Cholesterol: More on the Story

How often do your club members, clients and class participants come to you as a result of being told to reduce their cholesterol levels, lose a little weight and get fitter?

There is a wealth of research to suggest that elevated blood cholesterol is a risk factor for Coronary Heart Disease (CHD).

Other risk factors include obesity and inactivity, so you are in an ideal position to help out; but do you really have the knowledge to do so? The following update examines the role of diet and exercise in the cholesterol controversy, providing information to help you implement current guidelines to advise your clients.

What is cholesterol? Cholesterol is a fat-like substance found in animal-derived foods. It is a member of a group of lipids called sterols and can be manufactured by the body, in the liver. If the diet is low in cholesterol, the liver makes more as necessary. Although cholesterol is often labelled as being ?bad?, it is an essential part of every cell in the body and is involved in the production of vitamin D and certain hormones, including oestrogen and testosterone. It is also used in the production of bile acids which are needed for the digestion of fats in the gut.

Factors affecting blood cholesterol - Genetics, family history - Dietary fat intake: saturated fatty acids raise blood cholesterol - Exercise levels - Central obesity (intra-abdominal fat) - Other factors, e.g., alcohol intake, smoking, anabolic steroids, high body mass index, age

Dietary cholesterol

The main dietary factor associated with high blood cholesterol is a high fat intake and the type of fat in the diet. A ?low? cholesterol diet simply aims to reduce the amount by reducing the intake of foods containing cholesterol (e.g., shell fish and egg yolks), although there is little correlation in healthy people between the intake of cholesterol and blood cholesterol levels. However, there is a strong link between this and the intake of saturated fatty acids since saturates raise the level of cholesterol in the blood.

Saturated, Poly-unsaturated and Mono-unsaturated Fats

Fats and oils in food are made up of units called fatty acids which can be classified as saturated, polyunsaturated and monounsaturated. All fats and oils contain a mixture of these three fatty acids. Saturated fats (SFA) are usually hard at room temperature and of animal origin. Some dietary sources are beef, butter, lard, cream, whole milk, eggs and cheese. Non-animal vegetable saturated fats are coconut and palm kernel oil, cocoa butter and non-dairy milk and cream substitutes.

Polyunsaturated fats (PUFA) are usually liquid at room temperature and of vegetable origin. They are found in nuts, seeds, meat and many vegetable oils and spreads made from them, e.g., corn, sunflower, safflower. The two main groups are the essential fatty acids linoleic (n-6 or omega-6 family) and alpha-linoleic acid (n-3 or omega-3 family). Current dietary intakes should not be increased.

Monounsaturated fats (MUFA) are considered to be a healthier option. Olive oil is high in MUFA. The high intake of MUFA in Mediterranean countries is thought to contribute to their low incidence of coronary heart disease.

The Effect of Diet Lipoproteins are carriers that transport fat and cholesterol through the circulation. There are several different lipoproteins: however, the two that are usually considered are called low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL cholesterol is often termed ?bad? because high levels are associated with a greater risk of heart disease. HDL cholesterol is often termed ?good? as it helps to have a protective effect . Raised plasma cholesterol concentrations usually reflect elevated levels of LDL cholesterol. LDL is enriched in cholesterol and is the end product resulting from the transport of fat from the liver to the other tissues. Having delivered the fat to the tissues the remnant particle (LDL) is removed from the blood mainly by the liver.

The amount of LDL in the blood depends upon the rate at which it is synthesised and the rate at which it is removed from the blood. Upon reaching a certain concentration, LDL is taken up by macrophages (white blood cells) in the blood vessel wall. These then fill with cholesterol containing LDL, take on a foamy appearance and make up the fatty streaks seen in arteries. Some of these fatty streaks disappear and some go on to form atherosclerotic plaques.

Current research suggests that atherosclerosis may be prevented by anti-oxidant nutrients (including beta-carotene, vitamins C and E), possibly by preventing the oxidation of LDL cholesterol. PUFA in the LDL particle are susceptible to oxidation by the action of free radicals, which are highly reactive oxygen molecules. Free radicals are produced in the body as a by-product of normal metabolism and can also be taken into the body from the environment (e.g., via cigarette smoking, exhaust fumes, radiation)

Considering the potential damage that may occur when LDL cholesterol is oxidised, there is concern about diets with very high levels of PUFA. COMA has therefore set an upper limit of 10% dietary energy from n-6 PUFA. In other words, although partial substitution of n-6 PUFA for SFA helps to lower LDL cholesterol, it is considered unwise to tilt the balance too far. Anti-oxidant vitamins may help to reduce or prevent this oxidation and foods containing them should be increased in the diet.

Dietary sources of beta-carotene: carrots, tomatoes, red and yellow peppers, yellow and orange fruit and vegetables, green leafy vegetables.

Dietary sources of vitamin C: kiwi fruit, oranges, lemons, limes, green peppers, tomatoes, new potatoes, blackcurrants, strawberries.

Dietary sources of vitamin E: wholegrain breakfast cereals and bread, vegetable oils e.g., sunflower, almond, cheese, dairy products, margarine, eggs, avocado

Note that dietary cholesterol alone makes only a minor contribution to the amount of LDL cholesterol in the blood. COMA currently recommends that the current dietary intakes of between 300 and 400 mg/day should not rise. Restriction of dietary cholesterol (e.g., from eggs, shellfish) is advocated for those with particularly high levels because although dietary cholesterol is only moderately absorbed it seems to amplify the effects of saturates by restricting the liver clearance of LDL cholesterol. Fish oils (e.g., from mackerel, sardines, pilchards and salmon) may help reduce the tendency of blood to clot.

The Effect of Exercise

Even gentle exercise such as brisk walking has been shown to increase the HDL levels and reduce LDL levels and this effect is more marked with more intense exercise. These benefits have been shown particularly with aerobic exercise within the ACSM guidelines, but are probably also present within resistance training with medium resistance and high repetitions. In some people the total amount of cholesterol may remain the same, but HDL is, as we have seen, protective against CHD. So, combining a low cholesterol diet with regular exercise will lower significantly the risk of CHD

Is it really necessary to know blood cholesterol level? Knowing that you have a high cholesterol level may increase stress levels and since stress is itself a risk factor for CHD, it may be better to do everything possible to lower levels without actually knowing how high they are. People with a strong family history of very high cholesterol levels or of CHD (relatives suffering before 50 years of age) however should have cholesterol levels measured and lowered by drug therapy if necessary. The newer drugs available to doctors will lower very high cholesterol levels and reduce the risk of CHD.


PRACTICAL ADVICE TO DECREASE SATURATED FAT INTAKES:

- Major sources of SFA in the UK are meat products and dairy products. - Use semi-skimmed or skimmed milk in place of whole milk. - Use half fat cheese in place of regular cheese. - Buy lean cuts of meat. Trim the visible fat. - Choose cooking fats high in unsaturates, e.g. soya, corn, olive, rapeseed oils. - Use butter sparingly. - Avoid cream.


12 Tips to lower blood cholesterol levels

• Reduce intake of foods high in saturated fat
  
• Keep total fat intake low
  
• Eat more foods containing fibre
  
• Be regularly active
  
• Eat more beans and pulses
  
• Eat at least five portions of fruit and vegetables every day
  
• Choose vegetable oils for culinary purposes, e.g., olive, rapeseed, sunflower.
  
• Eat more complex carbohydrate foods, e.g., bread, rice, pasta, cereals and potatoes.
  
• Eat oily fish, e.g., sardines, herrings, mackerel, trout and salmon two to three times per week. - Avoid smoky areas and jogging along busy streets.
  

Cardiovascular Basics and APMH

Cardiovascular training is if you elevate your heart rate to 65-80 percent of your maximum and keep it there for a period of 15 minutes. Why? Because it will stimulate the production of fat-burning enzymes, strengthen your heart muscle, and increase the capacity of your lungs to reoxygenate your blood more efficiently. The idea here is not to work yourself to the max and go beyond your target heart rate, but to stay within that magic training range of 65-80 percent of maximum for a minimum of 15 minutes and, optimally, for 20-30 minutes.

Many people believe the reason for aerobics is to burn calories. The real purpose of cardiovascular exercise is to stimulate the growth of the body's own natural fat-burning enzymes long term so that your body burns more and more calories all the time, not just when you're exercising. If you increase the size of the engine, you will burn more gas. The same principle applies to the calorie-burning potential of your body.

Forms of aerobic exercise are as follows: walking, jogging, running, cycling, rowing, jumping rope, running in place, martial arts, and playing certain sports. As long as your heart rate is elevated into your target training range and it remains there for 15 minutes.

To determine your training range, simply calculate the lower limit at 65% of your Age Predicted Maximum Heart Rate (APMH) and the upper limit at 80% of your APMH. Age Predicted Maximum Heart Rate = 220 minus your age. For example, if you're 45 years old, your lower limit is 220 - 45 x 0.65 = 114. Similarly, your upper limit would be 220 - 45 x 0.80 = 140. If you elevate your heart rate somewhere between 114 and 140 beats per minute continuously for at least 12 minutes, you'll get the desired training effect on your heart.

Fitness Over 40

As we age we often pause to evaluate ourselves: Am I accomplishing all I want to? Am I doing enough to help others? Am I flossing enough? Do I like my work? All sorts of questions pop into our heads all the time. But when you turn 40, 50, 60, and beyond, the questions are a bit altered: Why is my body making that noise? Am I eating right? What sorts of exercises do I need to do to stay fit? And then some.

We all ask these questions because we all want to feel better and live healthier lives. But as we get older and the exercises we did in our 20s aren't so fun anymore--ouch, that hurts--then it's time to find new ways to make fitness work for us, not against. We know that regular exercise can and will keep us strong and vital, it's just a matter of finding activities that fit our needs.

Bodies, They are a Changing

Bear in mind that our bodies change throughout our lives. We tend to notice these changes more as we get older.

"We see the results of physiological changes around 40 and after," says Greg Payne, author and professor at San Jose State University's Human Performance Department in California. Payne says strength, cardiovascular capacity, metabolic rate, flexibility, and reaction time all decrease as we grow older.

Sue Paul, a wellness consultant and specialist in over-40 fitness, believes once the body peaks in the late 20s or early 30s, the functional capacity of most organ systems start to decline at the rate of .75 to one percent a year (or 10 percent a decade) if left unchecked. Decrease in bone mass which hastens osteoporosis, especially in women, and water loss are major changes that she takes into consideration when working with clients and students. "When the body loses water, the connective tissue shortens, and the result is less stability and mobility."

As we age we may also notice changes in our gait speed, length of stride, and width of our feet. Our sense of touch and pain sensitivity may be impaired and make us unaware when we exert too much pressure on a vulnerable joint. These are changes in our bodies we need to keep in mind when looking for a fitness routine.

"Optimistically, many of the symptoms of aging are really symptoms of lack of exercise," says Paul. She believes it's possible to prevent perhaps as much as 50 percent of functional decline by participating in regular exercise.

Payne concurs, "Decline is related directly to lifestyle choice rather than the biological process of aging."

Getting Motivated

Everyone has a different motivation for working out--everything from feeling better about your body to stress-management and a need for physical fun and social activity. One major reason people choose to exercise is appearance. "But for clients over 40," says Paul, "exercise becomes a health issue and stress-relief mechanism. Flexibility and strength become priorities because of the functionality in preserving their quality of life."

Payne recommends that people assess their needs and then choose a particular activity that is enjoyable to them. "The concept that exercise is important is now widely accepted, but adherence is the key. Having fun, joining a club, or working out with a friend, helps encourage regular activity."

However, many older people don't have the endurance level to enjoy various leisure activities that provide good workouts. Payne recommends walking for these folks because "it is simple, provides an opportunity to work out with a buddy, and increases the chance of sticking with it."

There are alternatives to a usual high-endurance cardio-vascular work out. Katie Smith teaches Kundalini yoga and meditation at Skylonda Fitness Center in Woodside, California. She works with businesses interested in stress-management techniques. She says that at 40, people aren't interested in exercises that push until it hurts. "The mindset changes to an awareness of the exercise process, not only the end result." Neil Johnson, a Skylonda fitness trainer and owner of the San Francisco Akido Arts Center, who works specifically in the mind-body connection says, "Most people in their middle years get dissatisfied with just the physical exercise so they look for more, and find that the physical and mental exercise of mind-body exercises like tai chi and akido produce something special."

Devising an Activity Program

Mind-body exercises can be incorporated into a comprehensive, broad-based exercise program that health professionals recommend regardless of a person's age or condition. A balanced exercise schedule includes aerobic/cardiovascular exercise (preferably low impact in nature), muscular strength, endurance training, and flexibility exercises.

Persons exercising for the first time, or returning to exercise after an extended period, can participate in many of the same activities as their fit counterparts, but should begin slowly. The process begins with basic strength, endurance, and simple flexibility exercises before moving to weight training, walks, and stretches. Inactivity has become a risk factor for cardiovascular disease, and the American College of Sports Medicine, the Center for Disease Control, and the President's Council on Physical Fitness all recommend moderate exercise for 30 minutes, most days of the week.

"Fitness level, not age, determines the design, content, and approach of a program," says Paul, citing that although age categories are used for research, no one exercise is the appropriate choice for everyone in the 40-plus age group. "When I consider the average inactive population, my philosophy is that something is better than nothing, and the goal is to encourage participation in any activity that will render health benefits."

Paul doesn't insist on a strict formula, but suggests her clients take brisk walks, garden, or line dance in order to get a total of 30 minutes of moderate exercise during the course of the day, as many days a week as they can. She also recommends at least two days of weight training to maintain muscle mass and help prevent osteoporosis. "Weight training allows the muscle to contract against the pure force of the weight or tubing. Walking itself does not provide enough resistance."

Safety issues become a significant concern for the older, deconditioned person as balance and motor skills are affected, and exercise modification may be necessary. Paul also considers possible side effects of medications that an older person may be taking.

When a person is already engaged in frequent exercise, Paul suggests following the classic cardiovascular formula of 20 to 30 minutes of sustained, non-jarring aerobic activity, at least three times a week. And don't forget to incorporate weight training two to three times a week into your schedule.

Cross training, or working out in a variety of activities, will provide essential fitness elements, avoid boredom, and help prevent overuse injuries in any age group.

Weight Training

A simple weight training program of three workouts a week consisting of three sets of 10 to 12 repetitions, using light weights, is sufficient to develop muscle strength and endurance. Pay close attention to the warmup [8-10 minutes] and proper form. Complete range of motion is essential in avoiding injury. For each exercise taking 4-6 seconds to complete the each repetition, exhaling on the exertional phase and breathing in [inhalation] on the return to starting position.

Basic Nutritional Considerations for the Strength Athlete/Bodybuilder

Proper nutrition is critical for both strength athletes and bodybuilders. While nutritional considerations will vary for each athlete depending on the time of year (off-season or competition), the basic nutritional fundamentals can be applied to both groups. This article will focus on the general needs of both athletes, covering kcalorie and macronutrient intakes.

The Importance of Adequate Kcalories

Gaining weight is a major concern for strength athletes, especially bodybuilders. While more muscle mass helps the strength athlete achieve bigger lifts, more muscle mass is what bodybuilding is all about. To help maintain one's strength and/or gain muscle mass, adequate kcalories (kcals) must be consumed. Without adequate kcals one's strength will suffer and adding muscle mass will not be
possible.

There are numerous methods for determining one's kcal needs. Some are very crude and some are quite specific. Examples include direct calorimetry, indirect calorimetry, and formulas such as the Harris-Benedict. Since the majority of us don't have access to the more specific methods (direct and indirect calorimetry). I will provide a very crude estimation method. First, you must decide if you have a slow, normal, or fast metabolism. Next, take your body weight in pounds (2.2 lbs = 1 kg) and multiply your weight by the appropriate variable (slow metabolism = 12, normal metabolism = 15, fast metabolism = 18). This will give you a rough estimate of your daily kcal needs. For instance, if we take a 175# man who has a normal metabolism he would need roughly 2,625 kcals/day to sustain his weight. This factor does not include exercise. If he was to train heavy for 1 hr doing exercises such as squats and stiff-legged deadlifts, he would need and extra 300-500 kcals to maintain his weight. If weight gain is desired, adding an extra 300-500 kcals/day on top of maintenance kcals and kcals expended from exercise should do the trick. Again, this is only a crude estimation, which may need to be adjusted for your individual needs. However, I have found this method to be quite useful for many of my clients.

Protein Power?

It is clearly established that strength athletes and bodybuilders need more protein 1, 2, 3). However, most already get more than enough. It is important to understand that total dietary energy (kcals), specifically carbohydrate energy, is the single most-important nutritional factor affecting accretion of muscle tissue (2). Therefore, your extra kcals should come from quality carbohydrate (CHO)
sources, not protein shakes.

It is generally recognized that strength athletes and bodybuilders require 1.7-1.8 g/protein/kg/day (1). For our 175# man this comes out to a protein requirement of 145 g/day, or around 20% of total kcals. Not many people need protein supplements to meet this requirement. Also, by eating sufficient kcals your protein requirement will be lower than when consuming a kcal deficient diet.

However, if you are training very intensely for an extended period of time more protein may be required. This can be achieved by increasing your daily intake to 2.2 g/kg or 1 g per pound of body weight. This would also be advised for a new trainee since his or her body is not as efficient in regulating protein catabolism. Under a kcaloric restriction this amount will need to be increased.

Make sure you get the majority of your protein from quality sources such as beef, chicken, turkey, milk, eggs, and cheese. If you must use a protein supplement choose one that is composed of various caseinates or whey. Isolated soy can also be an excellent choice if it is fortified with additional amino acids (glutamine, methionine, cystine, and histidine).


Carbohydrates as A Primary Energy Source

As stated previously, CHOs are the single most important nutrient for gaining lean muscle mass. This is because CHOs have a protein-sparing effect, which means the more CHOs you eat, the less protein (nitrogen) your body requires for resynthesizing damaged muscle tissue. CHOs are also a rapid source of ATP, which helps to generate energy during longer sets (once phosphocreatine stores are temporarily depleted).

Carbohydrates should compose around 50-60% of your total kcal intake. For our 175# man this comes out to 328g - 470g/day depending on the percentage desired and kcals expended from exercise. Quality sources of CHOs include whole wheat, oats, corn, potatoes, legumes, fruits, and vegetables. These foods are not only great CHO sources, but they also contain large amounts of fiber, vitamins, minerals, and sometimes even phytochemicals (something that can't be said for processed foods). By focusing on these sources you are ensuring an adequate intake of fiber, vitamins, minerals, and energy during your workouts. Unless you're trying to gain weight and don't have much of an appetite stay away from the SnackWells cookies.

Fat for Peak Performance

Fat is an important nutrient for strength athletes and bodybuilders. Not only does it aid one in consuming adequate kcals, but it also increases the palatability of our foods and provides very important performance benefits. It is well known, but not scientifically proven, that very-low-fat diets cause many people to lose strength and energy. This is obviously very detrimental to performance. It is also known that the concentration of testosterone decreases when following a very-low-fat diet (4). Add this on to decreased strength and you should just go home and forget about making gains in the gym. Finally, fat also provides energy during strength training and bodybuilding sessions. Although I often read that CHOs provide all the energy for training, I have a hard time believing this. Although I haven't seen studies over this topic, I would love for someone to prove to me that in-between my sets of squats, when my heart rate is 130-150 bpm, that I am not burning fat.

To ensure proper strength gains and anabolic hormonal concentrations, I recommend consuming no less that 20% fat. Personally, I prefer 25-30% of kcals as fat during off-season training. This will provide between 60g -105g/fat/day for our 175# man. Don't believe the hype that bodybuilders must follow very-low-fat diets. For those that have tried, you know that losing body fat is based more on a total kcal deficit than the percentage of fat in one's diet (although this is also an important factor).


Conclusion

Although I haven't provided "breakthrough" information here, I feel this topic is vital for athletes to understand. Without this basic knowledge it will be much harder to comprehend the concepts behind other issues that will be discussed in the future. By understanding and applying the information presented, you can be assured that you will be providing your body with the best nutrition possible for increasing off-season performance and health.


References

1. Lemon, P. R. (1995). Do athletes need more dietary protein and amino acids? International Journal of Sport Nutrition, 5, S39-S61.
2. Gatorade Sports Science Institute. (1994). Methods of weight gain in athletes. Sports Science Exchange Roundtable #15, 5 (1)
3. Butterfield, G., Cady, C., & Moynihan, S. (1992). Effect of increasing protein intake on nitrogen balance in recreational weight lifters. Medicine and Science in Sports and Exercise, 24 (5 Suppl), S71.
4. Volek, J. S. (1997). Energy metabolism and high intensity exercise: dietary concerns for optimal recovery. Strength and Conditioning, October, 26-37

The Dirty Truth About Probiotics

Americans spend millions of dollars on anti-bacterial soap, sponges, moisturizers, disinfectants and a whole array of cleaning products to kill germs, yet microbes -- far from being public enemy number one -- actually provide essential health benefits. The concept that tiny organisms, such as bacteria and fungi, can have health benefits is not new. For thousands of years, people have benefited from foods, such as yogurt and cheese, that are rich with microorganisms. Only recently however, has modern nutrition come to understand the health benefits of certain microorganisms when added to foods or taken as dietary supplements.

The human intestinal tract is a complex ecosystem of microbes, many of which live in harmony with their human hosts and do not promote disease or illness. Microbes that are health-enhancing are called "probiotics." Probiotics maintain the health of the cells lining the small and large intestine, which boosts the digestive tract's ability to absorb nutrients and fight unwanted toxins. Medical researchers are now looking into the various uses of probiotics to prevent and treat gastrointestinal disorders such as antibiotic-induced diarrhea, irritable bowel syndrome, "traveler's diarrhea," and other bacterial and viral infections. A recent issue of the Journal of the American Medical Association highlighted information from the World Congress on Pediatric Gastroenterology, Hepatology and Nutrition on the use of probiotics to improve health and fight disease.

Lactobacillus acidophilus (L. acidophilus) is a probiotic that has been well studied by scientists. L. acidophilus lives in the intestines and vagina and prevents bacterial disease, partly through the production of lactic acid. It also produces lactase, the enzyme that breaks down milk sugar (lactose) into simple sugars. People with lactose intolerance may benefit from the lactase produced by the microbes.

The primary dietary sources of L. acidophilus include the following:

• Acidophilus milk
  
• Yogurt (with live L. acidophilus)
  
• Miso
  
• Tempeh
  
• Fermented dairy products
  
• L. acidophilus is also available in freeze-dried granules, powders, capsules, and liquid form.
  

To be health-enhancing, orally ingested probiotics must endure a tough ordeal -- they have to survive the digestive process, implant in the gut, and multiply. Unfortunately, most yogurts and fermented milks contain a strain of probiotics that are lucky to make it out of the digestive process alive. If they do survive, their effects are rarely long lasting. This is why the most effective probiotics are taken as dietary supplements, such as lactic acid bacteria bifidobacterium sp. and lactobacillus sp.

Part of the mutual benefit between microbes and humans is the ability of the lactobacilli in the colon to break down carbohydrates, such as insulin and fructoliogsaccharide (FOS) to short-chain fatty acids, which provides fuel for the cells in the colon. Carbohydrates like FOS are called prebiotics and serve as food for the "friendly bacteria." Sources of prebiotics include onions, bananas, tomatoes, honey, barley, garlic and wheat.

Prebiotics should be taken along with the probiotics, as food or in a capsule form. It is important to note however, that adverse interactions between medications and some supplements are common. For example vitamins and minerals that exceed recommended dietary allowances may be harmful. Some common foods, including nuts, dairy products, fish, and eggs, may trigger allergic reactions, which may require emergency medical care. If you are considering taking dietary supplements or dramatically changing your diet, it is important to first consult with your healthcare provider or nutritionist.

For more information on nutrition, including a helpful a rating guide to nutrition sites on the Internet, contact the Tufts University Nutrition Navigator at www.navigator.tufts.edu. Another helpful source is the American Dietetic Association in Chicago, Illinois at 800-877-1600 or visit them on the web at www.eatright.org.

Abs, Biceps, Triceps and Chest Exercise Description

Upper Abdominals

Abdominal Crunch,Floor

Lay on the floor with your knees bent. Put both hands behind your head. Pull your shoulder blades off the ground with your nose facing straight up towards the ceiling as to help keep your posture and form correct. Pull only far enough to feel the abdominal area tighten, pause momentarily, and then release. ( Make sure that you do not pull with your hands on your neck, use your abdominals to do the pulling!) You could even do them with your hands in different positions such as on your stomach, on the ground, between your legs, etc. This will keep you from pulling on your neck.

Sit-Ups
Lie on the floor with your legs bent 90 degrees at the knee in the standard "sit-up position". Extend your arms by your head, on the floor. Gently reach your hands over your knees as you curl your chest toward your legs in a sit-up. As with the crunches make sure you are pulling with your abdominals and do not jerk or fling your self up!

Abdominals

Abdominal Crunch,Machine
Adjust the machine so that you fit comfortably. The chest pad should fit comfortably against your upper chest. Your feet should be planted flat on the foot rests. Your arms should be underneath the chest pad reaching up and grabbing the back of the pad. Crunch forward and release letting the plates come only far enough so that they come about one inch from each other and the crunch again until set is complete.

Leg Raises
Lay on your back with your hands at your sides. Start with your legs about six inches above the ground and raise them to about two feet and then lower them back down to six inches. You could put your hands under your lower back for more support if need be. For a more advanced version try bracing your arms behind you, holding your body up at about a forty-five degree angle, and then do as before. Start with your legs six inches above the ground and raise to about two feet, continue until set is complete.

Back

One Arm Dumbbell Row
Sit Grab a dumbbell and place your free hand and the same side knee on the flat bench. Hold dumbbell directly underneath your shoulder and pull up in a rowing motion toward the side of your abdomin. Make sure that you keep your elbow in tight while pulling and concentrate on contracting your back and then release in a controlled manner straight back down.

Reverse-Grip Barbell Row
Grip the barbell with your palms facing away from your body. Bend over so that your back is flat and your knees are slightly bent. Pull barbell up to your abdominal area and then release. Keep your elbows close to your body and concentrate on pulling with your back.

Trapezius

Dumbbell Shoulder Shrugs
SitStand with your feet shoulder width apart. Hold a dumbell in each hand with your palms facing towards your body. Keep your head facing straight in front of you. Keep your shoulders back and your chest out. Raise your shoulders up as high as possible and try to pause momentarily. Then lower your shoulders back down to the starting position.

Biceps

Dumbbell Curl
Standing with your knees slightly bent, holding two dumbbells of equal weight in each hand, with palms facing away from your body, curl one arm at a time up towards your shoulder and then back down. Continue doing dumbbell curls alternating arms until your set is complete.

Incline Dumbbell Curl
Use the same movement as you did with the Dumbbell Curls except do them while sitting on an incline bench. Starting position is with your arms hanging straight down and your palms facing away. Curl up toward your shoulder as you did previously. (Be sure not to jerk or swing the weights. Try to go in a nice controlled fashion.) Continue until set is complete.

Standing Bar Curl
Standing with your knees slightly bent, holding a curl bar with equal weight on each side and palms facing away from your body, curl both arms up towards your shoulders. (Keep your back nice and straight and don't swing the weight keep it nice and controlled.) Continue this movement until your set is complete.

Cable Curl
This movement has a few variations. You can use either the straight bar, the curl bar, or the rope. Connect your bar or rope to the bottom cable. Stand facing the cable with your palms facing out. Standing up nice and straight with a slight bend in your knees, curl both hands up toward your shoulders. Continue until your set is complete.

Upper Chest

Incline Bench Press
Lie on an inclined bench and grasp the bar with your palms facing toward the ceiling holding the bar about two inches wider than your shoulder width. Lift the bar off and lower it to your chest, making contact just above the nipples. Press instantly back up after the bar touches your chest until your elbows are fully locked. Make sure not to bounce the bar off of your chest.

Chest

Flat Bench Press
Lie on a flat bench and grasp the bar with your palms facing toward the ceiling holding the bar about two inches wider than your shoulder width. Lift the bar off and lower it to your chest, making contact just above the nipples. Press instantly back up after the bar touches your chest until your elbows are fully locked. Make sure not to bounce the bar off of your chest.

Flat Bench Barbell Press
Lie on a flat bench with a dumbell in each hand. Press the dumbells up keeping your hands about two inches wider than your shoulder width until your elbows become fully locked. Lower them back down keeping your hands two inches wider than your shoulder width and then press instantly back up.

Flat Bench Flies
Lie on a flat bench with a dumbell in each hand. Press the dumbells up and then with your palms facing each other keeping your elbows slightly bent lower dumbbells down to chest level. The trick is to keep your arms locked and use your shoulder as the pivot point. Imagine your are hugging a barrel, this will help keep your form good.

Forearms

Dumbbell Wrist Curls (Palms up)
Sit with your feet spread about shoulder width apart. Hold a dumbell in one hand with your palm facing up and the back of your forearm resting on one of your thighs. Curl your wrist up towards your body and then lower back down to unflexed position.

Quadraceps

Lunges
These can be done with or without dumbbells. If you are using dumbbells grab one in each hand. Start standing with both feet shoulder width apart. Take a step forward with your right foot and bend your left leg so that your left knee comes within one to three inches of the ground. Make sure that your right knee does not go past your right toe, this will help ensure good form. Press back with your right leg returning yourself to the starting postion.

Calves

Calf Raises
Start with your feet should width apart and the balls of your feet on some sort of elevated platform. Grab a dumbbell in each hand. Start with your heals lowered fully stretching your calves and then raise up on your toes so that your calves are fully flexed, pause momentarily and then release.

Shoulders

Seated Dumbbell Press
Sit on an upright bench with your feet spread about shoulder width apart and your head up. Hold a dumbell in each hand and lift them up to your shoulders with your palms facing away from your body. Press the dumbbells straight up over your head, making sure to keep your elbows out at the sides of your body. At the top of the movement your arms should be almost fully extended leaving just a slight bend.

Triceps

Tricep Kick-Backs
Start by grabbing an approprately weighted dumbbell. Place one knee on a flat bench, using the same side hand(left knee on bench then left hand on bench, right knee on bench then right hand on bench), bend over and support yourself with that hand making sure your back is flat. While hoding the dumbbell, keeping your elbow next to your body, extend straight backwards until arm is straight, keeping your palm facing toward your body then return to starting position.

French Press
Lay down on a bench and grab a barbell or EZ-curl bar with palms facing away. Hold barbell or EZ-curl bar straight above your forehead. Slowly take the barbell or EZ-curl down to about your hairline keeping your elbows in place only using them as hinges.

Tricep Push Downs (Machine)
Start by adjusting the machine to fit you properly. Grab both handles and push down until your arms are extended almost fully, then release slowly back to starting postion.

Push-ups Close Grip
Start in standard push-up position keeping your arms about shoulder width apart. While keeping your back nice and straight bend your elbows keeping them tight into your sides and lower your self until you are about a half inch from the ground, then push back up.

Eat Right When Eating Out

Americans, on average, eat out about four times a week. People eat out for many reasons including convenience, social or business engagements, and variety. Eating out can be a very enjoyable experience, to be shared with family and friends.

If you eat out occasionally, you may be able to order whatever you desire. However, if you eat out on a regular basis, be aware that choosing foods high in calories, fat, and cholesterol can impact your health.
Many restaurants offer heart healthy entrees or smaller portions for people that are watching their waistlines or their cholesterol levels.

Here are some restaurant options for you to consider when eating out. Please note the serving sizes given here. The recommended serving size for meat is 3 ounces. However, most people eat more than 3 ounces of meat when eating out. If you order a 12 ounce steak, you are eating four times the recommended amount of meat for one meal. This is okay to do occasionally, but, on a regular basis, can increase your risk of high cholesterol and weight gain.

Instead of this...	try this.
Large cheeseburger with double patty and bacon, french fries, milkshake	Regular cheeseburger with mustard and ketchup, green salad with low-cal dressing, vanilla ice milk cone, glass of low fat milk
1100 calories 50 grams of fat 125 milligrams of cholesterol 1400 milligrams of sodium	600 calories 20 grams of fat 70 milligrams of cholesterol 1000 milligrams of sodium
Instead of this...	try this.
Fried chicken breast with skin, potato salad, biscuit	Roasted chicken breast without skin, corn on the cob, baked beans, potatoes with gravy
800 calories 50 grams of fat 150 milligrams of cholesterol 2200 milligrams of sodium	650 calories 15 grams of fat 100 milligrams of cholesterol 2000 milligrams of sodium
Instead of this...	try this.
Large beef burrito	Bean burrito
500 calories 20 grams of fat 70 milligrams of cholesterol 1450 milligrams of sodium	400 calories 12 grams of fat 10 milligrams of cholesterol 1140 milligrams of sodium
Instead of this...	try this.
2 slices of extra cheese and pepperoni pizza	2 slices of vegetarian pizza
450 calories 20 grams of fat 35 milligrams of cholesterol 1100 milligrams of sodium	370 calories 12 grams of fat 15 milligrams of cholesterol 800 milligrams of sodium

How About Pizza?

Do you love pizza but have concerns about the amount of fat or sodium found in a typical pizza? Try some of the following suggestions for a healthier pizza.

Better choices: tomatoes, peppers, mushrooms, onions, pineapple, ham, canadian bacon, anchovies, and ground beef

Less healthy choices: pepperoni, sausage, salami, and extra cheese

Try this:
Consider making your own healthy and delicious pizza at home using a pre-made pizza crust or English muffins, top with tomato sauce, reduced fat cheese, lots of vegetables, and a little lean cooked ground beef or ham. Bake in the oven until the crust is crunchy, the cheese is melted, and the vegetables and meat are cooked. Enjoy!