February 19th, 2010
10:10 AM ET
By Laura Cozik
There are seven common training zones. The most utilized for triathlon racing is Zone 3, or your Tempo Zone. This is the zone you will race in, so it’s also where you should spend a lot of your training time. Zones 6 and 7 are not often visited by triathletes, as they are really your short burst of power efforts, lasting no more than 20 seconds to about 3 minutes in length. There are, however, benefits to applying them from time to time.
· ZONE 1 – Active Recovery – You can spend all day here!
Active recovery is easy, so easy it can be hard to maintain without going overboard. This level is not for training endurance but for recovering tired legs after hard training or racing. No significant effort whatsoever.
· ZONE 2 – Endurance – This is also an all-day pace or classic long/slow distance training.
This is a no-frills effort where most athletes spend the majority of their training rides – base training, easier intensity, low-level leg fatigue, breathing is more regular than at Level 1, but continuous conversation is still possible. It remains a completely aerobic effort.
· ZONE 3 – Tempo – This is our triathlon race pace.
A medium/hard level aerobic exertion, slightly more difficult than endurance level. This will require more concentration to maintain the effort and conversation will be difficult.
· ZONE 4 – Lactate Threshold – This is time trial pace, or your best 20-minute effort.
Lactate is a byproduct of anaerobic metabolism within the muscle, although lactate is produced continuously, even at rest. As exercise intensity increases, more lactic acid is produced in the muscle and is released into the blood. Lactate Threshold, or LT, is the point at which muscle lactate production into the blood is higher than the rate at which the body can metabolize it.
· ZONE 5 – VO2 Max – This effort lasts 3-8 minutes in duration.
Everybody has a physiological limit to the amount of oxygen that can be transported and utilized, which is the VO2 max or maximal oxygen consumption. This is the largest volume of oxygen your lungs can consume and the highest end of aerobic training. Strong to severe sensations of leg effort/fatigue. Conversation not possible due to labored, ragged breathing. These are hard efforts that teach an individual how to suffer!!
· ZONE 6 – Anaerobic Capacity – Up to 3 minutes sustained, high intensity effort.
This level is above aerobic exertion and must be performed in short 30-second – 3 minute repeats at the highest intensity one can maintain for those time periods. This is a very intense exertion and is typically not repeated consecutively, as recovery is needed. For example, a 1-minute interval generally takes about 3 minutes to fully recover from. Severe sensation of leg effort/fatigue, and conversation impossible.
· ZONE 7 – Neuromuscular Power – 20 seconds or less!!!
Strength! As hard as you can push the pedals for a very short time – 20 seconds or less. This level has short, maximal efforts without specific parameters. Greater stress on musculoskeletal rather than metabolic systems. Complete recovery needed.
Next week we’ll discuss the benefits of each zone.
February 18th, 2010
07:49 PM ET
By Saundra Young
If you are an asthmatic who uses long-acting beta agonists–or LABAs– to treat your asthma symptoms, your medication may be doing more harm than good.
The Food and Drug Administration announced new safety warnings Thursday saying the medications should never be used alone by children or adults. The agency says it will require manufacturers to add additional warnings to the product labels, and ask doctors and patients to scale back overall use of the drugs.
"Patients with asthma should try to get on a single-agent steroid inhaler," said Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research. "And not try to get on combination medications with LABAs unless they really need them"
According to the FDA, LABAs put asthma patients at increased risk of severe, worsening symptoms; they lead to increased hospitalizations and even death. The LABAs in question contain the single drug Serevent or Foradil and can be in the combination medications Advair and Symbicort, which also contain inhaled corticosteroids. Corticosteroids supress inflammation and help reduce symptoms in inflammatory ailments such as asthma and arthritis. Advair contains Serevent, whose active ingredient is Salmeterol. Symbicort has Foradil; its active ingredient is Formoterol.
"Although these medications play an important role in helping some patients control asthma symptoms, our review of the available clinical trials determined that their use should be limited, whenever possible, due to an increased risk of asthma exacerbations, hospitalizations and death." said Badrul Chowdhury, director of the Division of Pulmonary and Allergy Products at the FDA's Center for Drug Evaluation and Research.
Children are of particular concern, said Dr. Dianne Murphy, director of the FDA's Office of Pediatric Therapeutics. "Parents need to know that their child with asthma should not be on a LABA alone."
The new labels will warn that:
*Long-term use should be only in patients whose asthma can't be controlled by controller medications
*LABAs should be used only for the shortest amount of time possible, and discontinued once asthma has been controlled. Patients should then be maintained on an asthma controller medication.
*Pediatric and adolescent patients who need a LABA in addition to inhaled corticosteroids should use a combination product that contains both a LABA and an inhaled corticosteroid
Novartis, maker of Foradil, released a statement saying, "Novartis and Merck will work closely with the FDA to assess the guidance provided in the Communication and determine appropriate next steps. We are committed to helping ensure that healthcare providers and patients have the most accurate and complete information regarding the safe and appropriate use of FORADIL. We will continue communicating with patients, caregivers and healthcare providers about FORADIL in ways that will help inform their decisions about appropriate treatment choices."
GlaxoSmithKline (GSK), which makes both Serevent and Advair, says it has 30 days to agree with the proposed changes - or say why they aren't necessary.
"We will work with FDA to ensure that the final label for these products protects the interest of patients who suffer with this chronic and serious disease," said Dr. Katharine Knobil, vice president for Respiratory Clinical Research at GSK. "It is important that doctors have flexibility to make the proper clinical decisions to help patients gain and maintain optimal control of their asthma."
According to the FDA, in a 2008 trial of more than 13,000 patients who took Salmeterol, there were 13 deaths. But GSK says in 10 years of clinical studies, there were no asthma-releated deaths in the nearly 18,000 patients who took Advair.
Drug makers will now have to do additional safety studies that look at LABAs when used with inhaled corticosteroids. And, the agency says it will continue to scrutinize prescribing patterns to make sure the new safety controls are being followed. LABAs are also approved to treat people with chronic obstructive pulmonary disease or COPD. However, the new recommendations apply only to treating asthma patients.
February 18th, 2010
05:21 PM ET
By Miriam Falco
The World Health Organization is recommending that the H1N1 flu virus that’s currently circulating be included in the next seasonal flu vaccine for the Northern Hemisphere.
The WHO meets twice a year to determine which flu strains are the most dominant and chooses three strains to include in the regular flu vaccine.
Based on recommendations from flu experts from around the world, it was decided at the meeting Thursday in Geneva, Switzerland, that the pandemic H1N1 influenza strain go into the vaccine for the coming fall and winter, according to the Special Adviser on Pandemic Influenza to Dr Keiji Fukuda, director-general of the WHO.
The two other flu strains to be included into the next flu shot or flu
He told reporters in a teleconference that parts of Eastern Europe, parts of Northern and Western Africa and parts of Asia are seeing the highest levels of pandemic H1N1 flu activity.
In a meeting in September, the WHO had already recommended that the seasonal flu vaccine for the Southern Hemisphere contain the H1N1 strain.
Fukuda said so far, "over 200 million people have been vaccinated with
While the WHO recommends which strains go into the next flu vaccine, it's up to individual countries to decide whether they want to combine all three recommended strains into one shot, or if they want to have each strain in doled out separately. The pandemic H1N1 strain was not included in this year's flu strain because it emerged in April, about two months after the three seasonal flu strains had been selected for the 2009/2010 flu season.
The Food and Drug Administration's Vaccines and Related Biological
February 18th, 2010
02:17 PM ET
From Stanley in New Jersey:
“With all the different information available on the Web, how does one determine what to look for in a fish oil supplement?
Stanley, I’m glad you’re being proactive about your health and considering fish oil. It’s actually one of the few vitamins and supplements I take and there’s plenty of scientific evidence to show it can be a powerful tool in preventing disease. Fish oil supplements contain omega-3 fatty acids, which have been shown to reduce a person’s risk of heart attack and heart disease and protect against stroke, dementia and other cognitive problems.
The American Heart Association even recommends that people with high triglyceride levels take 2 to 4 grams of fish oil supplements containing EPA & DHA. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two fatty acids in fish oil thought to have the biggest benefits.
However, before taking any supplement you should speak with your health care provider. In the case of fish oil supplements, the FDA warns not to take more than 2 grams of fish oil per day. If you take high doses there can be side effects such as excessive bleeding or possibly an interaction with another medication you’re taking.
To get specifics on what you should look for when choosing your supplement I asked Dr. Brent Bauer. He’s the director of the complementary and integrative medicine program at the Mayo Clinic. He said he recommends three things to his patients:
I should also add that all the experts I’ve talked to say, if possible, it’s better to get your omega-3s from fatty fish such as salmon and tuna rather than from a supplement.
February 17th, 2010
04:18 PM ET
By Miriam Falco
WASHINGTON, D.C. (CNN) If you live in Vermont and read the paper last November, you may have gleefully seen that your state edged out Minnesota as the healthiest state in the union, according to the 2009 ranking of healthiest states by the United Health Foundation, a non-profit health advocacy group funded by the insurance giant United Healthcare.
But if you live in the upper Northeast part of the state, in Essex County, Vermont, you may not be so thrilled about a new report released today because it says you live in the unhealthiest county in your state.
On the other hand, if you live in DeSoto County, Mississippi, you live in the healthiest county of the unhealthiest state.
This is all part of the report that ranks the overall health of all 50 states, from healthiest to least healthy, courtesy of the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. They’re calling this report, “the first annual checkup for every county in the nation.”
Pat Remington, associate dean for public health at the University of Wisconsin in Madison and lead author of this new report, says what this report does is – by summarizing the overall health of a community –allows residents to know how healthy their county is and how it compares with neighboring counties.
Researchers ranked states based health outcomes, which they describe as on how long people lived (mortality) and how well they feel while they are alive (morbidity).
They also ranked them according to health factors, such as smoking and obesity; health care access and quality; unemployment; how many children live in poverty; air pollution and how much access there is to healthy foods.
If you look at their map of the United States showing the five healthiest and unhealthiest counties in each state, it may surprise you that they are often side-by-side. For example, according to the report, Chester County is the healthiest in Pennsylvania, but neighboring Delaware and Philadelphia Counties rank 36th and last in the state.
Remington and his colleagues hope the new report will change the landscape.
“It really is a call to action, not just for public health officials” says Remington, “it’s a call for action for educators, employers, community organizers to come to the table and start working together to improve the health of an entire community.”
Remington says after Juneau County, Wisconsin, was ranked unhealthiest in the state, the first response was anger and denial – but pretty quickly, rather than acceptance, the communities got motivated to make things better. Local health officials decided to add community access to health care, so everybody could be seen by a doctor. They also opened a free dental clinic and doctors started handing out books to improve literacy. Remington says these are just some examples of how a community can come together to make things better.
February 17th, 2010
02:35 PM ET
By Jennifer Bixler
We've told you before that aspirin can help with heart health. Now a new study suggests taking aspirin may keep breast cancer from returning.
Harvard researchers studied more 4,000 women participating in the Nurses' Health Study. They found women who had stage 1, 2 or three breast cancer and took aspirin on a regular basis a year after diagnosis were 50 percent less likely to die or have their cancer spread than women who did not take aspirin. The findings are published in the Journal of Clinical Oncology.
What's so special about aspirin? "We are gaining an appreciation that cancer is an inflammatory disease and aspirin is an anti-inflammatory," says Dr. Michelle Holmes, the study's lead author. While she says results are promising, Holmes empathizes this is an observational study and that clinical trials need to be done.
Dr. Eric Jacobs of the American Cancer Society agrees. He says the study results are "exciting," but also points out some important caveats. He says two earlier studies had mixed results. "It would be premature for breast cancer survivors to use aspirin in order to reduce the risk of breast cancer recurrence or of dying from their disease," said Jacobs in an e-mail to CNN.
So should breast cancer survivors start taking aspirin? Experts say for now, no. But if women are taking aspirin for other diseases, says Holmes, "They might take some comfort in knowing they might be preventing their cancer from returning."
February 16th, 2010
04:23 PM ET
By Angie Brouhard
When my husband heard about the Fit Nation Triathlon Challenge, the first thing he said to me was “You have a great story! I think you should share it!” I do have a good story, and I think a lot of women across our country can relate to my life.
CNN Fit Nation Challenge participant Angie Brouhard.
I have always taken care of myself and my family. We eat healthy meals, enjoy being active, avoid foods that are high in fat or cholesterol. So we were stunned by my April 2009 diagnosis of breast cancer, detected by a routine mammogram. My husband and I began gathering information, meeting with doctors, asking opinions, researching treatments. Our strong faith, our family and our friends helped us get through that difficult time.
At 40 years old, I was in pretty good shape, jogging a few times a week and biking with our kids. When the breast cancer diagnosis came, my activity level dropped. Throughout my surgeries and treatments, I walked through our neighborhood once or twice a week, but my energy level was low and my motivation even lower. I gained over 15 pounds from my diagnosis in April to my last surgery in December. Just one week after my reconstructive surgery, my husband saw Dr. Gupta’s segment on CNN that would change my life.
The hardest part of the Triathlon Challenge for me has been jumping into the fitness routine – especially the swim. My idea of swimming is floating in the lake wearing a life jacket or splashing around in the pool, playing sharks and minnows with the kids and jumping off the diving board. Not swimming lap after lap. The morning of my first swim workout, I watched the ladies on the masters swim team at our local YMCA. They looked so graceful, beautiful, and strong as they sliced through the water, lap after lap. I lowered myself into the water and splashed toward the other end, gasping for breath and praying that I could make it to the wall. Yesterday, I finished my 10th pool workout, and although I am still uneasy being seen in public in my swimsuit in February, I am happy to report that I can swim 700 yards – stopping to catch my breath after every 50. I have found that I love to swim!
The first day of my bike workout was a similar experience. Walking into a cycling class for the first time is intimidating. Everyone else followed the instructor’s directions without missing a beat – stand, lunge, push up, squat, stand again. I could hardly even stand and pedal. After 5 minutes, I was ready to climb off. Again, I am happy to report that the last class I took, I could complete 90 percent of the instructor’s directions. Much improvement in just a few classes!
My husband and oldest son are runners. When I watch my son run, I see him practically fly. His feet barely touch the ground. My first “run” of my training consisted of a 2-mile jog/walk through our neighborhood. Now, four weeks later, I can jog 4 miles without stopping.
I admit it is tough to juggle the everyday demands of life – keeping up with the laundry, cooking, cleaning, working, taking care of the kids, driving the carpool, shopping – without working out six days a week. Crazy! But I want to take control of my physical well being. I want to be an example to my kids that I am taking care of myself and that I will rise to any challenge – whether it be breast cancer or a triathlon.
I remember lying on the couch last summer recovering from a chemotherapy treatment and wondering if I would ever feel like myself again. With the motivation of the triathlon and the help of my faith, family and friends, I know I will not just feel like myself again, but I will feel better than ever! So when I cross that finish line on July 18, I will have completely conquered breast cancer. I will be strong and healthy and physically fit! And I will collapse in my husband’s arms and wish him Happy Anniversary!
I hope to inspire others across the country to get out there and do it! Join your local health club and swim a few mornings a week. Take a ride on your bike or get out and start walking. It might put you outside of your comfort zone, but you can do it! If I can do it, you can, too!
February 16th, 2010
10:13 AM ET
By Caitlin Hagan
A new study published in the journal Clinical Pediatrics has concluded that "the critical period for preventing childhood obesity...is during the first two years of a child's life and for many by three months of age." It's the first study to identify a so-called "tipping point" in a child's development of obesity. This new finding comes as first lady Michelle Obama is targeting childhood obesity in a new national initiative Let's Move.
"We've been struggling with the older kids, ages 6 to 8, who are already way overweight," says Dr. John W. Harrington of Children's Hospital of the King's Daughters in Norfolk, Virginia. "And at that age, it's too difficult to change eating habits."
Harrington and his team set out to determine the point at which a child's weight gain becomes unhealthy and leads to overweight.
"We backtracked and said, 'When did this weight first happen?'" says Harrington. "Since the age of 3 or 4 months, these children were overweight as babies...they had normal growth but their weights were averaging well above their heights."
By identifying when the weight gain first develops, Harrington believes pediatricians will be able to intervene early to change poor eating habits in babies and toddlers on track to becoming overweight.
But the study doesn't change the old adage that a chubby baby is still a healthy baby, especially since babies need extra fat for brain, eye, and nerve development. But Harrington argues that babies need less fat in their diets than was once thought.
"Parents feel the need to feed the child; feed them, feed them, feed them" says Harrington. "But they're not watching what the child is doing."
The key for parents is to pay attention to simple cues to ensure that they're not overfeeding their baby. For example, when a baby stops suckling while being breastfed or pulls his face away from his bottle, he may be too full to want more formula even if he's had only half of his usual serving.
Another cue is to watch how frequently your baby drools while feeding. Drooling from the side of his mouth could signal he's eaten enough.
"Your baby can control their eating habits" says Harrington. "And if you allow them to do that, they can control what they take in."
Harrington suggests a feeding schedule of 2 to 3 ounces per feeding during the first few weeks of your baby's life. That should increase to 5 to 6 ounces per feeding by your baby's 6-month mark. But he also cautions that all parents should consult with their peditrician about any concerns they have about feeding practices or their baby's weight.
Do you worry about your baby's weight? How often are you feeding your child?
February 16th, 2010
09:05 AM ET
By Ashley WennersHerron
I am an allergy sufferer — from seasonal sniffles to mushrooms and penicillin. Although I’ve been careful and lucky enough to have to use an adrenaline auto-injector only once, I’m wary of trying new things, whether it’s food or a new vaccine, out of fear of discovering yet another allergy. Despite my hesitation, I felt the protection granted by receiving the H1N1 vaccine outweighed the risk of a possible allergic reaction.
Early this month, I made an appointment with my school’s health center to receive the nasal spray vaccine. When I went in, I bravely tilted my head back, pinched one nostril and then the other for my two shots of vaccine nasal spray. The nurse told me not to blow my nose for 10 minutes and I was free to go.
Nearly 20 minutes later, I felt a familiar tingle in my mouth, similar to the one I get if I eat shellfish. Twenty minutes after that, with my tongue was twice as large as normal, I sounded like Daffy Duck. I had a fever of 102 degrees and a migraine. Yep, I added another allergy to my list — the H1N1 vaccine.
I called a local hospital to see whether I should go to the emergency room. They recommended that I take a Benadryl and come in if I developed respiratory problems. I took the antihistamine tablet and promptly slept away my symptoms. Three hours later, I was a bit groggy, but asymptomatic.
According to the Vaccine Adverse Event Reporting System, which is co-sponsored by the Centers for Disease Control and Prevention and the Food and Drug Administration, 6,528 individuals have reported an adverse reaction after receiving the H1N1 vaccine through injection. There have been 1,962 reactions reported for the live nasal spray vaccine. Both coincidental reactions and those caused directly by the vaccine are reported to the VAERS.
The CDC says that the nasal spray may cause a runny nose, but only in certain individuals is there a stronger reaction. If there is a severe reaction, such as trouble breathing, then the person should be brought to a doctor immediately. I was lucky to have only mild symptoms that did not require medical attention.
Despite my discomfort, I’m glad I received my vaccination. I live in a college dorm, surrounded by the 18- to 24-year-old age group most likely to be affected by this strain of influenza. I use public transportation, I shop in crowded grocery stores and I am constantly interacting with other people. The vaccine not only protects me, but it also aids in preventing transmission of the disease.
For me, a young and healthy individual, the flu would probably be mild, but I would still host the virus. This means I could pass it along to my classmates, my co-workers and to strangers on the subway. Someone with a compromised immune system, or someone with a chronic health problem could have much more severe consequences, such as developing pneumonia or respiratory problems.
I’m doing what I can to prevent people from getting sick; are you?
February 15th, 2010
05:04 PM ET
By Jennifer Bixler
To take hormones or not to take hormones: That is the question many women going through menopause ask themselves and their doctors. It’s been a topic of debate and discussion for years. Now a new study bolsters previous findings that women who received hormone therapy well into menopause may be at increased risk of heart disease.
A team lead by Harvard researcher Dr. Sengwee Darren Toh looked at over 16,000 post-menopausal women. The women were divided into two groups: One received estrogen plus progestin, one of the standard treatments for women going through menopause. The other group received a placebo. Toh and his team found that among women who began combined hormone therapy within a just few years of menopause, which is when women typically begin treatment, "There is no suggestion of a reduced risk of heart disease." But, he adds, "There is also no strong evidence to suggest a significantly increased risk of heart disease among these women either." Toh says that is primarily because their study sample for women who started therapy closer to menopause was small. "We just don't have enough women who were newly menopausal to get definite answers to this question."
However, the researchers did find that women who started combined hormone therapy a decade after menopause had an increased risk of heart disease.
The findings are published in the February 15th edition of the Annals of Internal Medicine.
Why is this important? For decades, hormone replacement therapy has been used to alleviate hot flashes and night sweats, two of the main symptoms of menopause. Doctors also believed that boosting estrogen levels could stop heart disease. However, in recent years, hormone therapy has been mired in controversy. In 2002, the Women’s Health Initiative stopped its clinical trial after researchers found hormone therapy actually posed more risks than benefits.
So what does this mean for women “going through the change?” The bottom line, says Toh, consult your doctor and do what works for you. If combined hormone therapy helps with hot flashes, keep it up. The Food and Drug Administration says women who want to try combined hormone therapy should use the lowest dose for the shortest time possible.
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