Solving the Riddle of Rheumatoid Arthritis

The final frontier-it isn't necessarily space. A lot closer to home, the human body holds just as much mystery. Consider rheumatoid arthritis (RA). After decades of research, scientists still can't pinpoint the exact cause of the disease. The latest studies suggest a complex combination of genetics and unhealthy habits, putting some of the power of prevention in our hands.

The RA riddle begins with the immune system-our body's natural defense network. In its quest to protect the body against harmful invaders-such as bacteria or infections-the immune system can sometimes go awry. It can start to attack the body's own cells. In such a situation, a person may develop an autoimmune disease, one of which is RA.

Like other types of arthritis, RA strikes the body's joints. It gradually destroys them, hindering movement. Common symptoms include pain, swelling, and stiffness. People often develop RA in their hands or feet. But it can affect any joint and even other body parts, such as the eyes and lungs. It may also prompt fatigue, fevers, and a loss of appetite.

A telltale sign of RA is its symmetry-it usually attacks the same joint on both sides of the body. Other than that, RA can be difficult to diagnose. Part of the problem: People with the disease may not suffer from symptoms all the time. It can flare up periodically. Initial mild symptoms may also mimic other conditions.

Although scientists understand how RA affects the body, why isn't as clear. Certain genes have been linked to the disease. People with these genes are more likely to develop RA. But having them doesn't guarantee it. That's where other factors enter the equation.

Scientists have studied viruses, hormones, and most recently, lifestyle-related links to RA. Obesity may be a possible promoter of the disease. Recent research has found a connection between the expanding rates of obesity in the U.S. and an uptick in cases of RA. Being overweight seems to especially ignite RA in women-who are more likely to suffer from the disease in the first place.

Smoking is another potential lifestyle risk for RA. A recent study in the journal Arthritis Research and Therapy followed more than 34,000 older women over eight years. Of those who developed RA, nearly two-thirds of them were current or former smokers. In fact, those who had ever smoked-even as little as one to seven cigarettes a day-were twice as likely to have RA. A separate study found a similar connection between smoking in women and men.

These findings suggest that RA-like other chronic conditions such as heart disease-may be partly preventable. Not smoking and watching your weight may help avoid RA. What's more, doctors could use this information to better screen for people who may be susceptible to the disease. That can help with early treatment-the best way to ease symptoms and protect against joint damage.

Always talk with your health care provider to find out more information.

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Be Smart About Sleep Aids

Sleep can be elusive. On some nights, we easily cozy up with it. On others, it may linger frustratingly out of reach. Struggling for some shuteye may entice you to try a sleep aid. Used properly, sleep aids can help. But they aren't without risks.

A recent government report documented a spike in emergency room visits related to the sleep drug zolpidem. You may know it better as Ambien. From 2005 to 2010, such visits jumped 220 percent. Half of those were the result of an interaction with another drug, often a pain reliever.

Zolpidem and other similar prescription sleep aids, such as eszopiclone (Lunesta) and zaleplon (Sonata), treat insomnia. A person with insomnia may have trouble falling and staying asleep. The condition can last a few days or extend for weeks.

Like other drugs, sleep aids can have side effects. The most common are daytime grogginess, headache, and dizziness. More serious side effects may include severe allergic reactions and behavior like walking, eating, or driving in your sleep. These unusual activities are more likely to occur if you use such drugs excessively.

Sleep aids are available by prescription and over the counter. Although you may be able to buy some in a store, they can be just as harmful as prescribed drugs when not used properly. In particular, they may contain antihistamines, which can cause bad reactions in some people.

If you are considering any type of sleep aid, talk with your doctor first. He or she can help determine the best option for you. Also follow these steps to avoid problems:

Use a sleep aid only as directed. Don't take extra doses for a better night's rest.Take sleep aids for as short a time as possible. Some can be addictive.Never combine a sleeping aid with drugs or alcohol. Bad reactions are more likely to happen. Take a sleep aid only when you are able to devote at least eight hours to rest. Otherwise, you may be too sleepy the next day to perform daily activities.Consider cognitive behavioral therapy (CBT) before trying a sleep aid. CBT can teach you better sleep habits and ease anxiety associated with insomnia.Always talk with your health care provider to find out more information.

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Americans Need to Learn More about Antibiotics

Mind and BodyAmericans Need to Learn More about AntibioticsDo antibiotics cure the common cold? If you answered yes, you've got good company in being wrong. A recent poll found that many Americans don't know enough about antibiotics and their proper use.

The CDC surveyed more than 1,000 people nationwide. Most of those surveyed correctly knew that antibiotics are used to treat bacterial infections. But more than 33 percent believed in error that such drugs also work on viruses, such as a cold and the flu.

Other revealing statistics focused on antibiotic resistance. Forty-one percent of those surveyed had heard little or never heard about the topic. Of those who knew about it, their understanding wasn't always correct. For example, many people believed that antibiotic resistance happens to the person taking the antibiotic. They thought that he or she builds up a tolerance to the medication. But it's actually the bacteria that become resistant to the drug. In turn, the drug becomes less effective in treating the bacteria.

Antibiotic resistance poses a serious concern for doctors and patients. That's because the overuse of antibiotics has fueled the growing number of "superbugs." These are infections that have become hard to treat with antibiotics. Methicillin-resistant Staphylococcus aureus, commonly known as MRSA, is one example. The number of Americans hospitalized for MRSA jumped from 2,000 to nearly 370,000 from 1993 to 2005.

The use of antibiotics is declining. It has dropped by 17 percent since 1999. But Americans can do more to prevent antibiotic resistance. Lauri Hicks, D.O., medical director of the "Get Smart: Know When Antibiotics Work" program at the CDC, offers these tips:

Talk with your doctor about when to properly use antibiotics.Always take antibiotics as prescribed. Use them until they are gone even if you feel better.Stay up to date on recommended vaccinations.Prevent illness in the first place by washing your hands often.Always talk with your health care provider to find out more information.

It can prevent colds, food poisoning, and even the flu-all without a prescription. What is this medical wonder? Simple hand-washing. According to experts, washing your hands regularly is one of the best ways to protect yourself from harmful germs and prevent passing them on to others.

Crucial times to make sure that you wash your hands include after using the bathroom, before and after preparing food, before eating, and after blowing your nose, coughing, or sneezing. In order to get the most out of this key step to good hygiene, consider these hand-washing tips:

Use the right hand-washing tools. You need clean, preferably warm, running water and soap.Take your time! Soapy hands should be rubbed together for 20 seconds. This is about as long as it takes to sing the birthday song twice.Go for full coverage. Scrub your hands, wrists, fingernails, and between fingers.Rinse and dry hands using a paper towel or air dryer. If possible, use your paper towel to turn off the water.Use a sanitizer. If you can't get to soap and water, use an alcohol-based hand sanitizer to clean your hands.Always talk with your health care provider to find out more information.

Sources & References

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Are Multivitamins Worth the Cost?

A pill packed with lots of nutrients-a multivitamin-may seem like the perfect shortcut to healthy living. Chances are, though, you're already getting all the vitamins and minerals you need from the foods you eat. So unless you have a nutritional deficiency, multivitamins may not provide much health benefit.

Multivitamins are the most popular type of dietary supplements taken in the U.S. Commonly sold in pill form, they contain all or most of the vitamins and minerals your body uses to function properly. The amount of each nutrient is often close to or equals the daily intake experts recommend.Nearly 49 percent of Americans take some kind of supplement, such as a multivitamin. Why? Mainly to boost or maintain health. Unfortunately, research doesn't necessarily support that rationale. In fact, health experts don't hold a firm stance for or against multivitamins because of conflicting evidence.A recent review of 21 studies on multivitamins found that they don't improve overall health. Most notably, they don't help protect against heart disease or cancer. Another recent study echoes that conclusion-at least for your heart. Researchers followed more than 14,000 men over an average of 11 years. Men on multivitamins didn't have a lower risk for heart disease. Yet those same men were slightly less likely to develop cancer.Regardless of the research, it's still a good idea to be cautious about multivitamins, especially if you are otherwise healthy. That's because too much of some nutrients can be bad for you. Consider iron. Many of us consume enough iron each day through food alone. But if you take a multivitamin loaded with iron, you may overdose on this valuable nutrient. High levels of iron can damage your liver and other organs.Like other supplements, multivitamins can also interact with medications. In particular, multivitamins that contain vitamin K can affect blood-thinning drugs like warfarin. Vitamin K impedes the effectiveness of such medication in the body.Nearly three-quarters of people who choose to take a supplement do so without their doctor's recommendation. That may not be the best approach. Your doctor can help you decide if a supplement is right for you based on your personal health history and dietary needs.Always talk with your health care provider to find out more information.Dietary supplements are more than vitamins and minerals; they include herbs, amino acids, even enzymes-basically anything that adds to your diet. Some people, such as pregnant women or older adults, may benefit from certain supplements. If you choose to take one, be smart about it:Talk with your doctor about any supplements you are taking. He or she can help ensure you avoid any adverse reactions.Don't buy supplements that contain more than the daily recommended amount of any vitamins and minerals. Taking too much of certain nutrients can raise your risk for serious side effects.Beware of words like "natural" on the label. Some supplements may contain products that are natural, but that doesn't mean they are safe for you. Watch out for misleading marketing. Avoid products that are based on a single study or claim they can prevent or treat a condition.Always talk with your health care provider to find out more information.

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Too Much Sitting Can Harm Your Health

If you spend a lot of time sitting every day, you may be harming your health, even if you exercise. A recent review of 18 studies with nearly 800,000 participants found a link between sedentary living and overall health.

People who sit for long periods of time during the day have a two-fold increased risk for diabetes and heart disease. They also have a higher risk for death compared with people who don't sit for extended periods. Researchers found that regular exercise did not seem to lower this risk.Although the study was not able to prove a direct link between too much sitting and worse health, the findings suggest people should be more mindful about their lifestyles. And fitting in regular exercise may not be enough."The average adult spends 50 to 70 percent of his or her time sitting, so the findings of this study have far-reaching implications," says study leader Emma Wilmot, a research fellow in the Diabetes Research Group at the University of Leicester in the U.K. "By simply limiting the time that we spend sitting, we may be able to reduce our risk for diabetes, heart disease, and death."People already at high risk for diabetes should especially take these findings to heart. "Our study also showed that the most consistent associations were between sitting and diabetes," Dr. Wilmot says. "This is an important message. People with risk factors for diabetes may be able to help reduce their risk by limiting the time spent sitting." Risk factors for diabetes include being obese or having a family history of the disease.You can take steps to be more active during the day. Study co-author Stuart Biddle of Loughborough University offers the following tips to reduce your sitting time:Break up long periods of sitting at work by standing while using your computer. For instance, place your laptop on a filing cabinet.Stand during meetings.Take a walk during your lunch break.Replace TV viewing with more active pursuits.This study was published in a recent issue of Diabetologia.Always talk with your health care provider to find out more information.

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Advances in Aerobic Training: How to Apply the New Heart Rate Formulas

Science and technology advancements mean that our knowledge of fitness is constantly evolving. What was once standard practice, such as calculating maximum heart rate, can quickly become outdated and irrelevant. In this article, I will explain how to apply some of the newer formulas for calculating heart rate and intensity, and how these new tools may make it easier to help your clients build a stronger base of fitness.

New Formulas for Calculating Heart Rate

To determine maximum heart rate, the old method was to subtract your age from 220. From there you would simply calculate the remaining number by some percentage to determine your training heart rate or training zone. The new way (which is not at simple, but is more accurate) to calculate maximum heart rate corrects for both younger (below 25 years) and older (over 55 years) people. There are many new maximum heart-rate formulas to choose from, but ACE uses 208 minus (.7 * age). Thus a 50 year old would be 208 minus (.7 *50) or 208 - 35 = 173. The old formula gives a result that is only 3 beats lower, but at 70 years of age this difference is a significant 9 beats per minute.

The other major shift is in the use of the heart-rate reserve (HRR) or Karvonen formula. Subtract your resting heart rate from the number derived from the new maximum heart-rate formula described above—this will give you your heart-rate reserve. Multiple that HRR number by some percentage, say 70%, then add back the resting heart rate to get your training rate. For example, if you are 25, and your maximum heart rate was calculated at 190, and your resting heart rate is 60, then your HRR is 190 - 60 = 130. You then multiply this by .7 to get 91, and add back the resting 91 + 60 = 151, which as a 70% HRR training level

for you. If you wanted to go to 80% HRR, your calculations would look like this: 130 *.8 = 104 and 104 + 60 = 164. So, you would train between 164 and 151 to be in the high end of your aerobic zone.

A Shortcut Method: The 180 System

The “180 system” was designed by Dr. Phil Maffetone, the physician who designed an aerobic-conditioning program for Mark Allen, arguably the greatest triathlete in the history of the sport. He believed that you could take 180 minus an individual’s age to figure out his or her maximum aerobic heart rate with some correction factors. The main corrections are needed for age and conditioning effect, or both.

If you don’t work out à subtract 5 beatsIf you only work out 1-2 days/week à subtract 2-3 bpm If you work out 3-4x/week, no changeIf you work out 5-6x/week, no changeIf you work out 7+/week for more than 1 year à add 5If you are over 55 or under 25 à add 5If you are 60 years or older or under 20 à add 5 more

So, for a 40-year-old, the calculation would be 180 - 40 = 140, while for the 25-year-old described earlier, you would add 5 beats for a 145 maximum aerobic training zone. The system allows the body to adapt to this heart rate and the speed will gradually increase until a plateau. Then you switch to anaerobic interval training as the primary modality. Dr. Maffetone warns it will take several months or even up to a year to see large differences in speed. Mark Allen shifted from an 8:15 minute/mile pace to a 5:20 pace at his 180-system heart rate. To this day, Mark has the fastest marathon split in the Hawaii Ironman at 2 hours and 40 minutes for his particular course.

The system is not meant to pound you into the ground, but rather let you feel refreshed and able to train the next day. In fact, the system requires you to do a high volume of training for maximum effectiveness. You should strive for two to three hours of training at this intensity in a week.

It should be noted that this is not the same as high-intensity interval training (HIIT) and may not elicit the super-fast results people expect. However, building the aerobic base slowly and surely across time is what 90 percent of all competitive endurance athletes still do.

If your clients are interested in training for endurance events or simply want to improve their fitness, visit www.acefitness.org/running for tools and resources that will help them reach their goals.

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E-Cigarettes: A Safer Source of Nicotine?

Anyone who has tried to quit smoking knows it can entail herculean efforts. Withdrawal symptoms from nicotine and constant cravings for a cigarette cause many smokers to quit on quitting. Some smokers may be tempted to try electronic cigarettes - or e-cigarettes. They may sound like a healthier option. But these devices may be no safer than traditional cigarettes.

Like the common cigarette, e-cigarettes jolt the body with nicotine. But you don't burn them. Instead, these battery-operated devices heat up and convert nicotine into a vapor. The nicotine comes packaged in replaceable cartridges. These cartridges may also contain other chemicals, including flavorings like chocolate, mint, or coffee. In a process called "vaping," users insert a cartridge in the e-cigarette and then inhale the emitted vapor.E-cigarettes are often designed to mimic other nicotine-providing products, such as cigarettes, cigars, or pipes. They can also look like everyday objects, such as pens or USB devices. Some versions have a built-in light on the tip that glows when puffed. They may also contain a chemical called propylene glycol that, when vaped, simulates smoke.Manufacturers of e-cigarettes have claimed their products are healthier than regular cigarettes. They have also recommended e-cigarettes as a quit-smoking aide. The problem? These claims lack supporting scientific data. E-cigarettes may emit no smell and leave no ash, but not enough research has been done yet to say they are safer or effective in helping smokers quit.A study in the journal Chest provides some compelling evidence against the use of e-cigarettes. Researchers measured how e-cigarettes affected the lungs of a small group of smokers. After only 5 minutes of using an e-cigarette, study participants showed signs of inflammation in their lungs. The study results suggest using e-cigarettes for a long period of time may harm the lungs and body.Until more is known, the National Lung Association and the FDA recommend that consumers not use e-cigarettes. Their main concerns: Some chemicals in cartridges may be toxic. The amount of nicotine in cartridges may also vary from what is advertised on the label; some tests have found cartridges to contain more or less of the addictive substance.Always talk with your health care provider to find out more information.

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