National Physical Fitness and Sports Month is a great time to promote the benefits of physical activity.

Getting active increases your chances of living longer and can help you:

• Control your blood pressure, blood sugar, and weight.

• Raise your "good" cholesterol.

• Prevent heart disease, colorectal cancer, and type 2 diabetes.

Here are some tips to help you get active:

• Aim for at least 2 hours and 30 minutes of moderate activity a week. This includes things like walking fast, dancing, or biking.

• Do muscle-strengthening activities at least 2 days a week. Be sure to strengthen all major muscle groups including the legs, hips, back, chest, stomach, shoulders, and arms.

If you are trying to help someone get active

• Invite them to walk with you.

Start small – try taking a walk after dinner twice a week.

• Get informed

Learn new stretches and warm–up exercises, find sample walking programs, and read about the benefits of exercise in your guide to physical activity and your heart [PDF – 1.29 MB].

• Be understanding.

What is your loved one's reason for not getting active? Maybe he or she feels overwhelmed or embarrassed. Be patient. Let your loved one do things at a comfortable pace. In the meantime, you can be a positive role model by staying active and eating healthy.

• Recognize small efforts.

Offer encouragement. Even if your loved one did not meet his or her exercise goals for the week, give praise for the activities your loved one did do.

• Choose healthy gifts

For birthdays or special rewards, choose gifts to encourage your loved one to exercise:

• New sneakers or workout clothes

• A basketball or balance ball

• Hand weights

• Pedometer

• Gift certificate to an exercise class

Quick Guide to Healthy Living

• Get Active

• Help Your Child Stay at a Healthy Weight

• Watch Your Weight

Personal Health Tools

• Assess Your Food Intake and Physical Activity

• Reduce Television Screen Time Log for Children (PDF - 230KB)

More Information (Health A-Z)

• Exercise and Physical Fitness

Resources

• President’s Council on Physical Fitness and Sports National Physical Fitness and Sports Month Sponsor

• President’s Council on Physical Fitness and Sports, The President’s Adult Fitness Test and the PCPFS National Physical Fitness and Sports Toolkit

• Department of Health and Human Services, Office of Disease Prevention and Health Promotion, 2008 Physical Activity Guidelines

• Department of Health and Human Services, Office on Women’s Health, Nutrition and Physical Activity Information: BodyWorks

• Department of Health and Human Services, Office on Women’s Health, Staying Active and Eating Healthy

• National Institutes of Health, National Heart, Lung, and Blood Institute, Physical Activity: Are You Ready?

• National Institutes of Health, National Heart, Lung, and Blood Institute, We Can!

Strengthening should transition from basic exercises to sport-specific exercises that are intended to replicate movements and skills common in your chosen sport.  Adjusting your strength training to be similar to sport movements will allow for a greater chance of positive transfer to that sport.  Sport-specific exercises are based on the principles of functional exercises.  Functional exercises are defined as exercises involving smooth rhythmic motions in all planes of motion.  The purposes of these exercises are to restore balance, strengthen, lengthen, improve neuromuscular relationship, and coordinate movement patterns specific to the particular sport. 

My path to becoming both a doctor and a writer began one fall afternoon in 1963.  JFK was President and the world seemed like a very youthful, modern place.  I had just turned 15 years old.    Despite living in what seemed to be a golden time,  I had two major fears:  I was afraid of nuclear war for one.  Everyone was in those days…the years of bomb shelters and air raid drills.   My second fear was the worry that something might happen to my parents.  My parents were 45 and 50 years old, and despite the fact that they both smoked, they seemed incredibly healthy.  But a number of events had conspired to make me nervous.  My closest cousin had lost her mother at a young age.  Soon after that, my Grandmother died of a heart attack.  And most recently, a friend of mine had returned from the movies to find that her father had suffered a cardiac arrest while on the living room couch. While most adolescents have a feeling of immortality, I no longer believed that either I or my family was invincible.

On the particular day in question, my parents, my sister and I were eating a  lunch of hamburgers and French fries at our tiny kitchen table.  I remember that my father stopped in the middle of helping himself to the ketchup.  He got a strange look on his face.  My mother sensed something was wrong immediately and asked what was going on.  My father didn’t know.  He had a strange pressure in his chest though.  Not a pain really, he said.  Just a tight feeling.  But within moments he began to sweat and said he was going upstairs to lie down.  This was odd indeed.  My father was known for bounding around, taking the stairs in our house two at a time.  We had never seen him taken ill suddenly.  My mother threw a few reassuring words our way and followed him upstairs. Within a few minutes, my mother was on the phone to our family doctor and then was hurrying out the door with my father leaning on her arm.  “Dr. Shapiro thinks that Daddy may be having a heart attack.” Was all she said.  “I am taking him to the hospital.  I’ll call you when I know what’s going on.” 

My sister and I were left at home.  We weren’t old enough to drive yet so we sat around waiting for the phone to ring.  We were terrified.  All I could think about was the night that my Grandmother had gone to the hospital with her own heart attack.  At three that morning, the phone had rung.  My mother had answered and I had heard her crying.  My grandmother had not survived the night.  From this I learned that a heart attack was a frightening, unpredictable, dangerous thing.

But my father was lucky.  Dr. Shapiro decided that he had suffered only a minor heart attack.   This sounded ok until my sister and I finally got to the hospital.  We found my father in an oxygen tent, a contraption that looked like a plastic bag with a zipper that sat around his head and shoulders.  The distorted view through the plastic, the distance it put between us and the uncertainty on my father’s face started a fresh wave of worry.   My mother told us that he would need to be in the hospital for a couple of weeks.  This was how things were done in the 60s.  A heart attack meant complete rest.  There was no such thing as cardiac rehab, surgical fixes, or fancy medicine.  

For days, I camped out in my father’s hospital room, coming right after school and staying until visiting hours were done.  My homework suffered because it was tough to concentrate. But at least I wasn’t worried about English class.  Although I was taking a college prep class, the school had assigned it to a teacher who had never worked with college bound students.  Her assignments tended to be boring and easy.    One evening, shortly after the heart attack, I sat in my father’s hospital room anxious and unable to think.  I was supposed to be writing an essay entitled, “Why We Study English” and it was due the next day. I opened my notebook, dashed off two pages that were pretty trite and called it quits.  It was the best I could muster at the time.  The gist of my essay was that language was important and knowing how to use it was important too.  We underestimated what we could accomplish by communicating, I wrote.  To make this point, I quoted the proverb: the pen is mightier than the sword.

 A couple of days passed.  I went to class by day and continued my hospital vigil at night. At the end of English period, I was summoned by my teacher and asked to stay after class. My teacher took me aside.  “Where did you hear the phrase, the pen is mightier than the sword?”  She asked.  She seemed belligerent.  I couldn’t answer.  It was simply a proverb I knew. I thought everyone did.  (By the way, the derivation is incredibly obscure.  According to Wikipedia: “The pen is mightier than the sword" is an adage coined by English author Edward Bulwer-Lytton; in 1839 for his play Richelieu; Or the Conspiracy.)   When I could not produce a source for this quote, my teacher went on to tell me that this proved that I must have plagiarized my entire essay.  In fact, she claimed to have the source for the original essay and said that she could produce it.  (This would have been a neat trick since the entire paper had been concocted in under 20 minutes in my father’s hospital room!!!) If I didn’t immediately fess up to my crime, she went on, I would face severe consequences. To say that I was dumbfounded is quite an understatement.  I fairly sputtered.  I explained about writing the essay on the fly while my father sat under the oxygen tent. She refused to believe me and also refused to produce the essay she claimed to have.  Instead, I was sent directly to the school disciplinarian, a fearsome presence in our high school and was threatened with several months of detention.  The whole matter became an escalating horror that lasted for weeks.  This incident taught me about the power of false accusation, particularly when you are in a subordinate position to the accuser.  In the end, the principal, my mother, and a whole cadre of my ex-teachers became involved.   It was all hushed up, but the teacher was never disciplined and the incident remained an unresolved blot on my high school experience. For me, the incident is inextricably bound up with the story of my father’s heart attack. While the whole mess was awful and unfair, but it became suddenly less important when, in the same English class that November, a classmate burst through the door with the news that John F. Kennedy had just been assassinated in Dallas.

After my father came home from the hospital, my mother decided to do whatever she could to make him well.  For her, that included a complete revamping of his lifestyle.  Although there was less known about the prevention of coronary disease then, my mother was savvy enough to figure out an effective plan.  Gone were the cigarettes, and gone were the fried and fatty foods.  Prior to his MI, my father had hated fish and refused to eat it.  Now my mother became insistent, and fish appeared on our menu.  So did chicken, which was a huge departure for my red-meat-eating Dad.  Then there was the exercise.  My mother got my father walking 2 miles a day, a habit he continued well into his 80s. 

My mother’s plan changed and prolonged my father’s life for sure, but he remained affected by his coronary artery disease. Today, thanks to her, he is 96 but he still needed a coronary bypass operation and several stents to go this distance. Once a disease process is established, it is easier to control than to eradicate.  Ironically, I am watching an example of this principle break on CNN as I write this.  Bill Clinton has just been admitted to the hospital to have stents placed in his coronaries.  He needs these despite having had earlier bypass surgery.  The message here is that medicine and surgeries can only get us so far.  We are best off…by far….if we prevent heart disease from ever getting started.  And that is quite possible.  Blocked arteries are not inevitable.  In fact, coronary artery disease is a condition that was largely unheard of until we started eating the modern diet and stopped using our bodies to do physical work. 

Prior to my father’s heart attack, I thought the world was fair.  After my father’s illness and my plagiarism experience, I found out that fairness was not guaranteed.  But through my mother’s interventions with my father, I learned that there was hope.  You could do something to help yourself, to change the odds. I became interested in medicine and in finding ways, as my mother had, to prolong life through disease prevention. Rather than being discouraged from writing, the false accusation emboldened me to use writing to get a bigger voice. So I suppose you might say that these two experiences converged and started me on the path that led to this very moment.  Here I am, writing to people all over the world about heart disease.

So what can we do about coronary disease? First and foremost, we should try to prevent it from happening in the first place. Heart attacks occur when the small vessels that feed our heart become inflamed, damaged, and blocked.  To avoid this, we should keep our waistlines trim (fat around the middle secretes chemicals that start off inflammation in our vessels and promote coronary blockage). We should eat a diet that does not resemble the standard American diet.  Mediterranean is good.   Ancient may be even better.  If our cholesterol numbers are high, we shouldn’t fear taking medicine.  Cholesterol lowering drugs are among the safest and they also decrease vessel inflammation.  We should do everything we can to avoid damage to our precious arteries.  Damage comes from sugar that is too high (above 100 when you’ve fasted overnight), from blood pressure that is too high (in the 120s or below is best) and from blood fats (cholesterol and triglycerides) that are too high.  We should make physical activity a priority.  Our heart is a muscle, and like all muscles it benefits from a work out.

Please join me in thinking about ways that you can treat your heart better.  Find ways to encourage the same changes in those you love.   And share the word.   Thanks Mom, for figuring this out 47 years ago.  And thanks, Daddy for following the program. 

Medical librarianship is a service profession.  Medical or health science librarians provide health information about new medical treatments, clinical trials, procedures, tests, and equipment to physicians, allied health professionals, nurses, patients, their families, and community residents.  They help health care professionals provide quality care to patients, help patients and families find information to understand their health conditions, and provide information to the health care industries.

A medical librarian needs a Master’s of library and information science degree from an American Library Association-accredited school.  The Lake Health Resource Centers located at TriPoint Medical Center and at West Medical Center are staffed by two professional medical librarians, Holly Kimborowicz, MLS, AHIP, Health Science Librarian or Cathy Murch, MLIS, AHIP, Systems Librarian.

The Medical Library Association (MLA) is the professional association for medical librarians with more than 4,000 health sciences information professional members and partners worldwide.  MLA provides lifelong education opportunities, supports a knowledgebase of health information research, and works with a global network of partners to promote the importance of quality information for improved health to the health care community and the public.

The letters AHIP after Holly and Cathy’s names stand for the Academy of Health Information Professionals.  AHIP is a professional development and career recognition program of MLA.  Members of the academy are credentialed as health information professionals by demonstrating their academic preparation, professional experience and professional accomplishments.

The April 2010 issue of the Journal of the Medical Library Association article, "Health sciences libraries building survey, 1999-2009" by L. Ludwig, included a brief description of the new Lake Health Resource Center at TriPoint Medical Center.  A copy of the article is available from the Lake Health librarians.

For more information about medical or health science librarianship, or about the Medical Library Association, visit the MLA website at www.mlanet.org.

If you would like more information, please contact a Lake Health Professional Librarian

I have this thing.  Maybe it’s genetic, I don’t know.  I sometimes become intensely interested in certain things, foods, people, microcosms.   I can eat the same meals, order the same kind of coffee, read the same book, watch the same movie a zillion times.  It’s not so much that I get stuck in a loop as that I enjoy things more with repetition. 

When I was about ten years old, this intense focus landed on an unlikely candidate:  Amelia Earhart.  I spent a whole summer  with my sister and my best friend researching and writing little books about Amelia.  We spent days in the library when we could have been swimming at the Boulevard Pool.  We discussed the details of Amelia’s life with the same fascination star-gazers usually reserve for celebrity gossip mags.  We were endlessly intrigued by her life story, particulary her marriage to George Palmer Putnam, which we judged to be loveless. 

Recently, my odd propensity for intensity has landed on a new subject:  Otto Warburg.  Warburg was a Nobel prize winner who was born in Germary in 1883. As a German biochemist living in the mid 20^th century, he got to hang around with some pretty impressive company:  people like Albert Szent-Gyorgyi and Hans Krebs, the guys who figured out the Krebs cycle (a cellular process, the memorization of which torments med students to this day).  Otto’s career in science went on hold when he joined the cavalry in WW I.    He loved anything equestrian (he never married and had no discernible love-life).   His devotion to the cavalry made his family worry that he might remain in the army permanently.   He was persuaded to return to research by a friend of his father’s who knew a bit about science:  Albert Einstein..   

It was a lucky thing that Warburg traded horses for the laboratory.  He made a major discovery, known to this day as the Warburg Effect.  To understand this discovery, you first need to know that all bodily cells make their own energy; in other words, they self-create the fuel they need to stay alive and to do their particular work.  This fuel is called ATP.

 You probably recall that cells have a kind of gel inside called cytoplasm.  Within this cytoplasm are small organelles…tiny factories that have special jobs.  Normally, cells make a bit of ATP by burning up some glucose, or blood sugar, in the cytoplasm.  That process throws off a molecule called pyruvate which is then taken up by  mitochondria (which are organelles).   Once in the mitochondria, a complex process turns the pyruvate into lots more ATP.   Warburg’s fascinating discovery was the following:  cancer cells aren’t able to make fuel by this normal pathway.  In cancer cells, the mitochondria are not working and cannot process pyruvate.  Thus, cancer cells are left having to make all of their fuel from glucose in the cytoplasm.  This takes a lot of glucose.   Essentially, cancer cells are obligate sugar burners.

This is not the case for normal cells.  Normal cells can burn other fuels, in particular ; chemicals which are made from the breakdown of fat.  We all know about this because we all know about the Atkins diet.  When sugar in the diet is reduced to nothing and most of what is consumed is fat and protein, the body soon begins to run on ketones.  It does just fine on this fuel.   Many of us believe that we will die unless we have glucose, but there are only a couple of areas in the body that must use glucose as fuel.  Enough glucose to feed these areas can be created within the body.  We don’t have to consume it.   For proof, we can look at the native diets of people like the Inuit, who survived in excellent health on little more than fish, meat and blubber and the Masai, who eat mostly meat, blood and milk.

Warburg first articulated his hypothesis in the 1920s and the Warburg Effect has been widely accepted for many decades.  The PET scan, which is a test which identifies active cancer cells, is based on the fact that tumor cells use up glucose so avidly that they can be spotted this way.  On the other hand, one aspect of Warburg’s work has remained highly controversial. 

Warburg believed that cancer itself was caused by the damaged mitochondria.  As we all know, cancer cells have many mutations and appear damaged.  It was Warburg’s belief that this DNA damage occurred as the result of the switch to an unnatural cellular fuel production method.  As the years progressed, most cancer scientist’s research came to believe that damage to DNA came first and the damage went onto cause the mitochondrial problems Warburg observed. 

Warburg was aware of the slipping acceptance for his hypothesis about the cause of cancer.  He never wavered in the belief that he was correct.  As he said at a meeting of Nobel laureates in 1996, “"the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar."  Further, Warburg felt that the refusal to accept his hypothesis was delaying research into treatments which might work on restoring mitochondrial function and thus cure, prevent or slow down cancer.   He himself became obsessed with dietary carcinogens as he became older and insisted on eating only organic foods.

So why am I so interested in Warburg?  You guessed it!  The sugar connection!!  Since it is my belief that ancient diets which are low in glucose-producing foods (starches and sugars) are the best for health, Warburg’s work makes a nice fit.  In doing some research on suggested diet for a patient who recently developed cancer, I came across Warburg.   I was hooked.  Two questions immediately came to mind:

1. Can consuming a very low glucose-producing diet slow down cancer?  If cancer cells can’t burn alternate fuels, this would seem to make sense.

2. Does continuing to eat a low glucose-producing diet perhaps inhibit small cancer “areas” that we may develop from time to time?  If that were true, would we see less cancer in those who eat such diets?

Interestingly, Warburg’s hypothesis is getting a new look.  The treatment of cancer with agents that might restore mitochondrial function or block the abnormal sugar burning process are now being investigated.  Here is one such attempt, reported yesterday in Science Daily.   This drug works by “choking off the sugar supply” to tumors.

But can we do something similar with diet?  To find out, I wrote to Dr. Thomas Seyfried, a Professor of Biology at Boston College.  Dr. Seyfried is among those who believe that cancer is a metabolic disease, as Warburg did.  He is conducting research on very low carb, ketogenic diets in the management of brain tumors.  In other words, he is trying to starve the tumors by forcing them to burn fuels that they cannot use.  Seyfried says that it is the number of calories (very low) and not the composition which is most important. The research is not yet advanced enough to draw conclusions, but Dr. Seyfried believes that such an approach may work.  When combined with other agents, it may work even better. 

As to the answer to question two, one can only speculate.  We know that animals that are calorie restricted have slower aging, less cancer and chronic disease.  Might this be related to a lower sugar environment?  So, I guess you know what I think.   

Reforming and improving healthcare is the focus and challenge of the future. In response to some of these challenges, a holistic approach to healing has begun to spread to major universities, hospitals, healthcare agencies and medical schools.  This holistic approach, known as integrative medicine acknowledges that healing is about addressing the mind, body and spirit of the person.

Integrative medicine is a model of integrating care from the best conventional medical protocols with complimentary therapies such as acupuncture, healing touch (an evidence-based modality used by nurses to manage pain, wound/fracture healing, etc), massage and music therapy, yoga and wellness coaching for support with life style changes. The efficacy of these therapies have been widely studied with conditions ranging from gastrointestinal disorders, cancer, heart disease, stroke, Alzheimer’s disease and stress related to medical illness and surgical procedures as well as pain management post-operatively.

The American Hospital Association reports that there has been a significant increase in hospitals offering complimentary therapies with only 8.6% in 1998 to almost 25% in 2004 with an additional 24% reporting plans to add services in the future. It has been reported that patients who use integrative medicine programs in a hospital are more likely to rate their overall experience higher.

The growing trend and appeal of integrative medicine appears to be coming from the consumers dissatisfaction with the current healthcare system including feeling rushed through appointments and viewed only as their disease or illness, e.g., the breast cancer or the diseased kidney. They want to be viewed in whole as the person with the disease. Healthcare providers are also embracing integrative medicine as a way to reduce their feelings of being overwhelmed and rushed in providing care under the current healthcare system.

Now that your physical fitness analysis is complete you can use your results to build your strength and conditioning program.  Completion of the physical fitness analysis allows you to structure your training program to improve muscle deficiencies, maintain strengths, or enhance sport specific neuro-muscular activation.  Keep in mind, athletes will not improve with just weight lifting alone.  Athletes require sport specific resistance training, such as, explosive power, muscular endurance, maximal strength or some combination of all three in order to excel. 

When selecting exercises understanding the exercise type is important.  Exercise type is classified as either core exercises or assistance exercises.  Core exercises involve large muscles.  Core exercises are chosen first because they have a direct effect on improving sport performance.  Assistance exercises isolate smaller muscles and are considered less important to overall improvement of sport performance.  However, the regular use of assistance exercises is for injury prevention and rehabilitation.  Incorporating both core and assistance exercises into your program is extremely valuable in order to improve performance. 

Examples of Core exercises:  bench press (chest), squat (thighs), shoulder press (shoulders), dead lift (hip and thigh)

Examples of Assistance exercises:  abdominal crunch (abdomen), seat row (upper back), lateral shoulder raise (shoulders)

Muscle balance

Keeping muscle properly balanced is another vital component to injury prevention.  The larger muscle groups work together in pairs called agonist and antagonists and those muscle pairs need to be balanced in terms of strength and flexibility.  Agonist is the muscle responsible for contracting during movement.  The antagonist does the opposite, allowing the muscle to relax and stretch.    For example, we bend our knee by using the hamstring muscles.  It's pair is the quadriceps muscle.  The quadriceps muscle must be willing to stretch for the hamstrings to contract and bend the knee fully.

Agonist & Antagonist Pairs

Sport specific exercises:  SAID Principle next blog….

Ultraviolet (UV) rays are an invisible form of radiation. They can penetrate your skin and damage your skin cells. Sunburns are a sign of skin damage. Suntans aren't healthy, either. They appear after the sun's rays have already killed some cells and damaged others. UV rays can cause skin damage during any season or at any temperature. They can also cause eye problems, wrinkles, skin spots, and skin cancer.

To protect yourself

• Stay out of the sun when it is strongest (between 10 a.m. and 4 p.m.)
• Use sunscreen with an SPF of 15 or higher
• Wear protective clothing
• Wear wraparound sunglasses that provide 100 percent UV ray protection
• Avoid sunlamps and tanning beds

Skin cancer is the most common form of cancer in the United States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, neck, hands and arms. Another type of skin cancer, melanoma, is more dangerous but less common.

Anyone can get skin cancer, but it is more common in people who

• Spend a lot of time in the sun or have been sunburned
• Have light-colored skin, hair and eyes
• Have a family member with skin cancer
• Are over age 50

Check your skin regularly for changes in the size, shape, color or feel of birthmarks, moles and spots. Such changes are a sign of skin cancer. You should have your doctor check any suspicious skin markings and any changes in the way your skin looks. Treatment is more likely to work well when cancer is found early. If not treated, some types of skin cancer cells can spread to other tissues and organs.

Overviews

• Basic Information about Skin Cancer (Centers for Disease Control and Prevention)
• Skin Cancer (American Academy of Dermatology)
• What Is Squamous and Basal Cell Skin Cancer? (American Cancer Society)

Latest News

• People Are Concerned about Skin Cancer Yet They May Not Understand the Risks of Sun or Indoor Tanning (05/10/2010, American Academy of Dermatology)
• New Survey Ranks the Nation's Most and Least Sun-Smart Cities (05/03/2010, American Academy of Dermatology)

Tools

• Skin Cancer Risk: Understanding the Puzzle (National Cancer Institute)
• "Suntelligence" Survey (American Academy of Dermatology)
• What's Your Sun-Safety IQ? (American Cancer Society)

Tutorials

• Skin Cancer (National Cancer Institute)
• Skin Cancer Non-Melanoma(Patient Education Institute)

Pictures & Photographs

• Basal Cell Carcinoma (BCC) (Logical Images)
• Basal Cell Carcinoma: What It Looks Like (American Academy of Dermatology)
• Squamous Cell Carcinoma (SCC) (Logical Images)
• Squamous Cell Carcinoma: What It Looks Like (American Academy of Dermatology)

Research

• Suntelligence: How Sun Smart Is Your City?(American Academy of Dermatology)
• Tanning Beds Pose Serious Cancer Risk(American Cancer Society)

Source:  MedlinePlus.gov

If you would like more information, please contact a Lake Health Professional Librarian

There are many different steps you can take when beginning a strength and conditioning program.  The first step is to get your doctor’s approval!  With your doctor’s permission you can begin by assessing your fitness level.  The big question in terms of fitness is “where are you at?”  It’s best if you determine at least a few things about your current fitness level so you can set realistic goals and have a standard for measuring your improvement.

The three key components that encompass total physical fitness are strength, flexibility, and endurance. The following physical fitness tests and corresponding desired norms for physical fitness are based on the nationally accepted fitness test standards for ages 18 and older.  Tests can be performed in any order and you have the option to test yourself in all areas or only a few.  Testing is intended to give you a good representation of your current fitness level and how well you will perform specific training activities. 

The President’s Challenge Adult Fitness Test website is an excellent resource for the physically active.  The website has links that will take you to in depth instructions and tips on performing each test.  After completing the tests you can enter your data online to receive an evaluation. 

The President’s Challenge Adult Fitness Test Website Link

Data Entry Online Link

Physical Assessment Tests and Desired Norms

STRENGTH

1.  Pushups

Pushup Standards:

Male: Average = 30; Excellent = 50

Female: Average = 7; Excellent = 25

2.  Pullups

Pullup Standards:

Male: Average = 8; Excellent = 13

Female: Average = 1; Excellent = 8

Flexed Arm Hang: (Alternative, if no pullups can be completed)

Flexed Arm Hang Standards:

Male: Average = 30 seconds (no Excellent standard for males as they should be able to perform pullups)

Female: Average = 7 seconds; PFT perfect score 1 min.,10 seconds

3.  Curl-ups (Situps):

Situps Standards:

Male: Average = 44; Excellent = 55

Female: Average = 34; Excellent = 44

FLEXIBILITY

1.  Sit and Reach Test

Sit and Reach Standards:

Male: Average = 15.5"; Excellent = 18.6"

Female: Average = 16"; Excellent = 19"

2.  V-Sit and Reach

V-Sit Standards:

Male: Average = 3"; Excellent = 7"

Female: Average = 4.5"; Excellent = 8"

ENDURANCE

1.  One mile run/walk

One Mile Standards:

Male: Average = 7:35; Excellent = 6:30

Female: Average = 10:51; Excellent = 8:22

2.  3 Minute Step Test (alternative to 1 mile run)

3-min. Step Test Standards:

The first episode of public backpedaling on vitamin supplementation probably occurred during Sanjay Gupta’s segment on CNN’s Situation Room.  Reporting on the results of a recent study that associated multivitamin use with an elevated risk of breast cancer, Gupta dared to venture that we should be cautious about vitamin use.  He spoke to the fact that the great majority of the many studies on vitamins do not show benefit.  He also said something that made me cheer:  removing a  vitamin from its food source and concentrating it many times may not work; may even be harmful.  Bravo for Sanjay.

But by later that day, the CNN website had thought better of Dr. Gupta’s comments.  http://pagingdrgupta.blogs.cnn.com/2010/03/31/can-your-multivitamin-give-you-cancer/   After warning readers about the shortcomings of this study (and there certainly are many), it carefully decided to cover all bases. 

First, it took one side: 

“The National Institutes of Health have said that ‘some of the roughly 75 million Americans who buy [multivitamins and supplements] may not need them.’" 

Then, the other:

"At the end of the day, it's always better to see someone taking a vitamin than not. The benefits outweigh the risks," advises Dr. Kent Holtorf, medical director of The Holtorf Medical Group, who was not affiliated with the study.

"The bottom line is a patient is not a population," says Holtorf. "It's better to take a vitamin than nothing but your best bet is to find out if you're deficient in anything and then treat those deficiencies in an individualized way."

This article equates information from the NIH with the opinion of Dr. Holtorf.   Since I had never heard of the Holtorf Medical Group, I Googled them.   They are a practice in California that deals in natural supplementation for a whole host of conditions from menopause to “adrenal fatigue”.  They also use supplements for anti-aging medicine.   This is not exactly an academically rigorous discussion of the issues raised by the study.   

But we shouldn’t be surprised.  The media does a generally poor job of covering complex issues like medical studies and treatment.  America is hooked on the idea that supplements are a magic wand that can erase our dietary indiscretions.    Very little science supports this view.   The AJCN study is challenging because it provides the springboard for discussion and for a re-evaluation of supplementation.  We should pick up that gauntlet rather than ignore it. 

It’s particularly interesting that the people who defend supplements most vigorously are those who believe in natural solutions to health.  There may be a basic misconception here.  Is supplementation with vitamins and minerals which are extracted from food sources natural? 

Even if vitamins are useless but harmless (they make very expensive urine, as a professor of mine used to say), there is potential damage from relying on them as a kind of magic feather that allows us to eat all kinds of bad stuff and assume we’ll be saved.  We use medicines like cholesterol lowering drugs and blood pressure pills the same way. 

In the meantime, I’m personally putting my money on original, whole foods from sources that (I hope) I can trust.  I remain suspiciously paranoid about ingesting anything made in a factory or deemed to be healthy be dubious experts.  We just don’t know enough about that stuff.  We do, on the other hand, know an overwhelming amount about the positive benefits of living clean.