Getting Started – Tips for Long-term Success

Walking, swimming, cycling, jogging, skiing, aerobic dancing or any of dozens of other activities can help your heart. They all cause you to feel warm, perspire and breathe heavily without being out of breath and without feeling any burning sensation in your muscles.

Whether it is a structured exercise program or just part of your daily routine, all exercise adds up to a healthier heart. Take the first step by walking. It’s free, easy to do and when you have a walking companion, you’re more likely to stay motivated.

Visit StartWalkingNow.org to find American Heart Association-designated Start! Walking Paths, personalized walking plans, an online community of walkers and more!

Here are some tips for exercise success:

Dress for success!

Wear comfortable clothes and sneakers or flat shoes with laces.
Wear comfortable, properly fitted footwear and comfortable, loose-fitting clothing appropriate for the weather and the activity.
Make the time!
Start slowly. Gradually build up to at least 30 minutes of activity on most or all days of the week (or whatever your doctor recommends).
Exercise at the same time of day so it becomes a regular part of your lifestyle. For example, you might walk every Monday, Wednesday, Friday and Saturday from noon to 12:30 p.m.
Find a convenient time and place to do activities. Try to make it a habit, but be flexible. If you miss an exercise opportunity, work activity into your day another way.
Keep reasonable expectations of yourself.
If you’ve been sedentary for a long time, are overweight, have a high risk of coronary heart disease or some other chronic health problem, see your doctor for a medical evaluation before beginning a physical activity program.
Look for chances to be more active during the day. Walk the mall before shopping, take the stairs instead of the escalator or take 10–15 minute breaks while watching TV or sitting for walking or some other activity.
Don’t get discouraged if you stop for a while. Get started again gradually and work up to your old pace.
Don’t exercise right after meals, when it’s very hot or humid, or when you just don’t feel up to it.
Make it fun!
Choose activities that are fun, not exhausting. Add variety. Develop a repertoire of several activities that you can enjoy. That way, exercise will never seem boring or routine.
Ask family and friends to join you — you’ll be more likely to stick with it if you have company. Or join an exercise group, health club or the YMCA. Many churches and senior centers offer exercise programs too. (Remember to get your doctor’s permission first.)
Use variety to keep your interest up. Walk one day, swim the next, then go for a bike ride on the weekend.
Use music to keep you entertained.
Track and celebrate your success!
Note your activities on a calendar or in a logbook. Write down the distance or length of time of your activity and how you feel after each session.
Keep a record of your activities. Reward yourself at special milestones. Nothing motivates like success!
Visit StartWalkingNow.org to find all the resources you need to get moving and stay motivated.

Physical Activity
• Home
• The Price of Inactivity
• American Heart Association Recommendations
• Physical Activity Improves Quality of Life
• Get Moving: Easy Tips to Get Active
• Getting Started!
• Resources
– Introduction
– Physical Activity for Older Americans
– Exercise Tips for Older Americans
– Target Heart Rates

Now you can create, find and track Walking Paths anytime, anywhere with the American Heart Association Walking Paths App for iPhone and Android. Use the apps and other free tools to get you started and keep you motivated.
Visit StartWalkingNow.org today!
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Lift weights to control diabetes

By Kathleen Blanchard RN on April 8, 2013 – 4:32pm for eMaxHealth
Diabetes Care Current News

Controlling diabetes might be easier with weight lifting as a choice for exercise. Researchers in the Life Sciences Institute at the University of Michigan have found resistance training promotes white muscle that is beneficial for glucose control instead of harmful as previously thought.

White muscle from weight lifting improves insulin response
The researchers were able to show white muscle that increase with weight lifting, running, diabetes and aging activates a pathway to make the body more responsive to insulin in mouse studies.

ATP is used by muscle for energy. With weight lifting, the muscles receive a signal to contract that in turn generates ATP from glycogen stored in white muscle. Glycogen storage is quickly depleted and only provides energy for a short period of time.

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Ten Important Things We Know About Autism Today – That We Didn’t Know a Year Ago

Thanks to your support, research is advancing understanding and treatment of autism spectrum disorder (ASD). Here are ten important things we’ve learned about autism since World Autism Awareness Day in 2012!

1. High-quality early intervention for autism can do more than improve behaviors, it can improve brain function. Read more.

2. Being nonverbal at age 4 does NOT mean children with autism will never speak. Research shows that most will, in fact, learn to use words, and nearly half will learn to speak fluently. Read more.

3. Though autism tends to be life long, some children with ASD make so much progress that they no longer meet the diagnostic criteria for autism. High quality early-intervention may be key. Read more.

4. Many younger siblings of children with ASD have developmental delays and symptoms that fall short of an autism diagnosis, but still warrant early intervention. Read more.

5. Research confirms what parents have been saying about wandering and bolting by children with autism: It’s common, it’s scary, and it doesn’t result from careless parenting. Read more.

6. Prenatal folic acid, taken in the weeks before and after a woman becomes pregnant, may reduce the risk of autism. Here’s the story.

7. One of the best ways to promote social skills in grade-schoolers with autism is to teach their classmates how to befriend a person with developmental disabilities. Read more.

8. Researchers can detect presymptom markers of autism as early as 6 months – a discovery that may lead to earlier intervention to improve outcomes. Read more.

9. The first medicines for treating autism’s core symptoms are showing promise in early clinical trials. Read more.

10. Investors and product developers will enthusiastically respond to a call to develop products and services to address the unmet needs of the autism community. Read more.

Effects of Stress on Alzheimer’s

Recently, findings were published in the Journal of Alzheimer’s Disease that may help explain why people who are susceptible to stress are at more risk of developing Alzheimer’s and why — increasingly — we are finding evidence that physical activity, which reduces stress levels, may reduce the chances of developing Alzheimer’s.

It is widely believed that the stress hormone corticotrophin-releasing factor (CRF) may have a protective effect on the brain, including the memory changes brought on by Alzheimer’s. CRF is associated with the production of stress and is found in high levels in people experiencing various forms of anxiety. Normal levels of CRF are beneficial to the brain, keeping cognitive abilities sharp and aiding the survival of nerve cells. Interestingly, previous studies have shown that people with Alzheimer’s disease have a reduced level of CRF.

In this paper, researchers used an experimental drug to prevent CRF from binding to the brain receptor called CRFR1 in mice with Alzheimer’s that were free from memory impairments, therefore blocking its effects. They discovered that the mice had an abnormal stress response with reduced anxiety and impaired learning. Moreover, they found that interrupting the hormone from binding to the CRFR1 receptor blocked the improvement of memory normally promoted by exercise. However, in mice with Alzheimer’s disease, moderate exercise restored the normal function of the CRF system allowing its memory enhancing effects.

The effects of stress on the brain have been studied for decades—ever since the initial work by Canadian endocrinologist Hans Selye, who coined the term”stress.” Selye himself went on to publish 33 books and more than 1,600 scientific articles, almost all of them on the subject of stress.

This study of biological stress and its effects is a science that continues to make advances today by connecting stress to illness, including Alzheimer’s disease. Certainly, more research is needed to map out the functions of CRF and CRFR1 in normal aging as well as in Alzheimer’s, and the findings published here are compelling for such work.

Thanks for reading.

Michael S. Rafii, M.D., Ph.D.

Director, Memory Disorders Clinic
Associate Medical Core Director, Alzheimer’s Disease Cooperative Study
University of California San Diego

Pardon et al. Corticotropin-Releasing Factor Receptor 1 Activation During Exposure to Novelty Stress Protects Against Alzheimer’s Disease-Like Cognitive Decline in AßPP/PS1 Mice, Journal of Alzheimer’s Disease.

This post originally appeared in Alzheimer’s Insights, an ADCS Blog.

Celiac Disease Symptoms in Children

Your child’s doctor may be more likely to suspect celiac disease when your child exhibits the “classic” celiac symptoms of copious diarrhea and fatigue, plus abdominal bloating and pain. However, celiac disease symptoms in children can be subtle — in some cases, your child may simply not be growing as rapidly as her peers, or she may be irritable and inattentive.

The wide array of possible celiac signs and symptoms (there are more than 200) means that you may want to consider testing for celiac disease in cases where your child doesn’t have clear-cut digestive effects… especially if you have a family history of the condition.

Typical Celiac Disease Symptoms in Children Include Diarrhea

Celiac disease frequently is diagnosed in children who suffer from large amounts of smelly diarrhea, plus abdominal bloating and pain. These children often look as if they have malnutrition (which they do); although they are generally very skinny, their stomachs stick out significantly due to the bloating.

Instead of diarrhea, children also can suffer from constipation due to celiac disease. Celiac constipation also occurs with bloating and abdominal pain, and some children may have alternating diarrhea and constipation.

Another “typical” symptom of celiac disease in children is failure to thrive — these children fall behind on the growth curve, showing height and weight gain that’s significantly below that of their same-age peers. If they remain undiagnosed, these children might wind up with short stature in adulthood due to their celiac disease.

However, children with celiac disease are not always underweight. Another recent study found that almost one in five children were overweight at diagnosis, while 75% were considered normal weight. Most of those children who were too heavy when they were diagnosed lost weight after they began following the gluten-free diet.

Children exhibiting typical symptoms of celiac disease tend to get diagnosed earlier than those who exhibit less typical symptoms, probably because their physicians recognize the possibility of celiac more readily. They also have more celiac-related intestinal damage than children with atypical celiac symptoms.

Atypical Symptoms In Children Include Anemia, Irritability, ADHD

A large minority of children — one study showed about 30% — exhibit iron deficiency anemia as a primary sign of celiac disease. This anemia, which is thought to occur in both children and adults with celiac because they cannot absorb iron from foods they consume, usually resolves itself fairly quickly once the person is diagnosed with celiac disease and begins following the gluten-free diet.

Many children with undiagnosed celiac also display near-constant irritability, although it’s not clear why this occurs. It’s possible that they simply don’t feel well, or there may be a connection with vitamin deficiencies — possibly deficiencies in vitamin B-12 and essential fatty acids, both of which affect mood and neurological function.

Finally, a diagnosis of attention deficit hyperactivity disorder in your child may be an indication that she should be tested for celiac disease. As many as 15% of people with ADHD may have celiac disease, and adopting the gluten-free diet seems to relieve their symptoms of ADHD quickly and thoroughly.

When To Test Children for Celiac Disease?

Like adults, children can develop celiac disease at any time, and so should be tested if they display symptoms… even if those symptoms are subtle or atypical.

In addition, children with close relatives who have celiac also should be tested, even if they don’t seem to have any symptoms. It’s fairly common to find “silent” or symptomless celiac disease in relatives of recently-diagnosed celiacs, and those people also should adopt a gluten-free diet to avoid future complications of the condition.

Celiac diagnosis usually involves a panel of celiac blood tests looking for specific antibodies. If those come back positive or suggestive of celiac disease, the next step is an endoscopy that looks for intestinal damage.

If your child ultimately is diagnosed with celiac, the only available treatment is a gluten-free diet. The good news: Your child may enjoy a growth spurt once diagnosed, and she may shed any inattentiveness and irritability quickly, too. Many parents find their newly diagnosed child seems much happier, is more energetic and even does better in school once she starts the diet.

Diabetes Drugs Emerge As Top Force In Drug Spending

By Armen Hareyan on May 16, 2008 – 11:07am for eMaxHealth
Diabetes treatments are now the leading driver of prescription drug spending growth, displacing lipid-lowering drugs which fell precipitously after a decade of reigning in the top position, as generic drugs cut the cost of treating high cholesterol. These new findings were reported by Medco Health Solutions Inc., the nation’s leading pharmacy benefit manager, in its just-released 2008 Drug Trend Report, a comprehensive analysis of prescription drug spending and utilization.

The report shows that despite continued growth in the use of cholesterol drugs, spending fell 8.5 percent in 2007 as usage of lower-cost generic versions of Pravachol and Zocor expanded in the marketplace, resulting in lipid-lowering medications experiencing the greatest spending decline of all drug categories. Meanwhile, spending on diabetes drugs increased 12 percent due to shifts toward higher-cost treatments, brand-name drug price inflation, and moderate growth in the number of patients receiving treatment.

For a decade, cholesterol drugs were the largest driver of drug trend — a measure of spending growth for pharmacy benefit plans. These medications still account for a sizable 10.8 percent of all prescription costs with utilization rising 5.9 percent last year as new clinical guidelines expanded the population that can benefit from these treatments.

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Teens eating way to heart disease, prevent with these 3 tips

By Teresa Tanoos on April 3, 2013 – 4:12pm for eMaxHealth
Heart Teen Health Current News

According to a new study from the American Heart Association (AHA), a whopping 80 percent of American teenagers are eating foods that will make them prime candidates for heart disease. The study’s researchers reported their findings Monday, saying teens in the U.S. are eating too much fat, salt and sugar and not eating enough fruits and vegetables.

Only one percent of the teenage participants in the study consumed what the AHA considers a perfectly healthy diet. And to make matters worse, they don’t exercise enough, said study leader Christina Shay from the University of Oklahoma Health Sciences Center.

“The far less-than-optimal physical activity levels and dietary intake of current U.S. teenagers, is translating into obesity and overweight that, in turn, is likely influencing worsening rates of high blood pressure, high cholesterol and blood glucose at these young ages,” Shay said.

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Parkinson’s Treatment: 10 Secrets to a Happier Life

By Michael S. Okun, MD
Available in Over 20 Languages
Dr. Michael S. Okun, NPF’s National Medical Director, has written a new book that focuses on the secrets that help people with Parkinson’s live with hope and happiness. Based on his experience as a Movement Disorders Specialist, the book addresses issues surrounding Parkinson’s disease and the secrets that have changed people’s lives.
There isn’t any joking with Dr. Okun about the 10 Secrets for a Happier Life in Parkinson’s disease. This book is a critical resource for Parkinson’s disease patients and families from around the world who speak different languages, but suffer from very similar and often disabling symptoms.
— Muhammad Ali
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3 Basic Tips for Coping with an Autistic Child One-Day-at-a-Time

By Timothy Boyer on April 4, 2013 – 11:33am for eMaxHealth
Autism Family Health News Analysis

Raising an autistic child is a marathon and not a sprint. And as such, parents of autistic children and other caregivers such as relatives or a child-sitter need to know the basics of how to care for and cope with an autistic child on a day to day basis. Autism experts from the University of Alabama at Birmingham recently offer tips that not only can help a child manage his or her autism, but in turn can also help parents cope with the disorder.

The following is a compilation of fundamental tips recommended by autism experts that can help parents and caregivers with the challenges of caring for a child with autism:

Autism Tip #1: Become an expert on autism and on your child, or autism spectrum disorder (ASD), is like the spectrum of wavelengths of light―each autistic child communicates on and shines under a different wavelength. According to Kristi Menear, Ph.D., chair of the University of Alabama at Birmingham Department of Human Studies, identifying and knowing the spectrum of your autistic child can help guide a parent in helping their autistic child with particular challenges such as with cognition, sensory integration, motor development, social and communication skills.

“Learn about where your child falls and what that means,” says Menear. “Once you know to what extent your child has the disorder, you can create a plan of action.”

However, there is more to educating yourself on autism than knowing where your child lies within the spectrum and what to expect, you must also learn the particulars of your individual and unique child. To accomplish this you need to be able to identify your child’s triggers:

• What does your autistic child find stressful?

• What does your autistic child find calming?

• What does your autistic child find uncomfortable?

• What does your autistic child find enjoyable?

To discover these triggers you need to be aware of nonverbal cues and pay attention to your child’s sensory sensitivities:

• Look for nonverbal cues that your autistic child may be using to communicate.

• Pay attention to the kinds of sounds they make, their facial expressions, and the gestures they use when they’re tired, hungry, or want something.

• Figure out what sights, sounds, smells, movements, and tactile sensations trigger your kid’s “bad” or disruptive behaviors and what elicits a positive response.

If you understand what specific triggers affect your child, you’ll have a better grasp of how to deal with a problem or situation.

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Ketoacidosis: A Diabetes Complication

Written by Bonnie Sanders Polin, PhD
Ketoacidosis can affect both type 1 diabetes and type 2 diabetes patients. It’s a possible short-term complication of diabetes, one caused by hyperglycemia—and one that can be avoided.

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious complications of diabetes. These hyperglycemic emergencies continue to be important causes of mortality among persons with diabetes in spite of all of the advances in understanding diabetes.

The annual incidence rate of DKA estimated from population-based studies ranges from 4.8 to 8 episodes per 1,000 patients with diabetes.

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Unfortunately, in the US, incidents of hospitalization due to DKA have increased. Currently, 4% to 9% of all hospital discharge summaries among patients with diabetes include DKA.

The incidence of HHS is more difficult to determine because of lack of population studies but it is still high at around 15%. The prognosis of both conditions is substantially worsened at the extremes of age, and in the presence of coma and hypertension.

Why and How Does Ketoacidosis Occur?
The pathogenesis of DKA is more understood than HHS but both relate to the basic underlying reduction in the net effective action of circulating insulin coupled with a concomitant elevation of counter regulatory hormones such as glucagons, catecholamines, cortisol, and growth hormone.

These hormonal alterations in both DKA and HHS lead to increased hepatic and renal glucose production and impaired use of glucose in peripheral tissues, which results in hyperglycemia and parallel changes in osmolality in extracellular space.

This same combination also leads to release of free fatty acids into the circulation from adipose tissue and to unrestrained hepatic fatty acid oxidation to ketone bodies.

Some drugs can affect these processes. Medications that affect carbohydrate metabolism such as corticosteroids, thiazides, and sympathomimetic agents may precipitate the development of both DKA and HHS.

Sometimes ketones are present in urine when blood sugar falls too low and the body has to use body fat to get energy. In young diabetic persons, psychological problems complicated by eating disorders may be a contributing factor in 20% of recurrent ketoacidosis.

Factors that may lead to insulin omission in younger patients include fear of weight gain with improved metabolic control, fear of hypoglycemia, rebellion from authority, and stress stemming from having a chronic disease.

The most common precipitating factor in the development of DKA or HHS is infection. Other factors are cerebrovascular accident, alcohol abuse, pancreatitus, myocardial infarction, trauma, and drugs. Arule of thumb to understand DKA is that dehydration plus blood ketones equals DKA.

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