Not all Web-based information is accurate.
More patients are turning to the Internet for medical advice. To determine the accuracy of online medical information, researchers in the U.K. used key words to search Google for advice about five common pediatric topics: measles-mumps-rubella (MMR) vaccine and autism, HIV infection and breast-feeding, mastitis and breast-feeding, infant sleep position, and management of green vomit. The first 100 websites listed in the results for each search were evaluated.
Thirty-nine percent of the websites gave accurate information (consistent with current U.K. recommendations), 11% provided inaccurate information (inconsistent with current U.K. recommendations), and 49% did not provide pertinent advice. Information on the MMR vaccine and autism and HIV and breast-feeding was correct in only 65% and 51% of sites, respectively. The websites on the other topics were accurate more than 94% of the time. All government sites were accurate. However, news sites were accurate only 55% of the time, and sponsored sites (sites that pay premiums to be featured prominently in results lists of search engines) were never accurate.
Comment: Online medical information is highly variable and often inaccurate. Learn the best sources of information for your patients, and recommend government-sponsored sites when available.
— F. Bruder Stapleton, MD
Published in Journal Watch Pediatrics and Adolescent Medicine April 28, 2010
Citation(s):
Scullard P et al. Googling children's health: Reliability of medical advice on the internet. Arch Dis Child 2010 Apr 6; [e-pub ahead of print]. (http://dx.doi.org/10.1136/adc.2009.168856)
Wednesday, April 28, 2010
Tuesday, April 27, 2010
Higher Depression Scores Linked to Greater Chocolate Consumption
A study linking depression to chocolate consumption has been receiving a lot of press attention. The study appears in the current Archives of Internal Medicine.
Some 900 adults in California who weren't taking antidepressants completed a depression scale and also reported how much chocolate they consumed. Those who screened positive for depression ate about eight servings of chocolate per month, while those without depression ate just five servings a month — a statistically significant difference. Consumption of fat, calories, carbohydrates, and caffeine did not appear to explain the difference between the groups.
The authors emphasize that given the study's cross-sectional design, conclusions cannot be made regarding causality or the direction of the association.
Archives of Internal Medicine article
Some 900 adults in California who weren't taking antidepressants completed a depression scale and also reported how much chocolate they consumed. Those who screened positive for depression ate about eight servings of chocolate per month, while those without depression ate just five servings a month — a statistically significant difference. Consumption of fat, calories, carbohydrates, and caffeine did not appear to explain the difference between the groups.
The authors emphasize that given the study's cross-sectional design, conclusions cannot be made regarding causality or the direction of the association.
Archives of Internal Medicine article
Anti-Aging Foods
It is becoming more and more obvious, and undeniable that you are what you eat- study after study demonstrating the link between a certain overall lifestyle or particular food and improved health are making news headlines on a weekly basis. Foods that we eat today will have both an immediate and long term effect on our bodies and fortunately (although many might argue that it is easier to be told) decisions regarding what we eat are individual. So the question that just about everyone wants the answer to, where is the fountain of youth can actually be answered quite simply- in your local supermarket or farmers market.
Taking care of what you eat and including foods rich in certain nutrients can help you look and feel your best. Supermarket Guru has compiled a list of favorites that can be found in your local market.
Avocados, usually thought of as a vegetable are a fruit rich in monounsaturated fats that may help to reduce the “bad” LDL cholesterol in the blood. Avocados are a good source of vitamin E, an antioxidant that protects skin from ultraviolet light, prevents damage from free radicals and allows for efficient cell communication. Avocados are also rich in potassium which is necessary for proper nerve and muscle function as well as maintaining calcium levels and helping to lower blood pressure.
Dark leafy greens, such as collard greens, kale and spinach are all full of antioxidants. The antioxidants found in leafy greens, lutein and zeaxanthin are vital in maintaining eye health and preventing macular degeneration. Leafy greens are also rich in vitamin K which allows for normal blood clotting (keeps bruising at bay), protects against osteoporosis and prevents oxidative cell damage.
Garlic, famous for its strong smell and flavor produced by the presence of allicin; a sulfur containing compound that promotes antioxidant activity as well as acting as an antiviral, antibacterial and antifungal. Scientific studies have demonstrated garlic’s blood pressure lowering capabilities and its positive effects on cholesterol levels. Garlic also contains compounds known to reduce inflammation and improve overall health.
Herbs and Spices not only pack a flavorful punch, but are also rich in ‘anti-aging’ compounds. Parsley, oregano, basil, turmeric and cinnamon are only a few of the many herbs and spices that are great sources of antioxidants, vitamins, minerals and other bioactive compounds that keep our bodies functioning in tip top shape. The deeper the color and fresher the herbs and spices, the better. Studies have shown that on a per gram fresh weight basis, herbs rank even higher in antioxidant activity than many fruits and vegetables.
Taking care of what you eat and including foods rich in certain nutrients can help you look and feel your best. Supermarket Guru has compiled a list of favorites that can be found in your local market.
Avocados, usually thought of as a vegetable are a fruit rich in monounsaturated fats that may help to reduce the “bad” LDL cholesterol in the blood. Avocados are a good source of vitamin E, an antioxidant that protects skin from ultraviolet light, prevents damage from free radicals and allows for efficient cell communication. Avocados are also rich in potassium which is necessary for proper nerve and muscle function as well as maintaining calcium levels and helping to lower blood pressure.
Dark leafy greens, such as collard greens, kale and spinach are all full of antioxidants. The antioxidants found in leafy greens, lutein and zeaxanthin are vital in maintaining eye health and preventing macular degeneration. Leafy greens are also rich in vitamin K which allows for normal blood clotting (keeps bruising at bay), protects against osteoporosis and prevents oxidative cell damage.
Garlic, famous for its strong smell and flavor produced by the presence of allicin; a sulfur containing compound that promotes antioxidant activity as well as acting as an antiviral, antibacterial and antifungal. Scientific studies have demonstrated garlic’s blood pressure lowering capabilities and its positive effects on cholesterol levels. Garlic also contains compounds known to reduce inflammation and improve overall health.
Herbs and Spices not only pack a flavorful punch, but are also rich in ‘anti-aging’ compounds. Parsley, oregano, basil, turmeric and cinnamon are only a few of the many herbs and spices that are great sources of antioxidants, vitamins, minerals and other bioactive compounds that keep our bodies functioning in tip top shape. The deeper the color and fresher the herbs and spices, the better. Studies have shown that on a per gram fresh weight basis, herbs rank even higher in antioxidant activity than many fruits and vegetables.
Monday, April 19, 2010
E. Coli Infections Dropped Last Year
By BETSY MCKAY
Infections from a dangerous form of E. coli bacteria dropped significantly last year, in a sign new food-safety measures are starting to pay off, federal health officials reported Thursday.
But food-poisoning rates for most common pathogens have budged little since 2004, with rare exceptions, including that of vibrio, a pathogen found in oysters and clams. Officials said they were trying to figure out why the rate of vibrio infections rose 21% in 2009.
The preliminary numbers were drawn from a national monitoring program for infections in 10 states and released by the U.S. Centers for Disease Control and Prevention. Officials said the data underscored the need to work more aggressively to plug holes in the nation's food-safety system.
Legislation that would give the government new powers to police food safety and prevent contamination is working its way through Congress.
The rate of infections from E. coli O157, which can cause bloody diarrhea, kidney failure and death, fell 12% in 2009, hitting its lowest level since 2004 and reaching the government's health target for 2010, the CDC said.
Officials credited new measures to monitor ground-beef processing and produce-growing practices for the decline. For example, as of July all components of raw ground beef are tested, said David Goldman, a USDA food safety and inspection service official.
Salmonella was the most common form of food poisoning identified in the report, the CDC said.
The pathogen has vexed food-safety officials in recent years, cropping up unexpectedly in a growing number of sources, including peanuts in early 2009. While the rate of infections declined 6.2% in 2009, at 15.19 for every 100,000 people, it remained far above a government target of 6.80 for 2010.
"We're quite a ways from that objective. It just shows us we're going to need a concentrated effort on salmonella," said Chris Braden, acting director of the CDC's division of food-borne, water-borne and environmental diseases.
"Salmonella is difficult to control because it can contaminate so many different types of new food," he said.
Measures are being taken to reduce salmonella, officials said, with a new effort to improve the safety of eggs that goes into effect this summer.
The rate of infections caused by shigella bacteria, which causes diarrhea, declined nearly 40%. But those infections are spread mostly by person-to-person contact, commonly in day-care centers, rather than through food. The CDC said the decline could be due in part to regular year-to-year fluctuations.
Officials said they were puzzled about the increase in the rate of vibrio infections, which remained rare but can be deadly. They said they haven't seen a significant increase in shellfish consumption and efforts were under way to improve industry practices.
The CDC estimates there are 76 million cases of food-borne infections annually, resulting in 325,000 hospitalizations and 5,000 deaths.
Infections from a dangerous form of E. coli bacteria dropped significantly last year, in a sign new food-safety measures are starting to pay off, federal health officials reported Thursday.
But food-poisoning rates for most common pathogens have budged little since 2004, with rare exceptions, including that of vibrio, a pathogen found in oysters and clams. Officials said they were trying to figure out why the rate of vibrio infections rose 21% in 2009.
The preliminary numbers were drawn from a national monitoring program for infections in 10 states and released by the U.S. Centers for Disease Control and Prevention. Officials said the data underscored the need to work more aggressively to plug holes in the nation's food-safety system.
Legislation that would give the government new powers to police food safety and prevent contamination is working its way through Congress.
The rate of infections from E. coli O157, which can cause bloody diarrhea, kidney failure and death, fell 12% in 2009, hitting its lowest level since 2004 and reaching the government's health target for 2010, the CDC said.
Officials credited new measures to monitor ground-beef processing and produce-growing practices for the decline. For example, as of July all components of raw ground beef are tested, said David Goldman, a USDA food safety and inspection service official.
Salmonella was the most common form of food poisoning identified in the report, the CDC said.
The pathogen has vexed food-safety officials in recent years, cropping up unexpectedly in a growing number of sources, including peanuts in early 2009. While the rate of infections declined 6.2% in 2009, at 15.19 for every 100,000 people, it remained far above a government target of 6.80 for 2010.
"We're quite a ways from that objective. It just shows us we're going to need a concentrated effort on salmonella," said Chris Braden, acting director of the CDC's division of food-borne, water-borne and environmental diseases.
"Salmonella is difficult to control because it can contaminate so many different types of new food," he said.
Measures are being taken to reduce salmonella, officials said, with a new effort to improve the safety of eggs that goes into effect this summer.
The rate of infections caused by shigella bacteria, which causes diarrhea, declined nearly 40%. But those infections are spread mostly by person-to-person contact, commonly in day-care centers, rather than through food. The CDC said the decline could be due in part to regular year-to-year fluctuations.
Officials said they were puzzled about the increase in the rate of vibrio infections, which remained rare but can be deadly. They said they haven't seen a significant increase in shellfish consumption and efforts were under way to improve industry practices.
The CDC estimates there are 76 million cases of food-borne infections annually, resulting in 325,000 hospitalizations and 5,000 deaths.
Sunday, April 18, 2010
Teen Girls' Drinking May Lead to Breast Problems Later
By Kathleen Doheny, HealthDay
Frequent alcohol consumption by teenage girls may increase the chances that they will develop non-cancerous breast disease in their 20s and possibly breast cancer later in life.
Research published online April 12 in the journal Pediatrics found that girls who drank the most alcohol during their teen years — daily or nearly every day — were five times more likely to develop benign breast disease as young adults than were their peers who never drank or drank less than once a week.
Benign breast disease (BBD) includes a number of nonmalignant conditions. Fibroadenoma, a noncancerous tumor, is the most common in those aged 30 and younger. Study co-author Catherine Berkey, a biostatistician at Harvard Medical School in Boston, said that benign breast disease is known to boost the risk for breast cancer.
So does that mean that teens who drink alcohol are increasing their breast cancer risk early in life?
"Our study may suggest that teen drinking increases the risk for breast cancer, whether in all females or in those who go on to develop BBD, but longer-term follow-up is certainly required" to confirm it, she said.
A unique aspect of Berkey's study was that the girls assessed their drinking habits while they were teenagers. Other studies have based their conclusions on adult women's recalling their teenage drinking many years later.
"Our new study is the first in which alcohol data were collected during adolescence, with continued follow-up in the females as they develop disease," she said.
The study involved 6,899 women who had become participants in the "Growing Up Today Study" when they were 9 to 15 years old. Information on alcoholic beverage consumption was collected in a follow-up survey when the participants were 16 to 23 years old, and a survey done when they were 18 to 27 years old included questions on breast disease.
In all, 147 participants reported having benign breast disease, with 67 cases having been confirmed by biopsy.
When Berkey and her colleagues looked at the diagnoses of benign breast disease and drinking, they found that risk for benign breast disease rose along with the frequency of alcohol consumption: from a 1.5 increased risk for drinking one or two days per week, to a three times greater risk for those drinking three to five days per week, and to a 5.5 times greater risk for drinking six or seven days per week, when compared with those who never drank or who drank less than once per week.
Even once-a-week drinkers may not be absolutely safe, Berkey noted. "I suspect there may be some small additional BBD risk for even small amounts of alcohol consumed during adolescence," she said.
Teen years are a critical time for potential cancer-producing exposures, she said, because the mammary glands are undergoing rapid growth during that period.
Berkey said she suspects the link is due to alcohol increasing total estrogen levels, raising the likelihood of benign breast disease.
"For me, this is not a surprise," said Dr. Patricia Ganz, director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles. Regular alcohol consumption is known to increase a woman's risk for both breast cancer and benign breast disease, she said, and "certain forms of BBD increase the risk of breast cancer."
And though she described the new study as excellent, she cautioned that the sample size was relatively small.
"I wouldn't scare (teens) and say, 'You are going to get breast cancer if you drink,'" Ganz said. But, on the other hand, she added: "The public health message is, these young girls shouldn't be drinking anyway."
Frequent alcohol consumption by teenage girls may increase the chances that they will develop non-cancerous breast disease in their 20s and possibly breast cancer later in life.
Research published online April 12 in the journal Pediatrics found that girls who drank the most alcohol during their teen years — daily or nearly every day — were five times more likely to develop benign breast disease as young adults than were their peers who never drank or drank less than once a week.
Benign breast disease (BBD) includes a number of nonmalignant conditions. Fibroadenoma, a noncancerous tumor, is the most common in those aged 30 and younger. Study co-author Catherine Berkey, a biostatistician at Harvard Medical School in Boston, said that benign breast disease is known to boost the risk for breast cancer.
So does that mean that teens who drink alcohol are increasing their breast cancer risk early in life?
"Our study may suggest that teen drinking increases the risk for breast cancer, whether in all females or in those who go on to develop BBD, but longer-term follow-up is certainly required" to confirm it, she said.
A unique aspect of Berkey's study was that the girls assessed their drinking habits while they were teenagers. Other studies have based their conclusions on adult women's recalling their teenage drinking many years later.
"Our new study is the first in which alcohol data were collected during adolescence, with continued follow-up in the females as they develop disease," she said.
The study involved 6,899 women who had become participants in the "Growing Up Today Study" when they were 9 to 15 years old. Information on alcoholic beverage consumption was collected in a follow-up survey when the participants were 16 to 23 years old, and a survey done when they were 18 to 27 years old included questions on breast disease.
In all, 147 participants reported having benign breast disease, with 67 cases having been confirmed by biopsy.
When Berkey and her colleagues looked at the diagnoses of benign breast disease and drinking, they found that risk for benign breast disease rose along with the frequency of alcohol consumption: from a 1.5 increased risk for drinking one or two days per week, to a three times greater risk for those drinking three to five days per week, and to a 5.5 times greater risk for drinking six or seven days per week, when compared with those who never drank or who drank less than once per week.
Even once-a-week drinkers may not be absolutely safe, Berkey noted. "I suspect there may be some small additional BBD risk for even small amounts of alcohol consumed during adolescence," she said.
Teen years are a critical time for potential cancer-producing exposures, she said, because the mammary glands are undergoing rapid growth during that period.
Berkey said she suspects the link is due to alcohol increasing total estrogen levels, raising the likelihood of benign breast disease.
"For me, this is not a surprise," said Dr. Patricia Ganz, director of cancer prevention and control research at the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles. Regular alcohol consumption is known to increase a woman's risk for both breast cancer and benign breast disease, she said, and "certain forms of BBD increase the risk of breast cancer."
And though she described the new study as excellent, she cautioned that the sample size was relatively small.
"I wouldn't scare (teens) and say, 'You are going to get breast cancer if you drink,'" Ganz said. But, on the other hand, she added: "The public health message is, these young girls shouldn't be drinking anyway."
Friday, April 16, 2010
Standardized Screening May Help Idenetify Suicidal Adolescents
April 15, 2010 — Standardized screening for suicide risk in primary care can detect adolescents with suicidal ideation, allowing referral to a behavioral healthcare center before a fatal or serious suicide attempt is made, according to the results of a study reported online April 12 and published in the May print issue of Pediatrics.
"Several associations and federal agencies have called for depression screening in pediatric primary care," writes Matthew B. Wintersteen, PhD, from Thomas Jefferson University in Philadelphia, Pennsylvania. "Screening for suicide risk is a natural adjunct to this call....To our knowledge, this is the first study to prospectively examine the impact of standardized screening for suicide risk on detection and referral rates in pediatric primary care."
The goals of the study were to evaluate whether brief standardized screening for suicide risk in pediatric primary care practices could improve detection of youth with suicidal ideation, maintain improved rates of detection and referral, and be duplicated in other practices.
Two primary care clinics (clinic A and clinic B) were selected as intervention clinics, and a third clinic (clinic C) asked about participating in the study and was offered the intervention. At these 3 clinics, physicians underwent brief training in detecting suicide risk, and 2 standardized questions for adolescents aged 12.0 to 17.9 years were added to their existing electronic medical chart psychosocial interview. Data without identifiers were extracted during intervention trials and for the same dates of the preceding year, and referral rates were determined from social work records.
The intervention was associated with doubling of the rates of inquiry about suicide risk, which resulted in a 219% increase overall (clinic A odds ratio [OR], 2.04; 95% confidence interval [CI], 1.56 - 2.51; clinic B OR, 3.20; 95% CI, 2.69 - 3.71; and clinic C OR, 1.85; 95% CI, 1.38 - 2.31).
In clinic A, the rate of case detection increased nearly 5-fold (OR, 4.99; 95% CI, 4.20 - 5.79), was maintained for a 6-month period after the intervention was implemented (OR, 4.38; 95% CI, 3.74 - 5.02), and was replicated in both clinic B (OR, 5.46; 95% CI, 3.36 - 7.56) and clinic C (OR, 3.42; 95% CI, 2.33 - 4.52). Across all 3 clinics, case detection rate increased by 392%. The rate of increase of referral rates of suicidal youth to outpatient behavioral healthcare centers was commensurate to that of the detection rates.
"Standardized screening for suicide risk in primary care can detect youth with suicidal ideation and prompt a referral to a behavioral health care center before a fatal or serious suicide attempt is made," Dr. Wintersteen writes.
Limitations of this study include suicidal ideation based on history, not necessarily on present thoughts; and inability to determine the impact of the brief training in suicide risk.
"The findings from this study are particularly timely after the recent recommendation of the US Preventive Services Task Force to routinely screen youth for a major depressive disorder," Dr. Wintersteen concludes. "In addition, the American Academy of Child and Adolescent Psychiatry along with the American Academy of Pediatrics Task Force on Mental Health also released a joint article in which routine behavioral health screening in primary care was recommended....Both reports cautioned against screening when psychotherapy followup was not readily available."
The American Foundation for Suicide Prevention supported this study. Dr. Wintersteen has disclosed no relevant financial relationships.
Pediatrics. Published online April 12, 2010. Abstract
"Several associations and federal agencies have called for depression screening in pediatric primary care," writes Matthew B. Wintersteen, PhD, from Thomas Jefferson University in Philadelphia, Pennsylvania. "Screening for suicide risk is a natural adjunct to this call....To our knowledge, this is the first study to prospectively examine the impact of standardized screening for suicide risk on detection and referral rates in pediatric primary care."
The goals of the study were to evaluate whether brief standardized screening for suicide risk in pediatric primary care practices could improve detection of youth with suicidal ideation, maintain improved rates of detection and referral, and be duplicated in other practices.
Two primary care clinics (clinic A and clinic B) were selected as intervention clinics, and a third clinic (clinic C) asked about participating in the study and was offered the intervention. At these 3 clinics, physicians underwent brief training in detecting suicide risk, and 2 standardized questions for adolescents aged 12.0 to 17.9 years were added to their existing electronic medical chart psychosocial interview. Data without identifiers were extracted during intervention trials and for the same dates of the preceding year, and referral rates were determined from social work records.
The intervention was associated with doubling of the rates of inquiry about suicide risk, which resulted in a 219% increase overall (clinic A odds ratio [OR], 2.04; 95% confidence interval [CI], 1.56 - 2.51; clinic B OR, 3.20; 95% CI, 2.69 - 3.71; and clinic C OR, 1.85; 95% CI, 1.38 - 2.31).
In clinic A, the rate of case detection increased nearly 5-fold (OR, 4.99; 95% CI, 4.20 - 5.79), was maintained for a 6-month period after the intervention was implemented (OR, 4.38; 95% CI, 3.74 - 5.02), and was replicated in both clinic B (OR, 5.46; 95% CI, 3.36 - 7.56) and clinic C (OR, 3.42; 95% CI, 2.33 - 4.52). Across all 3 clinics, case detection rate increased by 392%. The rate of increase of referral rates of suicidal youth to outpatient behavioral healthcare centers was commensurate to that of the detection rates.
"Standardized screening for suicide risk in primary care can detect youth with suicidal ideation and prompt a referral to a behavioral health care center before a fatal or serious suicide attempt is made," Dr. Wintersteen writes.
Limitations of this study include suicidal ideation based on history, not necessarily on present thoughts; and inability to determine the impact of the brief training in suicide risk.
"The findings from this study are particularly timely after the recent recommendation of the US Preventive Services Task Force to routinely screen youth for a major depressive disorder," Dr. Wintersteen concludes. "In addition, the American Academy of Child and Adolescent Psychiatry along with the American Academy of Pediatrics Task Force on Mental Health also released a joint article in which routine behavioral health screening in primary care was recommended....Both reports cautioned against screening when psychotherapy followup was not readily available."
The American Foundation for Suicide Prevention supported this study. Dr. Wintersteen has disclosed no relevant financial relationships.
Pediatrics. Published online April 12, 2010. Abstract
Saturday, April 3, 2010
Exercise with Anxiety and Depression
Regular physical activity is good therapy for both depression and anxiety, and it will also help improve your mood and self-esteem. Exercise will also help you reduce your stress, sleep better, and feel more energized. The key to maximizing the benefits of exercise is to follow a well-designed program that you can stick to over the long-term.
Getting Started
* Talk with your health care provider about integrating regular exercise into your treatment plan.
* Take all medications as recommended by your physician.
* The primary goal of your program is to find activities that you enjoy and will do on a regular basis. Choose environments that are comfortable and familiar to you and avoid situations that increase anxiety.
* If your fitness level is low, start with shorter sessions (even 5 to 10 minutes) and gradually build up to 20 to 60 minutes of aerobic activity, at least four or more days per week.
* At least two days per week, follow a strength-training program with one to three sets of exercises for the major muscle groups, with 10 to 15 repetitions.
* Mind-body activities, such as yoga and tai chi, are particularly effective for reducing anxiety and enhancing relaxation.
Exercise Cautions
* If you take medication, be aware of how it might affect your response to exercise. For example, some anti-psychotic medications can cause dehydration or gait disturbances, while certain antidepressants can cause fatigue, dizziness and weight gain.
* If you have been inactive, consider joining structured, supervised program to help develop a routine that you will continue to do on a regular basis.
Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic goals and design a safe and effective program that addresses your specific needs.
For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.
Getting Started
* Talk with your health care provider about integrating regular exercise into your treatment plan.
* Take all medications as recommended by your physician.
* The primary goal of your program is to find activities that you enjoy and will do on a regular basis. Choose environments that are comfortable and familiar to you and avoid situations that increase anxiety.
* If your fitness level is low, start with shorter sessions (even 5 to 10 minutes) and gradually build up to 20 to 60 minutes of aerobic activity, at least four or more days per week.
* At least two days per week, follow a strength-training program with one to three sets of exercises for the major muscle groups, with 10 to 15 repetitions.
* Mind-body activities, such as yoga and tai chi, are particularly effective for reducing anxiety and enhancing relaxation.
Exercise Cautions
* If you take medication, be aware of how it might affect your response to exercise. For example, some anti-psychotic medications can cause dehydration or gait disturbances, while certain antidepressants can cause fatigue, dizziness and weight gain.
* If you have been inactive, consider joining structured, supervised program to help develop a routine that you will continue to do on a regular basis.
Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic goals and design a safe and effective program that addresses your specific needs.
For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.
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