They are always your best source of health information. You can also check out a a book by Diana Dyer, a dietitian who has survived breast cancer twice.

The book, A Dietitian’s Cancer Story, is wonderful and can be purcahsed at Amazon.

Soy milk and soy foods in moderation should be OK according to the Soy Foods Council review of the medical research. Remember, you can always eat too much of any healthy foods.

And no, soy foods will NOT cause the breast cancer or any other cancers.

Beta-Hydroxy-Beta-Methylbutyrate (HMB)
HMB is the new kid in town. HMB is essentially a metabolite of the amino acid leucine. It is produced by the body in small amounts and is also found in some fish (catfish), many citrus fruits and human breast milk. It is thought that HMB helps to regulate the enzymes responsible for protein catabolism (breakdown), and that high levels of HMB will reduce the catabolism after intense bouts of exercise. This would, if the theory were correct, help endurance athletes maintain muscle mass and help strength athletes to gain it.

Current research seems to suggest that supplementation with HMB may increase muscle mass and strength. In one study (5), 41 subjects were given HMB and lifted weights 3 times per week for 3 weeks. Those subjects that received HMB supplements showed significant improvements in muscle mass and strength, as well as a decrease in muscle breakdown products (catabolism) when compared with a placebo group. In a second study (5), 28 subjects were given supplemental HMB and lifted weights 6 days a week for 7 weeks. The results of this study also showed increased strength and muscle mass as well as a decrease in body fat.

Since this is a very new supplement, it is too early to tell the long-term effects of using HMB. However, there have not been any side effects reported from its use. As such, we cannot definitively state the potential risks of using this supplement. Having stated this, based on the current available research, I give this supplement two thumbs up! It looks very promising. In these studies researchers used 1.5 to 3 grams of HMB, just in case you wanted to know.

Well, there you have it. The good, the bad and the ugly! As I have stated in this and other articles, there are many very good nutritional supplements out there that have the potential to benefit athletic endeavors.

However, there are also many, many, many supplements that are worthless and many that may be outright dangerous. You are responsible for the supplements you take. So, research supplements before you start taking them and check back here at FitnessHeaven.com for the “real” scoop on new sports and nutritional supplements.

In a recent study (2), 16 untrained males instituted a strength-training program for 12 weeks. During this time, half of the subjects were given 200 micrograms of chromium picolinate and the others were given a placebo. At the end of the 12-week program, body weight, percent body fat, lean body mass and skin-fold thickness was unchanged in both groups. These results indicate that supplementation with chromium, in conjunction with a strength-training program, did not promote a significant increase in strength and lean body mass, or a significant decrease in body fat. There are many other studies that demonstrate the same or similar results.

So, the bottom line here is this: chromium does not enhance fat loss or muscle development. While some exercise enthusiasts may need to supplement with chromium because of a poor diet in relation to loss of the substance through exercise, it will not help you lose weight or gain muscle.

L-Carnitine
Carnitine is an amino acid that synthesizes in the liver and kidneys from two essential amino acids, lysine and methionine. It is also commonly found in meat and dairy products. L-carnitine is billed as an energy-increasing supplement because it increases the body’s use of free fatty acids while reducing muscle lactic acid accumulation, which causes fatigue.

Similar to chromium picolinate, early studies of L-carnitine seemed to suggest that it caused fatty acids to be used during exercise instead of carbohydrates. However, recent (well-designed) studies do not support this idea. In fact, it appears that studies conducted measuring muscle glycogen and lactate levels through biopsy and serum analysis indicate that L-carnitine does not alter fat metabolism at all.

Dehydroepiandrosterone / DHEA
DHEA became popular in 1996 when manufacturers started marketing this substance as a food supplement and not a drug. DHEA is a hormone produced by the adrenal glands. It is a chemical precursor that the body uses to make both androgens and estrogens. This is why it has been marketed for both male and females. DHEA is also contained in wild yams.

Current thinking suggests that as a precursor to androgenic steroids, DHEA supplementation may increase the production of testosterone, which is thought to provide an anabolic steroid-like effect. In addition to the muscle building aspects, manufacturers also claim that it helps reduce body fat and slows the aging process.

While there have not been many well-designed studies outlining the effects of DHEA supplementation, a few studies tend to stand out. In one study (3), which focused on the effects DHEA supplementation in 13 men and 17 women, 40-70 years of age, fifty (50) milligrams of oral DHEA was given to some subjects daily, while the others received a placebo. At the end of six months, it was concluded that both men and women receiving DHEA experienced a significant increase in perceived physical and psychological well-being. In addition, researchers found that the subjects’ human growth hormone levels also rose to that of younger adults.

Another well designed study (4) found similar results. In addition, this study also found that 100mg of DHEA taken for 12 months increased the subjects’ muscle strength, lean body mass and immune functioning.

While the results of this and other similar studies seem very positive, there have been some fairly significant side effects reported from DHEA supplementation.

These side effects have to do with the increase in the levels of androgens in the body.

As such, some men develop gynecomastia (female-like breasts) and some women develop male-like characteristics such as hair loss, increased body hair and a deeper voice.

Due to the lack of long-term controlled studies, the effects of using DHEA on an ongoing basis are not known. In addition, there are those that believe that long-term elevation of estrogen and testosterone may contribute to an increased risk of uterine and prostate cancer.

Well, as science started to focus on exercise physiology and sports nutrition, all these tried and true methods of increasing athletic performance have been replaced with all manners of nutritional supplementation. These sport enhancing substances or “ergogenic” aids are all the rage. Everyone from weekend warriors to professional athletes seems to be using some sort of nutritional supplement. However, do these supplements truly increase athletic performance or do they only increase the profits of the manufacturers that sell them?

Many manufacturers of food supplements do not tell you everything you need to know to make an informed decision as to the potential benefits (or lack thereof) of their products. So, it is left to you, the consumer, to research and determine the truth about the latest ergogenic aid or supplement. Unlike many other authors at other so-called fitness websites, I do not get paid to endorse any particular product or service. So my friends, I can tell you the truth, as I see it. So on with the show!

While there are many “flash-in-the-pan” sports supplements that you hear about in the news, only a few have seemed to stay in the limelight. So, to save time and not bore you too much, we are only going to deal with the major supplements on the market today. These supplements are Creatine Monohydrate, Chromium Picolinate, L-Carnitine, Dehydroepiandrosterone (DHEA), and Beta-Hydroxy-Beta-Methylbutyrate (HMB).

Creatine Monohydrate
Creatine Monohydrate is an amino acid that is synthesized from arginine and glycine in the liver, pancreas and kidneys. Creatine is also found in red meats and fish. Creatine was first introduced to the athletic community as an ergogenic aid in 1993 and remains a very popular substance. Most professional strength athletes and many weekend warriors or fitness enthusiasts use this supplement.

Current thinking supports the idea that creatine supplementation increases the availability of phosphocreatine in skeletal muscles. What does this mean? It means that during brief bouts of high-intensity activity such as weight lifting, your muscles are able to re-synthesize adenosine triphosphate (ATP) faster. ATP is the direct source of energy for your muscles. So, creatine helps increase the availability of fuel to your muscles and reduces muscle fatigue. In addition to increasing the energy for short-term high-intensity activities, creatine also appears to buffer lactate production, which helps reduce lactic acid build up in the muscles and prolongs anaerobic activity.

In a recent study (1), subjects were required to complete 3 very intense bouts of cycling on a stationary bike. One group was given 5 grams of creatine 5 times per day for 5 days. The other group was given a placebo. The creatine group’s exercise performance was significantly enhanced over the placebo group for the first 2 bouts of exercise. The study concluded that the creatine group’s ATP was re-synthesized more quickly than the control group’s. As such, the creatine group had increased performance for intense/short duration exercise. See, I told you so!

Ok, so the verdict is in and creatine is a winner! In my experience, this is one of the most effective sports supplements on the market today. However, creatine is not cheap.

While it has come down in price since its introduction, it still is quite expensive. But, for those wanting that extra edge, creatine is worth the extra dough.

Chromium Picolinate
Chromium is an essential trace mineral present in many foods, such as mushrooms, nuts, dried fruits, whole grain breads and cereals. Most people get approximately 50% to 60% of the recommended daily allowance (RDA) of chromium. This is partially due to poor dietary habits and also the fact that it is not very well absorbed through the gut.

Step Five
The last issue in starting and maintaining an exercise program is boredom. You need variety. It is ok to change exercises, routines, health clubs, etc. Try the treadmill, swim laps, do an aerobics class, anything that keeps you from feeling bored or tired of the routine. Remember, the ONLY thing that needs to be routine is exercising your body. How you do that is up to you and your creativity.

To recap, here are some points to remember when making exercise a permanent part of your lifestyle:

Believe that regular exercise is required to have a long and health life.
Understand that it is going to be mentally difficult or challenging for the first few months, but it will get easier.
Do not set up criteria that need to be met in order for you to work out.
Make the choice (only once) that you are committed to exercising, and just do it!
Make exercise a part of your normal routine.
Do not give exercise more thought than brushing your teeth, taking a shower, etc.
Change your routine frequently to prevent boredom.

You can play the odds and pretend that nothing will happen to you as a result of inactivity. But, chances are you’ll lose!

If you don’t believe this, just look again at the millions of people above who played the odds and lost. Feel lucky? If not, follow these steps and make a commitment to exercise. Remember, you are the only person responsible for your health. So make the choice to live a happier and healthier life. Don’t make me have to tell you, “I told you so!”

On exertion, the joint may pop, lock and feel weak. Symptoms, however, may “wax and wane.” This injury may be treated medically, but in the athlete, assessment and treatment may require an MRI and surgical repair and even removal of the damaged meniscus. Removal of the meniscus could increase the risk of developing osteoarthritis. This should be considered and discussed with the physician. Most young athletes can resume their activity after meniscal surgery.

Minor tears to the meniscus may be medically treated with the help of physical therapy and include specific exercise regimens.

These include walking, leg bending and stretching exercises.

Ligament damage is of considerable importance in high-impact athletics such as football, hockey, basketball, soccer and skiing. The posterior ligament in the knee is often the most critical structure affected by direct impact. Initially, ligament damage may not always cause pain. A differential diagnosis results from an assessment of the nature of the injury and when the individual reports that the leg collapses when standing. An MRI is often useful in making the diagnosis of ligament injury. When an incomplete ligament tear occurs, conservative therapy is warranted, often stressing exercises that compensate for the ligament damage by strengthening the surrounding muscle groups. In the active athlete, a tear of the anterior cruciate ligament will, in most cases, require surgery and significant rehabilitation time. Rest and moderation of the exercise activity best treat medial and collateral ligament damage such as a sprain, which may now also including icing to reduce additional swelling that may occur.

Tendonitis (inflammation of the tendon) or tendon ruptures are usually the sequelae of overuse. Basketball players often complain of “jumper’s knee,” which is tendonitis of the patellar tendon. This condition results from repetitive muscle contractions that considerably stress the patellar tendon. Tendonitis is painful, and the damaged knee may often swell. If the tendon is ruptured, the individual will not be able to lift the leg against gravity. In the case of a limited tendon tear, a cast may suffice and surgery may not be required. If surgery is indicated, the ends of the ruptured tendon will be reattached, a cast put on for three to six weeks and crutches employed to limit impact loading on the damaged knee. When the diagnosis is tendonitis, the therapy is rest, elevation and ice packs if a limited exercise regimen is included. Aspirin and ibuprofen may be prescribed to control pain and inflammation. Exercise rehabilitation is generally more moderate to treat tendonitis than for ligament damage.

All joint injury should receive medical attention. Ignoring even a small joint injury may have long-term consequences.

The possibility that untreated joint damage may result in significant changes to the joint articular cartilage and bone requires that a physician make an accurate diagnosis and an appropriate course of action be developed to allow the joint to resume normal activity.

As discussed previously (www.fitnessheaven.com/health/healthy_aging/12,27082.asp), osteoarthritis is a degenerative condition of the synovial joint that may result from an antecedent trauma to the cartilage or soft tissues. In this regard, posttraumatic osteoarthritis in adults can be minimized by appropriate treatment of an injury sustained in children. A first consideration recommends bracing, which acts to stabilized the injured joint. Active physical exercise must temporarily be curtailed to minimize any additional damage to the joint as it heals. Most physicians advocate the use of braces and/or other orthotics when the child returns to high-impact physical activity.

Exercise-related knee injuries can take many forms. The health of the joint is jeopardized by damage to the cartilaginous and soft tissue structures. With respect to developing posttraumatic osteoarthritis as an adult, the knee, hip and shoulder are particularly sensitive, the ankle less so. Some injuries directly affect the articular cartilage and supporting cartilages of the joint such as the meniscus. “Runner’s knee” refers to the damage caused by a high level of running on the structures of the inside (medial aspect) of the knee. Overuse causes high levels of stress to the patella (kneecap) causing it to move from side to side over the groove in the femur resulting in a softening of the underlying articular cartilage. This condition is referred to as, “chondromalacia of the patella.”

The pain resulting from this damage may precede more serious damage to the underlying femoral articular cartilage where osteoarthritis may ensue. A differential diagnosis ruling out “patella tendonitis” is recommended before medical therapy is considered. Runner’s knee is generally treated conservatively. Treatment may include a reduction in running activity or complete rest if the pain and swelling do not subside. If a running regimen is maintained, the use of cold treatment (ice packs) is recommended with a 15 to 20 minute treatment followed by a warming-up time before reapplying the ice. Non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen may also medically regulate pain and swelling. In the active runner, controlled physiotherapy also may be helpful, which, if combined with improved orthotics, can be employed to treat the over-pronation that contributes to the development of runner’s knee (also see www.fitnessheaven.com/fitness/triathlon/running/52,26687.asp). Since weak or under-developed quadriceps muscles and muscle imbalance can also contribute to the development of runner’s knee it is recommended that specific exercises be used to strengthen these muscle groups.

Warming-up prior to exercise can help prevent traumatic joint injury. With specific reference to the knee, stretching exercises are mandatory prior to beginning high-impact exercise or running. Stretching should be preceded by warm-up either by walking or employing a stationary bike. Weight training under supervision may also help strengthen important muscle groups. Marked and sudden changes in the exercise level should be avoided, as the joint does not generally respond well to this alteration in regimen.

What if the joint is injured? A general approach is to first have a physician assess the type of injury and make a determination as to which of the cartilaginous or soft-tissue structures have been damaged. Direct damage to articular cartilage, menisci, muscles, ligaments and tendons must be differentially assessed. The approach to treatment will also vary according to the type and intensity of the individual’s physical activity.

Damage to the knee is determined by a combination of techniques. The previous medical history is crucial since it is informative of the nature of the cause of the injury and any past injuries or general health considerations that might contribute to the course of therapy. The physical examination will generally include bending, straightening, rotating or pressing on the knee to determine the location and extent of injury. Diagnostic tests may be combined with X-ray to localize the degree of damage.

In some cases, a Computerized Axial Tomography (CAT) scan will be employed since this technique can determine the extent of soft-tissue injury better than X-ray.

If necessary, a bone scan (radionuclide scanning), which determines whether blood flow to the bone has been affected by trauma, can also be employed. If surgery is indicated, physicians may require a Magnetic Resonance Imaging (MRI) of the knee, which is sensitive to detecting damage to muscles and ligaments. Arthroscopy may also be indicated. In this procedure, an orthopedic surgeon or other qualified physician employs a small, lighted optic tube (arthroscope) inserted through the skin to visualize the damage to the joint. The damage may be accurately assessed and moreover, repaired, if necessary.

Prone Two Leg Quadricep Stretches: Lay prone on a pad on the ground. Grasp both feet at the instep or front of the toes with the hand of that side. Pull on the feet to bend both knees, while relaxing the front of the thigh. Maintain this position for 20 seconds. Do this stretch at least twice.

Prone One Leg Towel Quadricep Stretches: Lay prone on a pad on the ground. Wrap a towel around the left foot at the instep or front of the toes. Put the knee of the left leg next to the knee of the right leg. Pull on the towel with both hands to bend the left knee, while relaxing the front of the thigh. Maintain this position for 20 seconds, then switch legs and repeat. Do each leg at least twice.

Prone Both Legs Towel Quadricep Stretches: Lay prone on a pad on the ground. Wrap a towel around both feet at the instep or ankle. Pull up on the towel with both hands to bend both knees, while relaxing the front of the thigh. Maintain this position for 20 seconds. Do this stretch at least twice.

Standing Quadricep Stretches: Stand in front of any sturdy vertical object. The right foot is on the floor with the toes pointing forward and the knee slightly bent. Grasp the left foot at the instep or front of the toes. Put the knee of the left leg next to the knee of the right leg. Pull on the foot to bend the left knee, while maintaining an erect posture. Maintain this position for 20 seconds, then switch legs and repeat. Do each leg at least twice.

Leg Up Quadricep Stretches: Stand in front of any sturdy object with a horizontal surface. The right foot is on the floor with the toes pointing forward and the knee slightly bent.

Put the left foot on the horizontal surface. With the back kept flat and the shoulders perpendicular, move the hips forward to bend the knee. Maintain this position for 20 seconds, then switch legs and repeat. Do each leg at least twice.

Waste elimination requires that safeguards be in place to ensure the value proposition is not compromised: Cut waste, not costs. Waste elimination may lead some people to look for shortcuts and chances to dupe customers. This could be absent-minded or devious; in either case, it needs to be quickly dealt with. If you have a juice bar, filling glasses only three-quarters full when you used to fill to the brim is not cutting waste; it is cutting value, and conning members and guests.

Waste elimination can also be used to deliver more value to members and raise satisfaction levels. Do members feel they got fair value for their membership fee? If yes, you are likely to keep their business; if no, you are likely to lose them. Some facilities operate along the lines of making money from members who pay and never show up. That is unlikely to be a sustainable business practice, as competitors will emerge who will ensure their members get their money’s worth.

Would you have the courage to put up a poster in your club, or send a letter to each of your members, that states, “Did you get what you expected, what you paid for and what you wanted from us?” Cut waste on all sides.

If you have a racquetball-playing member who joins and never comes because you converted your courts, you have a year of his money, but you lose a decade of referrals. To reduce waste instead of costs, make sure you knowwhat your members’ needs and expectations are right from the start.

Both internal and external factors affect your price floors and ceilings. Understanding where to gather this information can target your pricing and eliminate random shots in the dark.

The most important internal sources you have are your members — those who purchase your goods and services. Encourage not only your managers, but also your front-line staff, such as personal trainers, massage therapists and front desk clerks, to solicit feedback about pricing.

Train your staff to ask members why they purchase the product/service — what motivates them? Do they patronize the pro shop or restaurant out of convenience, or do they prefer the quality and/or service there? Why do they use your facility’s nail technicians or laundry service?

Also ask how much they value the product/service. Is it seen as an absolute necessity, or as an occasional luxury? How do your members feel about the worth of the product/service? Do they feel as though they are paying a reasonable price? Would they prefer volume discounts or packages?

Other sources of internal information are overall company developments, such as shifts in strategic goals or financial targets. Introduction of new products/services also will affect overall pricing. Past financial records for your facility, including sales reports, will give you a history of pricing and average actual selling prices.

External factors, such as your competition, economic fluctuations and consumer behavior, also greatly influence pricing. The better you understand your competitors, the more strategically you can position your facility. Although market research can be costly, the information you learn is worth the cost. You can even do an informal market research by sending “spies” to your competitors to gather facts.

Discover whether competitors are developing new products/services or programs, or if they are changing existing packages or special deals. For instance, if other clubs in the area have begun to offer spinning classes for free, you’ll have difficulty charging your members for these classes. If every nearby facility offers free parking, attracting new members or retaining old ones will be challenging if you charge for valet parking.

Finally, determine if your competition is expanding into new markets that you do not serve. Are local clubs offering senior’s or children’s programming and thereby attracting more families or making better use of traditionally slower periods? Are other facilities providing special services like physical therapy or nutritional counseling to serve as more of a wellness resource? Those with a wide array of goods/services that appeal to different markets usually can be supported by higher prices.

In addition to watching your competitors, you must consider the economic climate to help predict consumer spending behavior. Naturally, a recession will cause lower overall spending, particularly on items that consumers deem special treats or nonessentials. Soliciting economic data on past trends and comparing these to your sales can provide information for forecasting future purchasing patterns.

Also, use your accountant and consult business publications to predict the future economic climate. This will help you more accurately project sales.

Again, the more information you learn about the economy and its influence on consumer behavior, the more likely it is you’ll stay competitive.

Pricing can be intimidating for some accounting-challenged fitness center managers. But with research and careful study, setting prices correctly can become an effective method to boost your bottom line.