Q & A: What does "working in" mean?

If someone at the gym asks you if he can "work in," don't glare at him for making an indecent proposal. He's just asking if he can share the equipment in between sets.

If someone inquires as to how many sets you have left, it's good manners to ask if he or she would like to work in. This shouldn't interfere with your workout, and it could be a great way to meet a potential gym buddy or workout partner.

Cut the Sliced Bread (Out)

Any way you slice it, white bread isn't a good choice. A new Italian study concluded that eating more than four slices of white bread a day doubles your risk of developing kidney cancer. The reason: "White bread, like other refined grains, has a high glycemic index," says study author Francesca Bravi, ScD. "That means it raises blood sugar and insulin levels, which may spur the growth of cancer cells." Consider this yet another to curb your carb intake, as well as to make sure the bread you do eat is made with 100 percent whole grains.

Drug Warning for Expectant Mothers

Drug Warning! Women who take anti-inflammatory drugs (NSAIDs) such as Aleve, Advil, Motrin, Celebrex or Vioxx, during their first trimester of pregnancy may be more likely to have babies with congenital defects, especially heart abnormalities. Previous studies have shown that taking NSAIDs late in pregnancy can cause circulatory defects. For relief of minor pain during pregnancy, most doctors recommend Tylenol.

How Does Your Waistline Matter? Let Us Count the Ways.

NYTimes Explores Obesity



AT age 39, with diabetes and high blood pressure in her family, Linda M. was starting to worry about her weight and its health consequences. She was 5 feet 6 inches tall and weighed 170 pounds, which placed her in the overweight category, according to the standard definition. Although she was not officially obese, she said, “I realized I was not at my ideal weight.”

But Linda was in for a surprise during an appointment last fall with Dr. Judith Korner, an obesity specialist at Columbia University. Instead of weighing her, Dr. Korner whipped out a tape measure and measured her waist.

It was 35 inches, putting her in a danger zone, Dr. Korner explained. An overweight woman with a waist 35 inches or larger, or an overweight man with at least a 40-inch waist, is at increased risk for diabetes and heart disease.
“That was an education,” said Linda M., who did not want her last name revealed because of her weight. “I did not realize that my waist determined my future risk.”

Obesity specialists differ on what measurements are best.

Linda’s body mass index, or B.M.I., for example, was 27.4, far from the obesity category, which starts at 30. She would have to weigh 185 pounds to have a B.M.I. that high. (For comparison, a man who is six feet tall and weighs 221 pounds is considered obese.)

If a doctor were to use B.M.I. exclusively to evaluate Linda, the conclusion would be that her weight was not a serious health risk. She had only one risk factor for heart disease — a high level of triglycerides — and the guidelines for B.M.I. say that overweight people need two factors, like high triglycerides and a high cholesterol or blood pressure levels, to be considered at serious risk.

B.M.I. has limitations. Muscular men might have high B.M.I.’s, which make them seem fatter than they are. Old people often have deceptively low B.M.I.’s because they have lost so much muscle in the aging process.

In Linda M.’s case, adding her waist measurement to her B.M.I. indicates a high health risk, according to guidelines published by the National Heart, Lung and Blood Institute. For Dr. Korner, the test is useful in assessing if people like Linda M. — overweight but in a gray zone — face a true health risk? If her waist had been less than 35 inches, Dr. Korner would have been less concerned.

Dr. Ned Calonge, chairman of the United States Preventive Services Task Force, said the panel preferred B.M.I. measurements to determine whether people are fat enough to place their health at risk. For most adults, he explained, B.M.I. “is more feasible or has better validity than other measures.”

But, Dr. Calonge added, it is not enough to simply diagnose someone as obese. The goal should be better health.

And the problem with testing for obesity, using B.M.I. or anything else, is that the sort of counseling most patients get from their doctors has not been shown to improve health, Dr. Calonge said.

“You now have a, quote, diagnosis,” Dr. Calonge said. And there is at least fair evidence from research that intense and expensive counseling about diet and exercise can help people lose weight and improve conditions that place them at risk for heart disease. But, he added, “it is uncertain whether less intense interventions have any impact at all.”

For Madelyn Fernstrom, the director of the Health System Weight Management Center at the University of Pittsburgh Medical Center, the goal of a medical exam is not to document how fat someone is but to rule out rare metabolic conditions that might be causing the weight problem. An exam also helps to determine whether there are associated medical conditions that should be treated, like diabetes or high cholesterol or blood pressure.

As for Linda M., waist measurement made the difference.

“After that, I got myself in gear,” she said. “I tried to eat less sugar and healthier snacks; I was more conscious of what I was selecting.”

She lost 20 pounds and a couple of inches from her waist. Her triglycerides are lower, yet still a bit high. But, she says, as she sees it, with a smaller waist, “I’m out of the danger zone.”
Talk To Your Doctor:

• What is my body mass index?
• What does it tell me about my health risk?
• Does my waist size put me at higher risk for medical problems?
• Are there metabolic conditions that might be causing me to gain weight?
• Where can I go for practical advice on how to improve my diet and an exercise regimen to lose weight?

Eat This, Heal... Muscle Cramps

The most common cause of cramping is dehydration. Muscle twitches often indicate low potassium.

Your body needs: Fluid; plus electrolytes such as sodium, potassium, and chloride to maintain a balance in your muscles.

You should eat: Lots of melon. Try a quick salad made with 1 cup of chopped watermelon mixed with 1 cup of chopped cantaloupe.

(Personally, I like to drizzle a little balsamic on my watermelon. Also, I keep bananas handy in case of muscle twitches.)

Hot Topic

Research shows that a little spice can go a long way...

Prevent diabetes: Australian researchers found that women who ate chili sauce daily had lower spikes in their blood sugar (glucose) levels after meals than those with blander diets. More stable glucose levels reduce diabetes risk.

Stave off Alzheimer's: Curry contains tumeric, which is high in curcumin. According to a study published in Journal of Alzheimer's Disease, this antioxidant helps sweep away amino acids that can build up in your brain's blood vessels. Over time, these blockages can lead to dementia.

Protect against obesity: Early research from Taiwan found that chili peppers' capaicin may reduce the number of fat cells your body produces.

Tip: Metabolism Booster

EAT MORE!
This doesn't mean you should heap more food on your plate. Eating more frequent but smaller meals increases RMR (resting metabolic rate) higher than eating the same amount of calories spread over fewer meals.

from Hers Muscle and Fitness

Healthy Recipe: Vietnamese Chicken Skewers

Serve these as appetizers or on top of a bed of stir fried veggies as a main course.


Ingredients:
2 cloves garlic, minced
1 small red onion, minced
1 stalk lemongrass, inner leaves only, minced
1 tablespoon fresh ginger, peeled and minced
2 jalapeno peppers, split, seeds removed
1 cup fish sauce
1 tablespoon cilantro, chopped
2 tablespoons sugar
juice of 1 lime
2 boneless skinless chicken breasts, cut into 1" cubes
wooden skewers, soaked in cold water for 30 minutes

Directions:

Combine the garlic, onion, lemongrass, ginger, peppers, cilantro, fish sauce, sugar, and lime in a saucepan. Slowly bring to a boil over medium heat, then take off the stove and cool. Toss the chicken into the marinate for 1-2 hours. Skewer the chicken cubes and grill them for 3-4 minutes a side until they're firm and lightly charred. Makes 4 servings.

Nutritional Information, per serving: 112 Calories 16 grams protein 11 grams carbohydrates 1 gram fat <1>

The Gall of Flab

If your belly keeps making a comeback, you may be gaining more than a few pounds: University of Kentucky researchers recently found that men who yo-yo diet are 76% more likely to develop galls tones than those who maintain consistent weight. In fact, the more frequent and severe your body-weight swings, the greater your risk. The scientists aren't sure why weight cycling causes gallstone formation but note that it was specifically related to fluctuating fat levels.

Food Spotlight: Red Bell Peppers

Red Bell Peppers taste best during the summer and early fall, so enjoy now!

1 Cup Contains:
39 calories 2 grams protein 9 grams carbs 3 grams fiber 0 grams fat

When you look at the nutritional information, it's clear to see why you need more of this tasty vegetable in your diet. Besides simply snacking on sliced raw peppers, here are some more suggestions: grilled; blended in a food processor with low fat sour cream, salt, and pepper for a tasty sauce or healthy dip; stuffed with low-fat ground beef and rice; on kebabs.

Facts:
Red peppers contain

• nearly 20% of your daily requirement of Vitamin E, a powerful antioxidant that heads off cell damage by busting free radicals that roam your blood stream.
• more immune-boosting vitamin C than oranges and almost twice the amount as their green cousins.
• beta-carotene which your body uses to manufacture vitamin A, lycopene, which gives the red peppers their hue, has been shown to lower the incidence of certain cancers.