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As practitioners take long deep breaths to usher in International Yoga Day this week, purists and innovators debate whether alternative trends are overshadowing the traditional form

Racchana S Iyer

Inching towards the helm of a long silken cloth, 27-year-old Aditi Vaswani pulls herself higher, her finesse evading the toil that seems like an inevitable part of the art. She appears indifferent towards the asymmetry plaguing her moves. The loop around her right leg doesn't mimic that on the left, the red cloth cuts her arms at uneasy folds. Suddenly, she stops, as though calculating her grip on the silk. In one swift moment, she throws herself upside down, plunging several inches lower, only to stop midway, safely secure in the comfort of her rope. 'See?' the instructional designer smiles, delighted with the belief that she has successfully justified her love for anti-gravity yoga.

Vaswani is among a growing lot of women who are constantly in search of alternative forms of the traditional practice, with reports about Kareena Kapoor Khan too giving anti-gravity yoga a shot to get rid of her post-pregnancy weight.

Aerial Yoga

Yogic detour The demand for yoga with a twist is so high that even seasoned practitioners have been compelled to pay heed, albeit unwillingly. "The newer forms have people looking at yoga as a tool to lose weight. They are only being promoted for weight management and calorie burn," laments Iftekhar Ahmed Farooqui, a trainer at the Yoga Institute in Santacruz, one of the oldest in the city. "Yoga has to be an amalgamation of the mind, body and energy. You need to reach a pose, achieve it and hold it. Today, people want to focus on movement," he says, specifically referring to the unrealistic expectations that those propagating power yoga have created. "The additional forms hitting the market, like beach yoga, silk yoga and hot yoga, are only methods to make money."

It comes as a surprise then that Farooqui trains individuals in these glamourised forms. "I do it because I popularise yoga under the name of these additional trends," he reasons. "While I may focus on strenuous exercises during a class of power yoga, or flexibility work in hot yoga, to meet clients' demands, I will also take them through the principles of the traditional art. And that, I think, is how trainers must attempt to teach individuals, even while selling the offbeat forms."

Thirty-four-year-old Racchana S Iyer, founder of Mumbai-based Revival Yoga Studio, however, believes that such derivatives have only stemmed from people's interest, and must be encouraged to rope in enthusiasts to learn the original form. "Those inclined towards fitness came up with power yoga, those who love movement devised Vinyasa Flow, while aerial dance enthusiasts created anti-gravity yoga. All these forms include one or another principle of yoga, and can still help people," says the practitioner, who is quick to point out that the benefits of these offshoots are limited unless individuals are motivated to learn the original form. "They add an element of interest, but can't compete with the traditional practice. It's a marketing strategy. You won't reap long-term benefits if you don't grow, both physically and mentally. These forms will enhance your movement, not experience."

Mew-ga

Alternate cool At a popular Andheri cafe, Priti Jhavar conducts hour-long 'Mew-ga' sessions in the midst of a dozen felines, who leap and twirl around practitioners as they perform the art. "The cats even have their favourite mats. There is certainly a difference between those students who attend the Mew-ga class and those who practise traditional yoga. It is not in the manner in which they execute a particular asana, but in the warmth with which they look at animals," says the Ashtanga yoga practitioner.

However, Jhavar doesn't consider these additional forms a means to lure the younger generation. "People don't see yoga as something that those in their 60s practise. Today, a whole lot of youngsters are taking to the traditional practice also."

Vaswani seconds Jhavar's assertion, adding that she arrived at her decision of learning anti-gravity yoga after practising the traditional form for two years. "Yoga taught me to be happy, and by permitting myself to blend it with a form of dance I enjoy, I've only learnt to be happier and get physically stronger."

It's a crazy yogic world

Goat yoga: The latest fitness trend sweeping the US is similar to Jadhav's cat yoga, except here, the sound of bleating goats reverberate along with your trainer's cues. Interacting with the animal while executing yoga, claim practitioners, aids in relieving stress.

Yoga on ice: The polar opposite of the hot yoga trend, yoga on ice, as the name suggests, has practitioners take to the outdoors in freezing temperatures. Introduced by Sweden's Active North camp, the practice apparently forces the heart to work harder to circulate blood.

Yoga Raves: Fitness buffs found a way to party without alcohol or substance abuse when Argentina's Art of Living founders reportedly conducted rave yoga parties. Paddleboard yoga: If mastering your poses in the confines of your room is a seamless task, Paddleboard Yoga will give it a much-needed boost. Prepare to put your stability to test as you attempt the headstand while your board struggles to battle the current.

Nauli: The latest body buzzword taking over Instagram sees their users contort their ribcage into inverted shapes. Pics courtesy/Instagram, Hannah Sim

Yoga for the rushed The 12-step Surya Namaskar is ideal for time-strapped Mumbaikars, says Iyer."Begin with a minimum of five rounds on each side. If you have time, practise three asanas in the standing, seated and supine positions each,"she says. Selection should depend on medical history and fitness, based on which, a yoga instructor can suggest an asana chart."If you are flexible, work on building your strength; if you are strong, work at elongating muscles. Incorporate asanas that target the spine."Stiffness around the neck and upper back, says Farooqui, plague professionals."Include exercises that enhance movement and strength in these regions."

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Health: Are alternative trends overshadowing the traditional form of yoga? - Mid-Day

The Atkins diet is a famous weight loss program started by Dr. Atkins. It is centered on the idea that eating a low-carb diet will help you to lose weight. This gives you an opportunity to lose weight by using nutritional products. The diet has become very popular with most people and not only does it recommend you to eat low carbohydrates, it also advocates for a diet high in fats. People have realized it is a healthy way to live and keep in shape at the same time. Dr.Atkins proposes the diet as a way of losing weight in a natural way. It allows you to make a change in your eating habits, which alters your bodys metabolic process without having to go without food.

Atkins provides an alternate form of diet to the westernized eating habits that are loaded with high amounts of fat, which potentially increase the health complication risks of conditions such as obesity. For example, obesity is mainly caused by the intake of too much pure carbohydrates such as flour, white sugar, corn syrup which has a high fructose content just to name but a few. Additionally, consumption of saturated fats poses a great nutritional risk of development of vascular health problems. Atkins argues that by completely ignoring fats and carbohydrates has aggravated the problem of obesity and other weight related complications since you ignore the concept of balanced nutrients. The Atkins diet also gives emphasis to nutritional supplements and body physical exercises.

Though carbohydrates and fats are the major causes of dietary heath complications, Atkins recommends you not to completely by ignore them. The Atkins diet recommends a good proportion of fats and carbohydrates among other recommended foods. By drastically cutting the supply of carbohydrates (usually in the form of glucose) it denies your body the fuel to energy. The body turns to fats as an alternate source of energy which causes you to lose weight.

The Atkins diet permits you to indulge in a variety of meat, fish and various vegetables. Sometimes you may notice lack of weight loss even after adhering to the Atkins diet. This may result from the stagnating insulin in the body that is caused by the intake of too much refined carbohydrates. All you need to do in such a case is to change your metabolism order by reducing the intake of carbohydrate in the body, exercising regularly and taking some nutritional supplements.

Essentially, the basic principle behind Atkins diet is to safely reduce carbohydrates and supplementing with more proteins and fat to loose weight naturally without having to skip the essential nutrients.

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All about the Atkins - Good Herald

What do you do when youre on the other side of the battle against the scale? Heres how to pile on the pounds safely

Two weeks ago, Disha Selarka was complimented on being really pretty, but too skinny, the 20-year-old student and freelance image consultant from Mumbai tells us. She has been underweight since she was a toddler, and growing up, had a host of unflattering nicknames to contend with. Ive been called a twig, a stick...even sukha bombil (dried Bombay duck), Selarka tells us, sharing that, over time, shes learnt not to take the comments to heart. Selarka weighs 40.10 kg and is 54 tall. That makes my Body Mass Index (BMI) 15.5; ideally, it should be between 18.5 and 23; which means I need to put on a good eight kilos, she says.

Navi Mumbai resident, 38-yearold Ramkumar Sundaram assumes that his weight issue is a congenital problem. Hes 56 tall and weighs 68 kg. In his twenties, Sundaram tried hitting the gym, working with dumbbells, gulping protein mixes and shakes and just overeating. Nothing worked, he tells us.

What keeps it down?

Genetically speaking, deficiency of ghrelin or the hunger hormone, can make it difficult to gain weight, says Dr Pratit Samdani, Consultant Internal Medicine at Jaslok Hospital and Research Centre. Fitness coach Nawaz Modi Singhania adds, A small minority of people struggle to gain weight, and theyre usually envied. However, the reality is that inch and weight gain is harder to accomplish than inch and weight loss. Being underweight can come with a multitude of health problems. It could also be caused by health conditions like hyperthyroidism, so the first step is to seek medical advice.

Food, rest and massages

North Mumbai-based dietician Sheela Tanna recommends that those who want to gain weight, include more carbohydrates (whole grains, pasta, bread and roti) and tubers like potatoes in their diet as these convert into fat and sugar, and serve to energise. Also, consume dairy, because it helps build stronger bones, and helps with muscle gain. She adds, Eat small meals through the day as this helps in assimilation and proper digestion. Massage is also advisable as this improves blood circulation, improving digestion, which helps with fat deposition.

Compact servings of nutrition and calories +Health, wellness and fitness professional Kajal Khaturia cautions, Often, those who want to gain weight load up on junk food, so Ive had many clients come to me with this problem, and when tested, we found their lipid profile was haywire.

Khaturia therefore emphasises, Begin at the root of the problem. Is your low weight genetic or do you have a high metabolic rate? If your body burns calories from food fast, then Id recommend having many meals a day and keeping a little gap between meals these meals should be a combo of carbs, proteins and fats. For example, one may have vegetable paratha with a bowl of curd; wherever possible, opt for starchy vegetables, tubers and roots. Another great option is masala dosa as its a nutritive cereal and pulse combination. Fleshy fruits like bananas, chikoos and mangoes are good, healthy carbs. And, switch from wheat flakes to corn flakes, as the latter will not satiate, and youll be hungry again soon. Your calorie count should always be stepped up gradually.

Shake it up

Though it may seem counterintuitive, exercise is essential for weight gain, but Khaturia points out, Where I may tell someone whos trying to lose weight to jog four times a week, to gain weight, my advice would be to cut down on cardiovascular workouts like jogging and concentrate on weight training, as this will help build muscle mass.

If you resistance train correctly, you will achieve volume, size and bulk in the correct way and in the correct places, says Singhania, who recommends weight training every alternate day. I prefer compound weight training exercises that target many muscles all at once. The trick is to use heavy weights and do fewer reps, she adds.

Those who want to gain weight tend to load up on junk food to achieve this, which is wrong. When tested, their lipid profile values were haywire

Kajal Khaturia

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THE WEIGHT GAIN PLAN - Pune Mirror

Safe Kids offers free car seat safety checks.(Photo: neamov)

Child safety experts say a new law in South Carolina matches the longtimepediatrician recommendations for child passenger safety.

"For the longest time, we have just been so behind the times when it came to the laws about child passenger safety," said Lee Penny, Manager of Safe Kids Upstate."The evidence has been out for a long time and, unfortunately, our law was just outdated."

Achild passenger restraint bill, signed into law last week, makes several changes to the existing rules for child passengers, most notably how long they should ride in rear-facing car seats, when they can graduate from a booster seat.

According to the new law, children under 2-years-of-age "must be properly secured in a rear-facing child passenger restraint system in a rear passenger seat of the vehicle until the child exceeds the height or weight limit allowed by the manufacturer of the child passenger restraint system being used."The change makes South Carolina one of just five states to require children to remain in rear-facing seats until age 2.

Penny said the rule matches what American Academy of Pediatrics has been recommending for years because rear-facing car seats can offer morehead, neck and spine support in an accident.

"In watching the crash test videos, it's amazing to see how much safer children are when rear-facing," said Penny, adding that statistically they're about five times safer than forward-facing car seats.

A second big change is the recommendation that children under 8 years of ageor shorter than 57 inches should be restrained in a belt-positioning booster seat.

Even if a child reaches the age requirement, Penny recommends making sure children fitsafely in the seatbelt meaning the seatbelt is square on their shoulder, snug on their hips and their knees fold over the front of the seat before letting them graduate from the booster seat.

The new law also changes the age at which children are legally allowed to ride in the front seat of a vehicle to 8. It was previously 6.

Understanding the law and best practices can save lives, according to Penny.

"I don't think people realize how dangerous South Carolina roads are, unfortunately. We lose a child every week in South Carolina due to preventable injury from a motor vehicle collision."

Safe Kids Upstate estimates at least 80-percent of all car seats in Greenville, Pickens and Oconee Counties are not installed or used correctly, putting lives at risk. The non-profit organizationoffers free car seat inspections at nine locations across the Upstate. Appointments can be scheduled by phone or online.

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New car seat law changes how, where kids ride - Greenville News

Climb long enough and youll have a close encounter ... or several. Mine was in 1986 at Arches National Monument, five minutes up the black- top north of Moab. I had just rope-soloed a new route on the Organ, a five-pitch tower. Standing on the broad, plateau-like summit with night falling and no headlampI had expected to be down at my VW microbus well before darkI rushed through my first rappel setup, anxious to beat an incoming storm.

I strung the ropes through the rap station, shouldered the haulbag, which was loaded with enough pins, cams and paraphernalia for a Yosemite Grade V, and to save the time it would take coiling it, clipped a spare 9mm trail line so it dangled straight off my gear sling. I snapped on my rap device, leaned back into the twilight, and realized an instant too late that I hadnt clipped to my rappel ropes. With a snivelling sob, I plunged like a sack of potatoes toward the bedrock approach slabs, 500 feet below.

Until that moment, I hadnt considered exactly how I would die, and now that I knew it was to be rappelling, I was ashamed. Rappelling, dang dang it! I thought as I sped earthward.

I dropped 150 feet through the air, past the ends of the rappel ropes, then, miraculously, wrenched to a halt. The 9mm trail line, haphazardly clipped to the shoulder sling Id home-sewn on my mommas Singer, had snarled and, whip-snapping above me as I fell, jammed in a crackthe only crack on the smooth Entrada face. It had wedged, Stopper-style, and caught me.

Until that moment, I hadnt considered exactly how I would die, and now that I knew it was to be rappelling, I was ashamed.The shock exploded the sheath off the rope, blew a third of the core strands, and bent the carabiner on my gear sling, but I walked away without a scrape. I scavenged bits of that tattered rope and made a series of short rappels to the ground, where I vowed that, from that moment on, Id count on more than a guardian angel to back up my rappel.

The most commonly used technique for backing up a rappel is to slap a prusik or ascender on the rope and clip yourself to it. In the event you lose control of the rappel, or, like me, come unclipped, the prusik or ascender will grab, provided you fight the urge to death-grip it. Sounds simple, but there are many methods for rigging a back- up. So, what really works?

Of the myriad ways to kill yourself climbing, rappelling is the quickest, but also the easiest to safeguard. To determine the safest and simplest method, Rock and Ice tested a multitude of configurations, simulating rappel failures. The results were revealing.

Both the prusik and ascender are serviceable backups, but only when you rig them just so and understand their limits. A prusik has the advantage of easy availability: You can tie one from almost any bit of cord or sling (but not Kevlar, which slips); its lightweight, cheap, and has no mechanical parts to break or gum up; and it works on single and double ropes. It also grips in any direction, which is handy for backing up traversing raps. Perhaps best of all, you can put a prusik on the rope above or below your rappel device (more later). A prusiks limitations are largely determined by user error. If you rig the prusik sloppily, fail to snug it up, or dont wrap it enough times around the rope (at least three), it wont grip. A prusik is also a bugger to set up with one hand.

An ascender, such as the Jumar or any similar clamp, is a snap to attach to the rope with one hand, and is the common backup on big walls, where you often zip down fixed single ropes tied together. An ascender simplifies jumping these knots: Clamp your second ascender on the rope above the first ascender, clip into and weight it, remove your rap device, and replace it below the knot. Now, jump the lower ascender below the knot and above your newly established rap device, down- jug a move, weight your rap device, and remove the top ascender. The entire procedure takes roughly 10 seconds.

The obvious disadvantage to an ascend- er is that it doesnt work on double-rope rappels. Petzl (petzl.com) does offer a dou- ble-rope rappel backup, the Shunt, but it is a highly specialized device, one youre not likely to carry at all times. An ascenders other flawapparent as soon as you attempt to use it as a backupis that it will only work on the rope above your rappel device because its always either fully locked or fully open: You cant squeeze an ascender in your brake hand as you can a prusik, letting the rope slip through. Being forced to keep the ascender on the rope above your rap device creates problems, some surmountable, some not (see below).

BACKUP ABOVE THE DEVICE

In the 1970s, we were taught to place the prusik backup on the rope above the rappel device, which at the time seemed simple and logical. But, after an incident in which a prusik backup seized and the suspended climber was unable to release it (and suffocated, hanging in his swami), this system was the subject of much debate. What use was a backup, some argued, if it could kill you?

Today, none of us is apt to die this way because we wear leg loops. Still, an ascender or prusik on the rope above your rappel device can leave you in a pickle. For instance, make your connecting sling too longeven a single inch can be too much then, fast as a flash, your ascender or prusik can shoot out of reach, cinch up, and leave you stuck, dangling on the rope. Or, even if you dial the sling length perfectly, the prusik or ascender can lock up and leave you lacking a second ascender or prusikunable to unweight and release it. Stranded again!

The ascender lesson: If you use an ascender backup, keep its connecting sling short so you can easily reach it at its maximum weighted extension. Also, always have a second ascender or prusik with a spare sling available. Then, if your backup locks and you are unable to kip, or bounce up, and release it, you can rig a standard ascender setup and jug to freedom. That said, avoid all of the above unpleasantries simply by using a prusik backup, and placing it on the rope below your rappel device.

BACKUP BELOW THE DEVICE

Set your backup prusik on the rope below your rappel rig and you can casually grip it in your brake hand, which encircles both the prusik and the ropes. Each time you release the prusik, letting it lock, you can easily fiddle it loose again with one hand and resume your rappel. Despite this systems advantages, some people find this backup method awkward; also, it makes controlling your rappel speed a problem, and it comes with two critical caveats. Neglect either, and your prusik backup is as useful as an unbuckled seat belt.

Caveat number one: Do not clip the prusik to your harness belay/rappel loop. From there, it will either get sucked into your device, creating a terrible mess, or smash against your device, which will hold the prusik open, preventing it from cinching. In live drop tests where the prusik was clipped under the rappel device and to the rappel/belay loop, the backup failed 100 percent of the time! Instead, clip the prusik to the leg loop on the same side as your brake hand. While a single leg loop might not be quite as strong as a belay/rappel loop, and hanging by one leg loop isnt ideal, a prusik here cannot ride up into your rappel device, assuming you have your prusik length adjusted correctly (keep reading).

Caveat number two: Make certain the prusiks extended loop length is no more than three or so inches. Shorter is better. Tie the loop too long and the prusik can still slide up and jam against your rappel device, where it will be held open. Practice adjusting the loop to the perfect length while hanging safely in your har- ness from your favorite treenot on the cliffs. Some harnesses, such as those with elasticized leg loops, require shorter prusiks than others.

In the 1970s, we were taught to place the prusik backup on the rope above the rappel device, which at the time seemed simple and logical.It might seem as if the prusik backup is a bit too problematic. Wrong. The trick is to micromanage your backup, doing everything the same each and every time. Clipping the prusik to your leg loop is neither more difficult nor time consuming than clipping it to your belay/rap loop, and getting the correct sling length is a simple matter of 10 minutes of pre-adjustment. Properly tied and positioned, a prusik back- up will live up to expectations, allowing you to live up to yours.

As you might expect, a prusik sliding down the rope will wear out quickly. Just how quickly depends on the type and size of the cord or webbing, how tightly you cinch the prusikbetter too tight than too loose! and how fast you rap. Ideally, youll pre-rig your prusiks out of 6mm Perlon, which isstrong and supple; otherwise, in an emergency situation, you can use whatever slings or webbing are on hand. Keep an eagle eye on your prusik; inspect it after every rappel.

Backing up a rappel on two strands of rope isnt much different than the technique for a single rope: Wrap your prusik (or klemheist;) around both ropes, and short-clip it to a leg loop. You may need to add a prusik wrap or two, or remove one, to get the prusik to slide when you hold it loosely, yet grip when released. Ascendersaside from the Petzl Shunt dont work on double ropes.

I once thought that, in a pinch, I could stop a rappel near the rope ends by clamping down a foot or two from the ropes termini. I tested my theory on a rappel where the cords hung just shy of the ground. I rapped to just above the ends of the ropes, clamped down, and shot off the rope ends. As a parting insult, the rope tails bullwhipped me in the face. No backup can perform a miracle if you rappel off the end of your rope, perhaps the most common way that people die rappelling. Thus, you should always tie a knot/s in the end of your rope. The knots will stop you when they jam in your rap device, assuming you hit them before you hit the ground. Tying a knot into the end of your rappel rope takes five secondstheres simply no rationale not to. The only time you might not use a knotted rope end is in gusty winds, when the knot could jam in a flake or crack if blown sideways.

Likewise, while once bailing off a solo attempt on the Aquarian Wall of El Capitan, I forgot to untie the end knots from my rap ropes. I only realized my error as, while pulling the lines down, I looked up to see the knotted end of one of the lines 20 feet above me, well out of reach. Stuck at a hanging rappel station on a stretch of rock as smooth as a bowl- ing ball, I contemplated hammering the rope in half (no knife), but instead chained my aiders together, clipped all my hooks onto them, and, after a hundred or so tosses, just managed to snag the knot- ted rope end and pull it back down. Over 20 years have passed, and I have not repeated that mistake. The lesson? Always untie the end knots before you pull your rappels. For the end knot itself, tie a bulky figure-8-on-a-bight, which will not pull through your rappel device, even under pressure. Some people, myself included, clip a junk carabiner to the figure-8 loop to make it even bulkier, a wise precaution when you rappel using the relatively loose carabiner brake (the added weight of the carabiner helps the rope toss cleanly). Do not use an overhand knot. This low-profile knot can, under the jolt of just a one-foot drop, extrude through certain rappel devices, and easily squirts through the carabiner brake. Use a figure-8 instead.

As with all things, there is a right and wrong way to knot the end of your rope (or ropes if you are double-rope rappelling). Do not tie the ends of a double rope together, or they will twist around themselves like mating serpents. Instead, tie a knot in the end of each rope. This will let the ropes spin freely, working out any twists created as you rappel.

Use a backup every time you rappel whether youre in a hurry or not, whether the rappel seems rote or sketchy, or whether youre one pitch up or 20. Rappelling even once without a backup is an unnecessary withdrawal from your karmic savings account.

Duane Raleigh, publisher of Rock and Ice and father of two, has proudly left his sport-rappelling/freefalling days behind him.

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Climb Safe: Rappelling - Surviving Climbing's Diciest Business - Rock and Ice Magazine

Many women, and even some doctors, are basing fears of estrogen therapy (ET) on outdated research and are underutilizing estrogen when its safely indicated to ease menopausal symptoms in women in their 40s, 50s and possibly 60s, says Bruce Carr, MD, director of the Reproductive Endocrinology and Infertility Fellowship Program at UT Southwestern Medical Center in Dallas, speaking at the 26thAnnual Meeting of American Association of Clinical Endocrinologists on May 3, 2017, in Austin, Texas. There is a mistaken belief that ET for these age groups causes an increase in breast cancer risk and heart disease, though that has been disproven. I believe estrogen is grossly underused in healthy women who have the indications for it, Dr. Carr says. When it comes to vasomotor symptoms (night sweats, hot flushes) urogenital symptoms (such as burning, itching and painful intercourse), and the prevention of osteoporosis, theres no other drug as potent as estrogen, says Dr. Carr.

Other experts in the field agree. Women are suffering unnecessarily from the negative impact of hot-flushes on their day-to-day lives when many of them could safely and effectively be treated with hormone therapy, Kristen A. Matteson, MD, Associate Professor of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, and a spokesperson for the American Congress of Obstetricians and Gynecologists (ACOG). (ET is also referred to as hormone therapy, aka HT, when progestin is added to lower a womans risk of uterine cancer.)

Why arent more women with menopausal symptoms offered ET or willing to consider it when its suggested by their doctor? Because of an older study that has been found flawed, but which is still embedded in the thinking: In 2002, the Womens Health Initiative (WHI)1found a slight increase in breast cancer risk, as well as an increased risk of heart disease, blood clots, and stroke for women on ET. Upon its publication, millions of women and their doctors concluded that ET for menopausal symptoms was not worth the risk. Studies have suggested that systemic hormone therapy has decreased by about 80% over the past 15 years since the results of the Womens Health Initiative were first published, Dr. Matteson tells EndocrineWeb.com.

In the years since the WHI was first published, however, the vast majority of doctors view the results as skewed because it included an older set of women (the average age was 63), patients who were more than a decade past the average age of menopause and when there is rarely an indication for using ET to ease menopausal symptoms. (ET in women older than 70 does slightly increase the risk of breast cancer.) [In addition, the WHI wasnt really designed to look at breast cancer. The WHI was designed to determine the benefits and risks of hormone therapy when used by post-menopausal women for the prevention of chronic disease, focusing on cardiovascular outcomes, says Dr. Matteson.]

More recent research, including results from the Nurses Health Study, have found that there is no increased risk of breast cancer in women under age 70 taking estrogen alone and only a slight increase in risk (1.24) for women on combination estrogen-progestin therapy under age 70, says Dr. Carr. The increased risk of BC for women under 70 is equal to the risk incurred from being overweight or having started your period before age 12, he says.

Starting ET in a womans 40s or 50s can actually improve her health and mortality as she ages. Theres a window of opportunity to lower heart disease risk if you start women on estrogen therapy in her 50s, says Carr.

Indeed, a 2013 analysis in the British Medical Journal2 showed that estrogen avoidance of women in their 50s whod undergone a hysterectomy contributed to an increased risk in death, attributable in part to the cardiovascular disease that progresses in younger women when estrogen is absent. We know from a number of animal studies and some human studies that before a woman develops atherosclerosis, estrogen can help prevent the development of atherosclerotic plaque, says David Archer, MD, director of the clinical research center, department of obstetrics and gynecology at Eastern Virginia Medical School, adding that once the plaque process has started, however, estrogen could hasten the process (which may account for the increased risk of heart disease in women in their 60s and 70s in the WHI trial).

In addition, research has also found that HT may be linked to decrease in the risk of Alzheimers and colorectal cancer in women using hormone therapy (HT), says Dr. Carr. However, at this time, experts do not recommend putting women on ET or HT simply as primary prevention for chronic disease such as cardiac disease, osteoporosis or Alzheimers in the absence of menopausal symptoms.

While the data is clear that ET is safe and effective for healthy women in their 40s and 50s, women in their 60s should take an individualized approach. The North American Menopause Society recommends that at age 60, patients discuss all their risks with their doctor, acknowledging that around 42% of women continue to have symptoms that impair sleep and health between ages 60 and 65 3 The American College of Obstetrics and Gynecologists (ACOG) does not include age-based recommendations for or against ET or HT in their practice guidelines, stating that systemic hormone therapy, with estrogen alone or in combination with progestin, is the most effective therapy for vasomotor symptoms related to menopause. They recommend that the lowest dose of HT be used for the shortest amount of time to reduce symptoms, and that regardless of age, HT be individualized. Dr. Archer says doctors should also consider the beneficial role of estrogen on bone density when considering whether to place a woman on ET for menopausal symptoms.

Women who should not take ET for menopausal symptoms at any age, says Dr. Matteson, include those with porphyria cutane tarda (a rare enzyme deficiency that affects iron production) and should generally not be used by women with current, past or suspected breast cancer; undiagnosed genital bleeding; untreated pre-cancer changed of the uterus; previous or current venous thromboembolism; active or recent arterial thromboembolic disease (angina, myocardial infarction); untreated high blood pressures; or active liver disease.

As for breast cancer risk, Dr. Archer says, If women are truly concerned about their risk for breast cancer and heart disease, the best thing they can do is to lose weight, exercise, reduce alcohol intake to less than two drinks/day, regardless of hormone therapy status.

Financial disclosures: Dr. Archer is a consultant for Agile Therapeuts, AbbVei, TherapeuticsMD, Exceltis, Allergan.

Last updated on 05/15/2017

New Extreme Risk Category for Cardiovascular Disease & New, Lower LDL Target

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Estrogen Therapy Is Underused in Women in Their 40s and 50s, Due to Outdated Thinking - EndocrineWeb

DALLAS, TX--(Marketwired - May 11, 2017) - In the news release, "Weight Loss Surgeon in Dallas Explains the Necessity of Thorough Pre- and Post-Surgical Care Services," issued earlier today by Kim Bariatric Institute, we are advised that the source has been updated to "DFW Bariatric Institute" and the logo has been updated, as well. Complete corrected release follows.

Weight Loss Surgeon in Dallas Explains the Necessity of Thorough Pre- and Post-Surgical Care Services

Dr. Manuel Castro, Medical Director of the DFW Bariatric Institute and Medical Director of Bariatric Surgery at Destiny Surgery Center, discusses the importance of access to comprehensive care and support before and after weight loss surgery

DALLAS, TX -- May 11, 2017 --Surgical treatments for individuals fighting severe obesity have helped thousands of people across America lose significant amounts of weight and reduce serious and life-threatening risks to their health. While the surgery itself is an important step in the treatment process, it is often only one part of a full program designed to help patients lose weight safely and support them through the physical and emotional aspects of the journey they are embarking upon. Dr. Manuel Castro, a Dallas weight loss surgeon and Medical Director of the DFW Bariatric Institute, says comprehensive care both before and after surgery is a necessary and even vital component to the overall treatment process. "Weight loss surgery provides patients with a tool to assist in modification of lifestyle. Therefore, pre- and post-operative programs that assist in lifestyle change, including diet, exercise, and eating behaviors, lead to improved long-term weight control."

The surgical weight loss program at the DFW Bariatric Institute involves a multidisciplinary approach that gives patients access to many types of assistance. Nutritionists, psychologists, dietitians, exercise specialists, experienced nurses, and bariatric surgeons themselves are all on-hand to provide patients with the guidance and support they need both before and after the surgery. Both online and in-person weight loss surgery support groups are also available through the practice to help patients meet others who are going through similar circumstances. Dr. Castro says these groups can be very helpful for patients from both an educational and an emotional perspective, allowing them to listen to others' experiences and to talk about their own. "Individual and group counseling help educate and motivate patients. In general, support group sessions provide ideas that patients can try on their own in order to fine-tune their lifestyle change."

When it comes to the pre- and post-operative periods for patients, Dr. Castro says some of the most important components include:

Dr. Castro notes that the period before surgery ultimately gives patients the opportunity to develop a greater understanding of what they can expect, and the aftercare stage is designed to assist them with safely and effectively losing weight while offering a helping hand down the challenging path of the dietary and physical changes they will need to navigate during life after weight loss surgery. In addition to these aspects of support, Dr. Castro says the importance of emotional assistance cannot be underestimated. That's one reason why access to counseling in the time before and after treatment is a standard part of the program at the DFW Bariatric Institute. "The weight loss journey provided by bariatric surgery is marked by a significant number of emotional challenges. These range from alterations in self-esteem to changes in the workplace to modifications to marriage and friendship dynamics. These challenges are best handled when emotional support is provided by an experienced professional."

Dr. Castro says individuals should understand that there are programs available to help them through every step of the process. He encourages people who are considering bariatric surgery to seek out experienced weight loss surgeons who have established thorough treatment protocols that can serve their needs before, during, and long after they have surgery in order to maximize the potential for optimal results.

About the DFW Bariatric Institute

Dr. Manuel Castro is a Fellow of the American College of Surgeons and has performed more than 3,500 bariatric surgeries. He is a member of the American Society for Metabolic and Bariatric Surgery and the Texas Association for Bariatric Surgery. Dr. Castro and the team of weight loss surgeons at the DFW Bariatric Institute offer a full range of bariatric surgery treatment options, including gastric sleeve surgery, gastric bypass, and adjustable gastric banding procedures. The practice also offers advanced non-surgical treatments such as the gastric balloon and the Medical Weight Loss Program. The DFW Bariatric Institute provides an all-encompassing pre-treatment and aftercare program designed to help patients through all aspects of the weight loss process. Dr. Castro is available for interview upon request.

For more information about DFW Bariatric Institute, visit drdkim.net and https://www.facebook.com/dfwbi/.

To view the original source of this press release, click here: https://www.drdkim.net/practice-news/weight-loss-surgeon-in-dallas-explains-the-necessity-of-thorough-pre-and-post-surgical-care-services/

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CORRECTION - Weight Loss Surgeon in Dallas Explains the Necessity of Thorough Pre- and Post-Surgical Care ... - Benzinga

One common reason to exercise in the spring of each year is to get ready for swimsuit season. This article talks about exercising and swimsuit season.

I read an article recently that talked about swimsuit season and defined a bikini-ready body as simply a body that could physically put a bikini on that body, regardless of size and shape. There is a lot of pressure to be perfect by the standards that women set for themselves. This article also showed many pictures of women in bikinis, and some of them were pregnant, had stretch marks from previous pregnancies or showed women of average to above-average weight.

So, is it worth the trouble to exercise if you dont end up with the perfect bikini body?

Research has confirmed that any amount of exercise, at any age, is beneficial. And, in general, the more you do, the greater the benefits. The National Academy of Sciences has recommended that everyone strive for a total of an hour per day of physical activity. Sounds like a lot, but the hour can be made up of several shorter bursts of activity (it can be walking, gardening, even heavy housecleaning) done throughout the day.

Walking, lifting weights, doing chores its all good. Regardless of what you do, regular exercise and physical activity is the path to health and well-being. Exercise burns fat, builds muscle, lowers cholesterol, eases stress and anxiety and lets us sleep restfully.

Another important part of health and that perfect body is eating for health. To lose weight, most people need to reduce the number of calories they get from food and beverages (energy in) and increase their physical activity (energy out).

For a weight loss of 1 to 1 1/2 pounds per week, daily intake should be reduced by 500 to 750 calories. In general:

Eating plans that contain 1,200 to 1,500 calories each day will help most women lose weight safely.

Eating plans that contain 1,500 to 1,800 calories each day are suitable for men and for women who weigh more or exercise regularly.

Very low calorie diets of fewer than 800 calories per day should not be used unless you are being monitored by your doctor.

So, I am still wondering if I do all the appropriate exercise and diet plans, will I have that perfect bikini body? That is where genetics and general body build come into play and results will always vary. However, in general your health will always be better with exercise and a healthy diet regardless of the size of your swimsuit or other clothing.

Have a happy and healthy summer.

Sources: Web MD, Women on the Web and National Heart Lung and Blood Institute

Marcia Grant is a wellness coordinator, personal trainer and fitness instructor at Columbus Family YMCA.

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Grant: 'Bikini body' isn't only reason to exercise - Columbus Telegram

Two bills very pertinent to bicyclists and pedestrians are set for hearing at Mondays Assembly Transportation Committee: one would allow bikes to treat stop signs as yield signs, and the other would make clear that pedestrians are allowed to cross while their signals are counting down.

IDAHO STOP LAW A.B. 1103s authors, Phil Ting (D-San Francisco) and Jay Obernolte (R-Hesperia), bring bipartisan support to a bill that rationalizes the vehicle code for people riding bikes.

Obernolte says he became interested in the issue when he first heard about the so-called Idaho stop law, which has been in place since 1982 and allows bicyclists to treat stop signs as yield signs. In Idaho, a bicyclist must still slow down and check for other traffic, and the right of way rules are no different. But riders can slow down, pause, and negotiate the right of way, without being required to come to a full and complete stop, especially if there is no other traffic.

Before that, said Obernolte, I was not aware that other states had tried this. So I did some research; I found the UC Berkeley study, and others, that support the idea that this could save livesthat it is far safer to do it this way than the way CA currently has its laws.

The UC Berkeley study is the work of Jason Meggs, who researched the law while completing a dual Masters degree in environmental health science and city planning.

Meggs found reports that indicated that after the law passed in Idaho, bicycle injuries fell 14.5 percent. He also compiled data on fatalities per bicycle commuter, and his results showed that over the last fifteen years, Idaho is half as dangerous as California, he said.

Meggs also searched for a city comparable to Boise, Idaho, to do a thorough comparison between a city with the law and one without. The best parallel he found was Sacramento, California. Not only do the two cities have similar weather and topography, he said, They have similar land use structures; they both have a river going through them; they are both capital cities with many one-way streets. They both have relatively high levels of cycling and bicycle commuting not high, he pointed out, just higher than most other U.S. citiesand there are many children and college students on bicycles. All those things and more matched up very well between the two cities, he said.

And lo and behold, in terms of injuries per commute, its twice as dangerous in Sacramento as in Boise, he said.

Of course there are other differences between the two states, he said, and Im not claiming that the Idaho stop law caused the difference in injury rate. But its very clear that the Idaho stop law is not causing mass carnage. Everything I found supports the idea that this bill should increase bicycling and reduce injuries.

There are many possible reasons to explain why allowing bike riders to treat stop signs as yield signs is safer. One is that it can clear up uncertainty about what behavior is expected. Current enforcement of stop sign law is inconsistent, and frequent stop signs along bike routes are enough of a hassle that many otherwise law-abiding cyclists dont stop when there is no cross traffic. Changing the law to legalize rational, safe behavior choices could also remove excuses for the kind of uneven police enforcement that leads to incidents like the recent jaywalking beat-down that happened in Sacramento.

Such a law would also allow bikes, which are fundamentally lighter and more agile than cars, to get out of the way and clear intersections where there is an opening, said Meggs. Because bicyclists lose momentum when they come to a stop, they spend more time in an intersection and take longer to clear it than most cars, which adds to the potential risk of injury. This could also reduce delay for motorists, as well as reduce their risk of colliding with a bike.

Intersections are the riskiest places for bicyclists, said Meggs, and the faster we can clear them the better.

There are a lot of risks bicyclists face that have little to do with stop signs, said Meggs, but more do to with whether other people see us or not. Bikes are more like birds; momentum is our friend. A bike rider can more easily slow down, speed up, and gracefully glide through an intersection than a car can.

There are also a lot of good reasons for a bike rider to avoid coming to a complete stop, despite what car drivers may believe. For someone on a bike, every stop take a lot of extra time and energy, as well as wear and tear on the body and risk of injury. Theres an extra strain on knees. And if youre carrying any kind of load, for example on a cargo bike, it is much easier to keep going, even if very, very slowly, then to start up from a complete stop, he said.

But, noted Meggs, the bill does not change the right of way law. Bikes can roll through [a stop sign], but they dont take precedence when someone else is therewhoever is there first still have right of way.

Specifically, A.B. 1103 would

authorize a person operating a bicycle approaching a stop sign, after slowing to a reasonable speed and yielding the right-of-way, to cautiously make a turn or proceed through the intersection without stopping, unless safety considerations require otherwise.

For his part, Assemblymember Obernolte sees other benefits from the bill. He hopes that making streets with a lot of stop signs more attractive to bike riders will incentivize bike traffic to divert off arterials and travel on slower side streets. They arent there now, because of the stop signs, he said. That would encourage a more compatible mix of bikes and cars, especially on quiet streets, he said.

And another big reason to change the law is that a lower incidence of crashes will encourage more people to try biking, which will help California meet its greenhouse gas emission goals, he said.

His fellow author, Phil Ting, represents San Francisco, which triedand ultimately failedto reform local enforcement of bikes stopping at stop signs. The law itself needs to be changed at the state level, however.

When asked about the chances of the bills passing, Obernolte said, Its hard to handicap that. But when you have a Republican from one of the most conservative parts of the state joining with a Democrat from one of the most liberal parts of the state, thats a good indication you have a strong, bipartisan bill. He is, he said, cautiously optimistic about the bills chances.

On the other hand, the same organizations that recently opposed a bill to allow the use of speed enforcement cameras in a pilot programthe California Police Chiefs Association and the AAAare also opposing A.B. 1103. Thats no surprise, really. Unfortunately those groups seem to pull a lot of weight, and they succeeded in stalling the speed camera bill.

PEDESTRIAN SIGNALS The other bill to be heard on Monday, A.B. 390, would clear up a different gray area, this one affecting pedestrians at crosswalks.

Current law states that pedestrians facing a flashing or steady Dont Walk or Wait signal may not start to cross an intersection, but newish countdown signals that have gone in around California arent covered by the law.

From a pedestrians point of view, its pretty clear that the countdown is just a more accurate source of information about the time remaining to cross a street than a random flashing hand. The countdown number varies with the width of the intersectionit can be as long as 26 or even 30 seconds, if the crossing is especially wide. Since some people can make it across more quickly than others, presumably the decision would be left up to the person crossing as to whether they can walk fast enough or not.

But in some areas, like downtown L.A., the police have applied the law as currently written to countdown signals, and have ticketed people for jaywalking when they step off the curb after the countdown starts. Its pretty ridiculous.

But A.B. 390, authored by Miguel Santiago (D- Los Angeles) and, again, Ting, would clarify that the intent of those signals is to give information to pedestrians:

This bill would authorize a pedestrian facing a countdown signal to proceed across the roadway in the direction of the signal if there is sufficient time left on the countdown to reasonably complete the crossing safely.

Currently there is no formal opposition to A.B. 390.

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Legislative Update: Idaho Stop and Pedestrian Signals to Be Heard Next Week - Streetsblog California (blog)

By Courtney C.W. Guerra 05.02.17 | 11:00 am

Getting blamed for a colleagues screw-up doesnt just feel crappy, it also puts you in a difficult spot. If you say nothing, youre taking the fall for someone elses mistake, which might reflect on how well (or not) your boss thinks you can do your job. But if you speak up, you risk seeming petty or even dishonest. So you have to proceed with extreme caution.

Heres what to do the next time you find yourself in that situation:

First things first, its almost never a good idea to just silently accept blame for something that isnt actually your fault. There are exceptions to every rule, but here are the only two circumstances where its a reasonable strategy:

1. Its such a minor issue that no one actually cares.This only applies if the supervisors or other stakeholders involved are pretty blas about it, and if its an isolated incident (not the latest mistake by someone whose work is generally shoddy). If it feels like youll just confuse things further by trying to explainthat itll involve a level of detail that the situation doesnt warrantthen you can hold off.

2. You want to do a favor for the mistake-makerand its a relatively small error.If its a colleague whos recently done you a solid, or someone with more to lose (an up-and-coming junior person who doesnt have a great relationship with their boss, for instance), then you can keep quiet. However, be careful about this one, because you dont want to be covering up someones chronic poor performance.

Notice that theres no No. 3) To be nice or No. 4) To avoid having a tough conversation. Being forthcoming about process problems doesnt make you a tattletale or a jerkit makes you a forthright professional who recognizes when an organization isnt functioning properly. Managers need to know if someones not pulling their weightthey cant do their jobs if theyre misinformed about who needs discipline or extra coaching.

Related: 5 Strategies To Stop Coworkers From Interrupting You All The Time

So if you decide keep your mouth shut when accused of someone elses error, make absolutely sure youre doing it for one of these two reasons, and not out of a misplaced sense of responsibility for other peoples mistakes.

Lets assume that none of your coworkers are outright liars. Realistically that might not always be the case, but I want to believe that most people are fundamentally honestand more importantly, universal benefit of the doubt is the best approach strategically. If someones a crook, thatll become apparent eventually, and you can watch it happen from your position on the high road.

The next step is following up with the right people. Who those people are will depend on your role, your relationships with your coworkers, and the nature of the mistake.

If youve been implicated in writing, then you want to make sure the truth gets documented as well. In some caseswith coworkers you know have integrityyou might even forward the original message to them with a note like, Billy seems to think I messed up the sales projections, but didnt your team work on that? A good colleague will probably jump into the conversation to clear your name, but not everyone will take the hint. (Keep this in mind whenever youre the one in the wrongreliably taking responsibility for your own mistakes will prove that youre trustworthy.)

Related: The Scientifically Proven Way To Deal With Difficult Coworkers

With less dependable actors in the mix, youll have to do the dirty work yourselfbut as with any of these delicate situations, you want to be as dispassionate as possible. You might suspect there was some creative license involved with someone elses explanation, but dont imply that anyone was being intentionally misleading. Just stick to the facts: Hi all, I just wanted to clear up the workflow on this project since there seems to be some confusion. The sales projections actually came from Tinas team, so hopefully she can explain the inaccuracies. And then you copy Tina on the reply.

Basically, the maneuver here is to pretend like your reputation isnt at stake, in spite of how you really feel. If someone told you, New York is on the West Coast of the United States, you wouldnt get all how dare youyoud just correct them based on the factual reality of the world we all live in. Thats the tone youre going for here as well: A kind of bemused vibe of, Im not sure why you got this wrong, but no worrieslets clear it up once and for all.

For complex or super-serious situations, it might be wise to enlist your manager as your ally (or another senior colleague who knows the whole story, if the accusation originates with your own boss). If the screw-up involves a lot of peopleor one particular person whos known to be especially pricklythen a supervisor can help get to the bottom of things. An informal (face-to-face or phone) conversation is probably best, although e-mail will work if necessary. As always, be calm and factualand as succinct as possibleas you lay out the details and then solicit advice on how to handle it. Even if your boss tells you to deal with it yourself, that preliminary discussion will prove invaluable if things escalate.

Documentation can save your hide in these situations, but if the mistake originates in the course of verbal conversation, the only official evidence will be highly fallible human memory. Someone still has to back down, thoughand sometimes, for whatever reason, that person is going to have to be you. But that doesnt mean you have to admit outright defeat. In the same neutral mistakes were made tone as in all these other examples, you can issue a verdict of, Well, I remember it differently, but whats done is done, and I suppose this is a lesson to take better notes. (And then, needless to say, you do start keeping a more robust record so that you dont find yourself in this position again.)

Sometimes when a big project goes awry, theres no clear target for blame, and so it just kind of splashes all over everyone involved. If that happensor you otherwise get dinged for something you really couldnt controltry not to let it get to you. A crusade to indict the real culprit isnt a good look. If your work is otherwise good, and youve proven yourself to be an upright citizen in the office, your reputation can safely survive a few mistakeseven the ones that arent actually yours.

This article is adapted fromIs This Working?: The Businessladys Guide to Getting What You Want from Your Careerby Courtney C.W. Guerra (The Businesslady)and reprinted with permission from Adams Media, a division of Simon & Schuster.

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What To Do When You Get Blamed For Your Coworker's Screw-Up - Fast Company

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