 heart defibrillators - including its top seller, the Contak Renewal 3 - and almost 200,000 pacemakers because of reported malfunctions. Pacemakers use mild electrical current to speed a slow heartbeat; defibrillators use a bigger jolt to correct life-threatening irregular heartbeats. The company acknowledged it waited years to alert physicians about some problems and now faces multiple lawsuits as well as regulatory investigations. John Putnam, an analyst with Stanford Group Co., said releasing information such as Wednesday's report could help the company rebound. Putnam upgraded his rating of the company's stock to buy. "They'll probably stabilize their market share with these press releases and information dumps," he said. "They will pull themselves together and they will move forward and they will dress themselves up and they will become an acquisition candidate again." Guidant is suing New Brunswick, N.J.-based J&J to force it to complete its $25.4 billion US acquisition of the heart device maker. The deal was announced in December and received federal regulatory approval last week. But J&J officials have said they aren't obligated to follow through the $76-per-share deal because of Guidant's device problems. Guidant shares rose 26 cents to $56.79 in late afternoon trading on the New York Stock Exchange. J&J stock rose 48 cents to $61.35.

ID Biomedical Corp. loses $35.6M in Q3, compared to $7.6M loss a year ago

ID Biomedical Corp. lost $35.6 million in the third quarter, compounding a year-earlier loss of $7.6 million, as the company which holds Canada's pandemic flu vaccine contract spent 228 per cent more on research and development. The company's per-share loss of 82 cents compares with a loss of 18 cents per share a year ago. Revenue in the latest quarter was $17.7 million, up from $17.4 million. The company sold $11.3 million worth of product, down from $13.6 million. Most of those sales are related to its Fluviral and NeisVac-C vaccines for the Canadian government. Pandemic readiness fees, from the federal government, and fees to store and distribute vaccines from the Quebec Ministry of Health totalled about $1.1 million, up from $200,000. Costs of product sales were $8.8 million, up from $7.2 million, and research and development spending increased by $21.4 million to $30.8 million for the three months ended Sept. 30. On Thursday, shares in the Vancouver-based pharmaceutical company rose one penny to trade at $34.47 on the Toronto Stock Exchange.

What's your BMI?

The healthy weight range is based on a measurement known as the Body Mass Index (BMI). This can be determined if you know your weight and your height. Frame sizes vary and it is difficult for any simple measurement to establish a person's frame. It is more accurate to recommend a weight range, rather than a specific weight for a given height. Here, we've made it easy for you. To calculate your BMI simply select your correct height and weight and let the BMI Calculator do the rest. Remember that weight is also related to build, and you should make allowances if you are stocky or of heavy build. Your BMI will vary slightly according to gender. If you're a number-crunchy fan and would like to calculate your BMI manually just follow these three steps. 1-Work out your height in metres and multiply the figure by itself. 2-Measure your weight in kilograms.3-Divide the weight by the height squared (ie. the answer to Q1.) For example you might be 1.6m (5 feet 3 inches) tall and weigh 65kg (10 stone). The calculation would then be: 1.6 x 1.6 = 2.56. BMI would be 65 divided by 2.56 = 25.39.

The best ways to gain weight

The media may concentrate on those who need to shed a few pounds, but for those who need to put on weight the task can be just as daunting.

Take it slowly: Gaining weight and keeping it on can be as tricky as losing it and keeping it off. Rather than having the occasional extra snack, you need to regularly take in more calories than you burn. Combining this with toning exercises helps too. Set yourself realistic target weights and aim to gain gradually - say, around 1kg (2.2lb) a month. To do that you'll need to add an extra 300 to 350 calories or so to your daily intake. It's best to do this in a healthy way as part of a balanced diet, rather than simply eating more fried foods or chocolate!

Top tips

Keep a food diary for a couple of weeks to learn more about your eating habits.
Rather than struggling to eat a few really big meals, plan three regular meals plus two or three snacks.
If you tend to eat erratically, write down a regular meal plan and keep to it.
Make meals a little larger or more calorific. For example, have an extra slice of toast at breakfast; drink grape juice rather than orange juice; make coffee with milk; serve an extra spoon of mash, rice or pasta; be more generous with healthier unsaturated oils, salad dressing and spreads; always have a dessert.
Have snacks to hand so you never go short. Good choices include nuts, seeds and raisins; pots of rice pudding, custard or yoghurt; cereal or cereal bars; flapjacks; milk, yoghurt drinks or smoothies; a scone or fruit bun; wheatmeal biscuits; cheese and crackers; fruit plus small chocolate bar.

Exercise options

Although exercise helps to burn calories, it's important to include some form of activity into your plan to help keep your bones strong and your muscles toned.

Ensure regular physical activity for 30 minutes (or two 15-minutes sessions), five days a week - walking is ideal.
Combine this with some resistance training using gym equipment or home weights, if possible. First seek safe advice from a qualified fitness adviser.
Take care not to be too active. If you're someone who's always on their feet, make time to relax each day.
Keep up your increased food intake to fuel your exercise - with enough to spare to allow you to gain weight gradually.

Maintaining your healthier weight: Once you've reached your target weight, to maintain it you need to keep up the lifestyle changes you've made.

HEALTHY ACTIVITIES

Woman jumping

Everyday activities such as gardening, walking to the shops, vigorous housework, dancing and even having sex count as a form of exercise. In fact, anything that makes you breathe more heavily than usual counts as activity.

Your aim

Your aim is to do 30 minutes of moderate activity a day. If you haven't been physically active for some time, aim to make gentle, steady progress. A good way to start is to carry on with your everyday routine, but do things in a way that requires a bit more energy. Walking is often the best way to begin. Here are some ideas that could work for you.

When you walk, walk faster.
If you're very inactive, start with a five-minute walk each day, increasing by five more minutes each week.
Use the stairs instead of the lift or escalator.
If you use the escalator, walk up it instead of standing still.
For short journeys, walk or cycle instead of going by bus or car.
Get off the bus or train one stop early and walk the rest of the way.
Take the dog for a walk. Or offer to take someone else's out!
You should try to walk 10,000 steps (about five miles or eight kilometres) a day.

Setting goals

Once you've started to incorporate more exercise into your lifestyle you'll be well on the way to becoming fitter and managing your weight. The key is to stick to it, so exercise in your daily routine becomes as second nature as having a cup of tea or brushing your teeth.

Think ahead

Whether you're just getting started or building up, work out what you aim to do for the next month.

Think about how many minutes you exercise for each day. Aim to gradually increase your daily total.
If you're just getting started, think about ways you could work more activity into your day, or how you could do more walking.
If you already do some exercise, think about which other activities you could do.

How do I know I'm exercising hard enough?

Your heart is beating faster than usual, but not racing.
Your breathing is deeper and more rapid than usual, but not uncontrolled.
You're warmer than usual and slightly sweaty, but not dripping.
You feel you could comfortably continue exercising at the same level without stopping.
You can still have a conversation while doing the activity.

Sensible precautions

If you have any concerns about your health, or any illness or injury, check it out with your doctor or practice nurse before becoming more active. There are many different ways to be more active but it's important to find activities which are safe and right for you. Remember to:

Build up gradually.
Do warm-up and stretching exercises before you start, and cool-down exercises afterwards if you're taking part in sports.
Stop exercising if you get any pain or feel dizzy, sick, unwell or very tired. If the symptoms don't go away or come back later, see your doctor.

Steps to follow to become more active

Cut down the amount of time you spend watching TV.
Get out of your chair whenever you can at home and at work. Stand up while you're on the telephone and hide the remote controls for the TV and stereo.
Seek out rather than avoiding the opportunity to be active during your day. Use the upstairs bathroom, park the car at the edge of the car park rather than by the supermarket door, walk to the local postbox/newsagent, and so on.
Use household chores as an exercise class. Turn on some music and tackle the work with vigor.
Plan a 20- to 30-minute period of specific activity on most days of the week: for example, walking, swimming or gardening.
Take a family trip to the park or swimming pool instead of the cinema. And play badminton or go dancing with friends rather than spending a night in the pub.
Take part in a specific sporting activity. Consider resuming a sport you enjoyed at school, learn how to play a sport you enjoy watching, or join a local club.

WHAT PEOPLE WOULD HAVE DONE

PROCEDURE	WOMEN	AVERAGE COST
1. Breast surgery	58%	£5,750
2. Liposuction	33%	£4,450
3. Tummy tuck	25%	£5,200
PROCEDURE	MEN	AVERAGE COST
1. Nose job	30%	£4,450
2. Liposuction	25%	£4,450
3. Mini facelift	11%	£4,600
Source: Abbey