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News Tips From Duke on Diet and Fitness

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Pot or handles – which is better?

So, guy, you've picked up a few pounds, maybe 10 or 15,
since the lean college days. There's more belly, but it's hard
as a rock. No flabby love handles. You're in good shape,
right?

Maybe not, according to Dr. Michael Hamilton, medical
director for obesity treatment at Duke University Medical
Center. The pudginess on the sides may be less problematic than
the tight protruding belly.

"With superficial fat, such as the typical image of 'love
handles,' there is some increased risk of cardiovascular
disease, but it's mainly the visceral fat that's a danger," he
says.

Visceral fat translates to fat in the gut – the fat that's
deep within the abdominal cavity, crowding the space meant for
intestines and liver and other vital organs. A belly that's
hard, with skin tight across the bulge, could signal a build-up
of visceral fat ... and a higher risk of heart disease. A
fairly flat stomach with a slight roll of pinch-able fat may
look flabbier or softer, but may be less risky to the
owner.

Sizing up the type of fat is no sure way to tell if you're
at risk, though. Hamilton says if you're interested in
cardiovascular health, quit pinching and sucking in your gut
and ask your doctor about your body mass index (BMI). If your
BMI is greater than 30, your may be a candidate for heart
disease.

So how to attack the fat?

The trip to the beach is a few weeks away and you want to
drop the pounds that crept on in cooler weather. Can you do
it?

You can try speed shedding of unwanted weight, according to
Terri Brownlee, a registered dietitian at the Duke University
Diet & Fitness Center, but don't count on great success. To
dredge up the old adage, there is no free lunch. Most
quick-reduction diets help you temporarily lose some water
weight, but the result often dissolves over the vacation.

"For most people a realistic expectation is that they can
lose a half pound to a pound a week, so you're looking at maybe
4 or 5 pounds over the month. You might up that a little bit
with additional exercise," Brownlee says.

So what's a sensible plan? Modify your diet reasonably now
and step up exercise. Then concentrate on not putting weight
back on during the vacation itself. Once on holiday, try to
maintain your regular schedule and structure, eating at the
same times and in similar portions, she advises. Watch the
extra munching during the day -- one point where calories might
be sneaking into your diet and foiling your pre-vacation
attempts to slim. Add a little activity to the vacation daily,
and you'll have a better chance of maintaining your weight
while having fun. Moving to five a day

Scientists think at least 30 percent of cancers are linked
to dietary factors and that eating more fruits and vegetables
lowers the risk of some cancers. But finding a way to get
people to change food choices has been a puzzle.

Researchers at Duke University say the church may be the
answer to reaching minority residents in rural areas. In a
two-year project to boost the number of servings of fruits and
vegetables eaten by African Americans, a team from Duke, the
North Carolina health department, UNC-Chapel Hill and N.C.
State University worked with nearly 50 churches in 10 rural
N.C. counties to promote the idea of "five a day" for better
health.

The teams worked with pastors and lay leaders to support the
concept, and reached church members through bulletins, monthly
packets of brochures and written material. Churches planted
"victory gardens" and fruit trees, hosted classes on canning,
freezing and cooking vegetables, modifying recipes and
cookbooks, and served up more fruits and vegetables at church
functions.

At the end of a year, targeted participants had increased
their daily intake of fruits and vegetables by a serving and,
after two years, a third of the study group was following the
five-a-day plan.

The study was too short to show the expected impact on
cancer development, says Duke researcher Wendy
Demark-Wahnefried, but reveals an effective way to change a
community's eating habits that can lead to better health.
Exercise for a lifetime

Learning to exercise for a lifetime. It's a phrase you
wouldn't be surprised to hear from your kids' gym teacher, but
from a geriatrics expert?

Researchers from the Duke Center for Aging teach exercise
routines to the 65 and older set, with an eye on improving
their everyday living.

"The people we see are in poor to moderate physical
condition – they're not exercising regularly," explains Miriam
Morey, an exercise physiologist who coordinates the study for
sedentary seniors. "The first 12 weeks is a teaching process.
We want to teach them everything we can so they can exercise on
their own. They're learning to exercise for a lifetime. The
payoff of this study is how what they learn rolls into life
activities."

Exercise physiologists and a physical therapist coach
seniors in a group setting three times a week, first in a
conditioning program and then a personalized exercise program.
Half the seniors follow a conditioning regime, half work on
both conditioning and a set of axial mobility exercises. The
researchers are gathering information to see if one approach
works better than the other. Morey expects everyone in the
program to improve.

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