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The Healing Properties of Water Exercise

We think of swimming as summer fun, but it can be serious
therapy, too. For arthritis patients, aquatic exercise can
shift a slow, grinding lifestyle into high gear.

"There's a national movement to increase the activity level
of arthritis patients," says Dr. Virginia Kraus, a Duke
University Medical Center researcher studying the effects of
exercise on patients with the joint disease. "And there's been
an increasing awareness of the importance of physical activity
for the prevention of arthritis-related disability and
cardiovascular disease."

To exercise safely, arthritis patients need to minimize the
load on their joints. One of the best ways to do that is
through aquatic therapy. In water the body weighs an eighth of
what it does in land, so the joint load is minimized while
movement can be maximized -- without fear of injury or joint
stress.

Her studies have shown that water exercise improves a
patient's ability to walk on land and decreases overall
disability. It may also help remove substances that can build
up and

harm the joints. Patients in Kraus's studies show reduced
pain and disability and a better overall sense of well-being,
she reports.

Joint movement helps preserve joint range of motion,
maintains muscle strength and also enhances joint nutrition -
by increasing blood flow and the flow of nutrients in and out
of cartilage.

The Duke program, based on a set of movements developed by
the Arthritis Foundation, is entering its fifth year of work
with patients with osteoarthritis and rheumatoid arthritis, as
well as ankylosing spondylitis.

Exercise Extremes ...

In the matter of exercising, American children seem to fall
into two extremes, says Duke pediatrician Dr. Deborah
Squire.

Some only do stretches - on a couch. They are conditioning
themselves for future health problems.

"There are children who watch as much as five hours of
television a day and who are at risk for obesity. I see a fair
number of them in my pediatrics practice," she says. "In fact,
exercise should be promoted throughout childhood, and the
younger the better. I now ask 5-, 6-, 7-year-old kids who come
in for physicals what they are doing for exercise."

At the other end of the spectrum is the group of children
"who are involved in so many sporting activities, they can
suffer from stress fractures and overuse injuries." As bad as
physical injuries may be, the emotional toll can be as high.
"Children can be so overbooked they don't have a social life,
and sports can often breed excessive competitiveness," she
says.

If parents ever wonder if their children are doing too much,
Squire has a few words of wisdom for them: "Just ask the kids
if they are still having fun."

The Next Mark McGwire?

As Mark McGwire was chasing Roger Maris' home-run record
last year, word leaked out that he was using androstendione,
commonly known as "andro," a substance that raises the level of
testosterone in the body and gives that person more energy.

Young athletes everywhere who had dreamed of being the next
McGwire suddenly had a "secret weapon" they believed would give
them the energy and strength to excel.

But, before rushing off to pick up some andro, Duke sports
medicine specialist Dr. Richard Ferro offers strong words of
caution: "Androstendione is very dangerous, especially for
young athletes," he says. "Androstendione use leads to an
arrest of growth development, meaning you get bigger but not
taller. And there are several serious side effects."

According to Ferro, those side effects are male pattern
baldness, testicular atrophy and impotency for men and
baldness, body hair growth and a lower voice for women. Ferro
also says the use of androstendione has been associated with
prostate cancer, although that hasn't been proven.

So, for young athletes chasing their dreams, the best plan
is to work hard and stay away from "secret weapons" or "quick
fixes."

Heat's an Ally in the Battle of the Bulge

You may not be able to beat the heat, but summer does give
you an advantage in the battle of the bulge.

"I think it's easier to maintain a lighter diet in the
summertime, with the greater availability of fresh produce,"
says Terri Brownlee, a registered dietitian and nutrition
director at the Duke Diet and Fitness Center. "People are
getting more fruits and vegetables into their diets, which
means higher water content and lower fat. That's a good start
for maintaining or losing weight."

And you can thank the heat for some other side effects. It
often cuts the appetite, Brownlee says, so people tend to eat a
little less in the summer. People also develop a yen for colder
foods rather than heavy hot meals, and that means more salads
and fruits show up on the dinner table.

"Think about what you crave in the summer. Nice, cold
watermelon in July is mouth watering. If you compare the number
of calories in a cup of watermelon as opposed to a cup of
thick, heavy cream soup, you're going to see a big calorie
difference," Brownlee says. "The benefit is that we get a
higher nutrient content - more vitamins, minerals and fiber -
and less fat."

A seasonal change in cooking methods skims away calories,
too, she says. Those who fire up the grill aren't just treating
the taste buds; they're losing fat in the cooking process. Fat
drips off the food rather than pooling around it and being
absorbed. Even when you do cook indoors, you're more likely to
use lower-fat techniques, like a quick saut», that doesn't heat
up the kitchen.

If you're trying to trim some extra calories, stick with
cool, light summer snacks and desserts - frozen fruit or pops,
skim milk pudding, sorbets and other cold treats that will feel
good. If you've got to have your cake, try angel food with
fresh or frozen fruit as a topping.

Anti-Depressant Drug Knocks Out Taste of Food

The roses may smell sweeter when you're no longer depressed,
but the anti-depressant drug that improves your outlook could
diminish the pleasure you derive from food, according to new
research conducted by smell expert Susan Schiffman.

Four widely prescribed anti-depressant drugs, in a class
called tricyclic anti-depressants, can distort the taste of
foods or make them downright flavorless, Schiffman says. This
deficit is particularly serious in the elderly, for whom proper
nutrition is a huge factor in staying healthy, the Duke
professor of psychology says.

"The decline in taste among the elderly can be severe enough
to put them at risk for malnutrition, lowered immunity to
disease, accidental poisonings and chronic diseases like
hypertension and diabetes," she says. For example, deficits in
sweet taste perception make elderly people with diabetes more
vulnerable to the adverse effects of excess sugar, while loss
of salt perception can cause hypertensive patients to
inadvertently eat too much salt. Even in healthy younger
people, sensory loss can lead to food poisoning, improper
nutrition and a general discontent with their treatment.

"Unpleasant side effects like loss of taste are a primary
reason for people discontinuing their drug treatments," she
says. Tricyclic drugs in particular are known to have more side
effects than the newer generation anti-depressants that act on
serotonin, called SSRIs. But Schiffman says there is anecdotal
evidence that SSRIs may also diminish or distort taste
perception as well.

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