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June 2012

How to Stay Fit While Holidaying

How to Stay Fit While Holidaying

By Kya Grace

Holidays are times when you look forward to eat, drink, party and indulge in all kinds of fun activities. With an increase in the stress levels in today’s world, you crave for this break from your daily routine to totally relax and chill. It is very natural to crave for different types of delicacies during holidays as that is the only time when your taste buds are on an overdrive. Here are some simple yet effective ways which could help you to enjoy your vacation in great health without lowering your spirits and appetite.

Fitness Schedule
While it is very easy to give in to laziness during holidays, understand that it is important to have a definite exercise schedule. Plan your workout regime with your boot camp trainer in advance. Ask him to chart out a combination of exercises that is both fun and engaging. This would not only burn out the calories but also make you look forward to hitting the gym regularly.

Easy way to keep fit
If you are going to miss your boot camp sessions during vacation there is nothing to worry. You still have great many options. Physical fitness is not just about lifting weights and doing cardio. You can tone your body and burn calories doing some simple activities like walking, swimming, cycling, jogging and playing outdoor games. Whatever you do, ensure that you do some physical activity every day. Enjoy these activities this vacation and the see the difference it makes to your body and mind.

If you have already made arrangements to go to a holiday destination, look out for activities the resort or the hotel of your destination has to offer. Be a sport and try different adventure games exclusively available there. Trekking, rock climbing, snorkeling, scuba diving are some adventurous activities which we do not indulge in on daily basis. Try them and see the amount of calories they burn and the confidence they bring into you.

Enjoy Your Food but in Moderation
Keeping an eye on what you eat does not necessarily mean that you have to cut down on your favourite food items. Moderation is the key word for you, if you feel depressed when you are restricted from eating certain types of food. If there is a tendency in you to go overboard try drinking a glass of water before you start eating either in a party or in the restaurant. Follow this with a bowl full of fresh garden salad. Salad is very nutritious and filling and it will naturally bring down your intake.

If you are still hungry take a single helping of the spread on the counter. If there is a particular food you are crazy about, ensure that you cut short all the other dishes and take a healthy amount of this delicious food. Eat sensibly to avoid stuffing yourself. However, it is perfectly alright to go overboard once in a while as long as you are aware that you can come back to your fitness schedule after that.
Water wonder

Water can do wonders for your body if you drink at least eight to ten glasses of it every day irrespective of anything. It flushes out the toxins in your body and keeps your body well hydrated. Dehydration can cause fatigue, weakness, headaches and countless other problems. Try replacing your cocktails with water as water can definitely help you to lose weight and give that lovely glow to your skin.

Rest and Relax
It is a holiday. There is no reason why you should not take your much earned rest now. Keep yourself active but at the same time do not forget to put your feet up and relax. Do not feel guilty about it. Remember that you deserve this break.

About the Author: If you would like to attend a Hurstville Boot Camp, or book for boot camps free trial, visit Sydney Boot Camp.

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Top Stories Of The Week



Vitamin D and Calcium Can Add Years To Your Life - Danish researchers have evidence that health supplements can increase life expectancy. Read the article to find out more about it.

Loneliness Is Linked To Cognitive Decline And Death - Learn how lack of social contact can lead to an early death.

Living Alone Is A Heartbreaker - Living alone can be deadly. Read the article to find out why.

Metformin Lowers Breast Cancer Risk, Study - Researchers have proven that a popular diabetic drug is effective against one of nature's deadliest cancers.


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"Top Stories Of The Week" copyright 2012 Living Fit, Healthy and Happy. All Rights Reserved.


How an Acid Diet Makes You Fat

How an Acid Diet Makes You Fat

How an Acid Diet Makes You Fat
By Yuri Elkaim

When your body notices that the blood has become to acidic and there are no longer any alkaline reserves, it quickly makes the decision to alleviate this dangerous situation. One of the first things your body does to alkalize the blood is remove acid from within the blood stream, storing it in your fat cells.

So, if you're hoping to lose weight, then this is critical to understand. You can exercise all you like and will your way to a leaner body, but if you do nothing to alkalize your body, your attempts will be in vain. Think about it - the human body is very intelligent. As you become more and more acidic your body starts to set up defense mechanisms to keep the damaging acid from entering the vital organs. It is known that acid gets stored in fat cells. After all, if the acid does come into contact with an organ it has a chance to eat holes in the tissue. Fat cells and cellulite deposits begin packing up the acid and try to keep it a safe distance from your organs. The fat may be saving your vital organs from damage.

So, if your body is acidic, then it requires more fat to be able to store all the acid. Not until you start reducing the acidity in your blood will your body begin to realize that it no longer needs as much fat. Makes sense - less acid means less fat is needed to store it! Many people have found that a return to a healthy inner biological terrain helps them to lose excess fat.

Along with refined foods, sugars, and animals products, stress is a big producer of acid. Consider the example of a woman who is obsessed with losing weight. It's all she thinks about. Do you think that might create some unneeded stress? Unfortunately, this scenario is far too common among women living in the Western world. An unattainable media and fashion portrayal of the "perfect" body has skewed the way many people see their body. The result is that more and more people (not just women) are stressing about how their body should look. This type of worry or obsession creates greater amounts of acidity within the body and essentially works against their mission of losing weight. So, their weight goes nowhere and they don't know why!

3 things you can do immediately to reduce the acidity in your body include:


  1. eating a more vegetarian diet
  2. adding more greens into your diet
  3. starting your day with a glass of lemon water


Copyright 2007 Yuri Elkaim, BPHE, CK, RHN

Yuri Elkaim is a registered holistic nutritionist, highly acclaimed personal trainer, certified kinesiologist, former professional soccer player, speaker, and owner of Total Wellness Consulting. He is also the author of the revolutionary Eating for Eating � a guide to healthy eating that has awaken the world to the power of natural living foods. It includes 120 recipes, a 12-week meal plan, and more great nutritional tools for living the best life ever! For more information on Eating for Energy please visit

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Metformin Lowers Breast Cancer Risk, Study



A popular diabetes drug has been proven to reduce breast cancer risk in women, researchers say. According to a report published in the Journal of Clinical Oncology, metformin, a drug commonly prescribed to treat type 2 diabetes, can lower breast cancer risk in post-menopausal women. Such findings suggest that metformin may have curative properties that extend beyond diabetes treatment.

Rowan T. Chlebowski from UCLA's Biomedical Research Institute led a research team which sought to investigate associations between diabetes, metformin use and breast cancer in postmenopausal women. The researchers based their assessment on data obtained from 68,019 postmenopausal participants in the Women's Health Initiative (WHI) study.

During the course of 11.8 years, 11,290 women were diagnosed with diabetes, 3273 with invasive breast cancer and 754 with ductal carcinoma in situ. Although there was no overall difference in invasive breast cancer incidence between all women with diabetes and women without the disorder, researchers saw different results when they specifically compared with diabetes to those without diabetes.

Results of that comparison revealed metformin lowered breast cancer incidence in women who took the medication compared to those who did not. Medication type had a significant impact on the outcome.

Participants who took medications other than metformin to control their diabetes didn't fare so well. In fact, breast cancer incidence was slightly higher (italics) in those women. It's also important to note, that incidence of ductal carcinoma in situ wasn't associated with metformin use.

While the precise mechanisms by which metformin inhibits breast cancer aren't understood, Chlebowski and his colleagues cited other research which proposes the drug could affect biological pathways involved in development of the disease.

Their's is not the first study to show an association between metformin and lower breast cancer risk. In 2009, Harvard Medical School researcher Heather Hirsch and her colleagues reported that metformin selectively kills cancerous stem cells in different types of breast cancer.

Stem cells have the ability to differentiate i.e. develop into a variety of different cell types; in adults, stem cells replace worn out cells, thus making them crucial to survival. Unfortunately some stem cells become defective, transforming into rapidly dividing cells that, if left unchecked, become deadly.

Using mouse models, Hirsch and her colleagues demonstrated that metformin in combination with chemotherapeutic drugs could be helpful for treatment of breast cancer. Now, Chlebowski's research team has proven that metformin can effectively lower breast cancer risk in postmenopausal women. 

The results of the WHI study add to a mounting body of evidence showing an association between metformin and reduction of breast cancer. If future research substantiates such findings it could lead to the development of new treatments for breast and other types of cancers which would potentially save millions of lives.

Based on the findings of their own research, Chlebowski and his colleagues concluded that metformin can effectively lower breast cancer incidence in postmenopausal women saying: "Our findings are of most direct relevance to women with diabetes, most of whom were overweight or obese. However the consideration of the totality of available evidence does provide support for the ongoing clinical studies of metformin, including a prospective, full-scale, multicenter adjuvant trial and proof of principal studies in prevention settings."

Let's hope so.


God is loving and gracious. He is saddened whenever we sin. Do not sin but turn toward the Lord and receive His blessings and the peace of serving Him.


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Article Sources 

Chlebowski RT, McTiernan A, Wactawski-Wende J, Manson JE, Aragaki AK, Rohan T, Ipp E, Kaklamani VG, Vitolins M, Wallace R, Gunter M, Phillips LS, Strickler H, Margolis K, & Euhus DM (2012). Diabetes, Metformin, and Breast Cancer in Postmenopausal Women. Journal of clinical oncology : official journal of the American Society of Clinical Oncology PMID: 22689798

Hirsch HA, Iliopoulos D, Tsichlis PN, & Struhl K (2009). Metformin selectively targets cancer stem cells, and acts together with chemotherapy to block tumor growth and prolong remission. Cancer research, 69 (19), 7507-11 PMID: 19752085


"Metformin Lowers Breast Cancer Risk, Study" copyright 2012 Living Fit, Healthy and Happy(SM). All Rights Reserved.


Living Alone Is A Heartbreaker



**We conclude our two part series on loneliness and health with an article wherein researchers establish a link between loneliness and heart disease.**

Loneliness is bad for the heart, new research shows. According to a report published in the Journal of the American Medical Association, scientists present evidence that loneliness increases cardiovascular disease mortality. These findings, along with a similar study on loneliness and cognitive decline, show that social interactions are crucial to human survival.

Dr. Deepak Bhatt from Harvard Medical and colleagues investigated the association between living alone with increased cardiovascular disease risk and mortality as part of the global REduction of Atherothrombosis for Continued Health (REACH) Registry 

The study, which began in late 2003 and concluded in 2008, included 44,573 adults aged 45 years or older with or at risk of arterial blood clots from 44 countries around the world; of this number, 8594 REACH participants reportedly lived alone.


Loneliness Can Be Fatal

Over the next four years, scientists followed the participants for cardiovascular events. During this time, 2612 cardiovascular disease deaths were reported. As the study progressed, it became increasingly obvious that age combined with living alone played a huge role in the number of people who died. 

For example, Bhatt and his colleagues noted that

  • participants aged 45 - 65 years were more likely to die if they lived alone rather than with other people (7.7% vs. 5.7%)
  • participants aged 66- 80 years who lived alone were at greater risk of dying than those who lived with others (13.2% vs. 12.3%)

Interestingly, just the opposite was observed in people over age 80. Among participants of that advanced age, were not at higher risk of mortality compared to those who lived with other people (24.6% versus 28.4% respectively).

It's also important to point out that participants who lived alone tended to be over the age of 80, female, black or white, living in North America or Western Europe, less educated, and retired from employment.


Why Does Loneliness Kill?

Study author Bhatt pointed out that a number of studies establish a link between loneliness and stress. Isolation contributes to changes in neurohormonal-mediated responses to stress, has a tendency to influence healthy behavior, affect access to health care, and cause or contribute to cardiovascular disease.

In a nutshell, loneliness leads to a broken heart.

When people feel unwanted or unaccountable, it may seriously affect their outlook on life. People whom live alone may be less motivated to pay attention to their health, largely because they feel that nobody cares about them. (It's important to point out that hypertension, obesity and smoking were associated with living alone.)

The research team concluded that: "living alone was independently associated with an increased risk of mortality and CV death in an international cohort of stable middle-aged outpatients with or at risk of atherothrombosis. Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of CV disease, and this observation warrants confirmation in further studies."

It really doesn't come as much of a surprise to me that younger people are so adversely affected by isolation.

People whom are 45 years old are relatively young; young people tend to be physically and socially active i.e. married, dating, belonging to social organizations. If they don't have these social contacts, they may be more susceptible to feelings of isolation.

By contrast, people over the age of 80 may be more accustomed to living alone and thus less affected by feelings of loneliness. My hypothesis is that people of such advanced years have adjusted to solitary living, and through independence have become more resilient than younger people who live alone. 

For their part, Bhatt and his colleagues assert that among older persons solitary living is "potentially associated with independence and better health rather than a maladaptive environment associated with CV risk."

Nonetheless, loneliness had lethal consequences for people across all age groups in the REACH study which, to me, underscores the need for people to have wholesome i.e. healthy social interactions.

God created us to have fellowship with Him and to develop meaningul relationships with other people. Begin by accepting that God loves for you and that you matter to Him.

It's not always easy to make friends, particularly when you're shy or have been ostracized by others, but if you start out slowly you can do it. Say hello to people on the street or at the supermarket.

If someone scowls at you, don't let it set you back; just say hello to the next person. Also, consider places where you can volunteer to help others, or join a church group, book club, etc. When you allow God to work through you to help others, you'll see that He has helped you, too. When you're doing His work and feel His presence around you, you won't have time to feel lonely.


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Article Source

Udell JA, Steg PG, Scirica BM, Smith SC, Ohman EM, Eagle KA, Goto S, Cho JI, Bhatt DL, & Reduction Of Atherothrombosis For Continued Health Reach Registry Investigators FT (2012). Living Alone and Cardiovascular Risk in Outpatients at Risk of or With AtherothrombosisLiving Alone and Cardiovascular Risk. Archives of internal medicine, 1-10 PMID: 22711020


"Living Alone Is A Heartbreaker" copyright 2012 Living Fit, Healthy and Happy(SM). All Rights Reserved.


Loneliness Is Linked To Cognitive Decline And Death



**We're kicking off a two part series on the dangerous combination of loneliness and aging. Today you'll learn about aging, cognitive decline and death. Tomorrow, we'll present an article about loneliness and cardiovascular disease.**

Loneliness can kill, new research suggests. According to a report published in the Journal of the American Medical Association, loneliness can lead to mental decline and death in people over 60 years of age. Such findings underscore the integral role that social interactions play in human health.

Researcher Carla M. Perissinotto from the Division of Geriatrics at the University of California at San Francisco and colleagues studied the relationship between loneliness, loss of cognitive ability and death in older US adults. It is through their investigation they learned some sad facts about the effects loneliness has on the elderly.

They began by selecting 1604 people with mean age 70.9 years for participation in the Health and Retirement Study. Perissinotto and her colleagues began assessing participants every two years beginning in 2002 and ending in 2008. During these assessments participants were asked if they felt left out, isolated or lacked companionship.

The primary outcomes of the 6 year study were time to death and functional decline through four specific measures including difficulty increasing difficulty in performing activities of daily living (ADL), increasing mobility problems, increasing difficulty in using their upper extremities and increasing difficulty climbing stairs. You should notice that each measure is looking at how loneliness makes life increasingly difficult to the point of death.

Well, that's precisely what happened to some of the people participating in the study. In fact, over 6 years of follow-up, loneliness was associated with 22.8% risk of death versus 14.2% for people who were not lonely. Loneliness also affected people in others ways:

  • 24.8% of lonely people experienced decline in active daily living compared to 12.5% for people whom were not lonely
  • 41.5% of lonely participants experienced difficulty performing upper extremity tasks compared to 28.3% for participants who did not report being lonely
  • 40.8% increased risk of difficulty climbing stairs compared to 27.9% for not lonely participants
  • 38.1% of lonely participants experienced mobility decline compared to 32.8% of participants whom were not lonely.


Loneliness Hurts, Loneliness Kills

You don't have to be a statistician to see what is happening. The Health and Retirement study proves that loneliness is linked to cognitive decline and death. As they gradually age, lonely people have greater difficulty getting around and performing daily tasks. Loneliness can also kill. In the Health and Retirement Study, the people who reported feeling lonely experienced isolation, exclusion and felt as if they had no friends. 

The elderly are particularly susceptible to feelings of isolation because they're often left out of activities that younger generations often take for granted. It's important to remember that people can be surrounded by others and still feel lonely. Perissinotto said that many of the people whom were reportedly lonely were either married or did not live alone. So it goes deeper than merely being in the company of others.

Humans are social creatures. We need connections and personal involvement to make our lives feel worthwhile.

Perissonotto and her colleagues say questioning elderly people about loneliness could potentially spot those at risk for poor health outcomes.

"Ultimately, by asking about psychosocial concerns important to patients, our treatment focus may shift, and we will likely enhance the physician-patient relationship. By identifying loneliness we will be better able to target interventions intended to prevent functional decline and disability." the team said at the conclusion of their report.

Essentially it comes down to taking the time to check up on other people. Everyone, regardless of age needs to know that someone cares about them. Showing compassion might just save a life.

Next time we'll look at what loneliness can do to the human heart.


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Article Source

Perissinotto CM, Stijacic Cenzer I, & Covinsky KE (2012). Loneliness in Older Persons: A Predictor of Functional Decline and DeathLoneliness in Older Persons. Archives of internal medicine, 1-7 PMID: 22710744


"Loneliness Is Linked To Cognitive Decline And Death" copyright © 2012 Living Fit, Healthy and Happy(SM). All Rights Reserved.


Vitamin D and Calcium Can Add Years To Your Life



Calcium supplements and vitamin D may extend senior citizens' life expectancy, new research suggests. According to a report published in the Journal of Clinical Endocrinology and Metabolism, the results of a large Danish study shows that Vitamin D extends life expectancy but only if combined with calcium supplements. Such findings are good news for people hoping to extend their golden years.

Lars Rejnmark from Aarhus University Hospital in Denmark and colleagues made the connection after conducting a study designed to assess mortality among patients whom took vitamin D and calcium or vitamin D alone. Therefore, researchers recruited 70,528 elderly Danish patients for participation in one of a series of research trials wherein they received either Vitamin D or Vitamin D and calcium.

Over a course of 3 years, research showed that participants who took vitamin D and calcium were able to lower their mortality risk whereas vitamin D alone had no such effect. Rejnmark's team was able to demonstrate that when taken together vitamin D and calcium are able to increase senior citizens' life expectancy. 

Calcium and vitamin D are essential nutrients that play an important role in such processes as signal transduction, muscle contractions, bone mineralization, etc. Thus, it stands to reason that maintaining healthy levels of both nutrients could increase longevity.

Seniors may be particularly aware that these nutrients help prevent osteoporosis and thus protect the aging skeletal system from bone fractures and possible mortality.

However caution is waranted. While the results of the Danish study are very remarkable, it's important to bear in mind that other research shows that calcium supplements can have adverse effects on the body.

Indeed, results from Women's Health Initiative/Vitamin D Calcium Study (WHI CaD Study) established that calcium supplements increas heart disease risk in post menopausal women.

Based on results of that study, it would appear that calcium supplements may not be as healthy as calcium from dietary sources e.g. milk, cheese, sardines, orange juice and other foods.

Therefore, in light of the drastically different outcomes of the WHI CaD Study and the Danish vitamin D and calcium trial, people may take the time to carefully consider the risks versus benefits of vitamin D and calcium supplements.

For more information about dietary calcium, please visit Dietary Supplement Fact Sheet: Calcium from the National Institutes of Health's Office of Dietary Supplements.


It is a fact that Satan has been defeated, he was defeated when Jesus died on the cross and rose on the third day. Turn away from your sins and turn to the Living God so that your sins will be forgiven lest you also be cast into the lake of fire reserved for the devil and the demons. Confess your sins to God, believe in Him and you will be saved. 

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Article Sources 

Rejnmark L, Avenell A, Masud T, Anderson F, Meyer HE, Sanders KM, Salovaara K, Cooper C, Smith HE, Jacobs ET, Torgerson D, Jackson RD, Manson JE, Brixen K, Mosekilde L, Robbins JA, Francis RM, & Abrahamsen B (2012). Vitamin D with Calcium Reduces Mortality: Patient Level Pooled Analysis of 70,528 Patients from Eight Major Vitamin D Trials. The Journal of clinical endocrinology and metabolism PMID: 22605432

Study: Calcium Supplements Can Cause Heart Attacks


"Vitamin D and Calcium Can Add Years To Your Life" copyright © 2012 Living Fit, Healthy and Happy. All Rights Reserved.


Cognitive Behavioural Therapy (CBT) and Negative Automatic Thoughts (NATs)

Cognitive Behavioural Therapy (CBT) and Negative Automatic Thoughts (NATs)

By Dr Steve Last, Edinburgh

Cognitive Behavioural Therapy, or CBT, is a an effective psychotherapy for a wide range of emotional problems. The theory underlying CBT is that our thoughts directly affect the way we feel - if we think in depressed ways then we will feel depressed. As such, a primary aim for a CBT therapist is to help a client recognise when they're thinking in unhelpful ways. This article is a brief overview of one method of doing exactly this. I'll use the example of someone suffering from social anxiety, a common problem amongst people I work with as a Psychiatrist and therapist in Edinburgh.

The first step for the client is to start "recording their thoughts" when they feel anxious - that is, writing down (in brief sentences) what's going through their head. This may sound a little strange at first, but it really is an essential part of the CBT method. Ideally the client should stop and write down what they're thinking at the moment they're thinking it, but writing it down at the end of the day is also acceptable. They should write down everything they were thinking of - this will usually produce quite a list of thoughts and statements and beliefs. In addition, the client should note both how they felt (physically and emotionally) and the situation in which these feelings occurred.

In my example, the client would record that the situation was a social gathering of work colleagues after work. His heart was racing, he felt hot and sweaty, and he was a little light-headed (physical feelings). He described his emotional feeling as "very anxious". Afterwards, when back at home, he wrote down the following thoughts that he remembered having at the time: "I don't know anyone very well", "I've got body odour", "They're all friends", "This place is too busy", "I hate these things", "I want to go home", "I'm going to faint and make a fool of myself", "I've got to get out of here"

This list of thoughts that he has recorded is a list of what a CBT therapist would call "Negative Automatic Thoughts". They're "Negative" in that they tend to hinder the person's motivation and ability to engage with activities, and contribute to emotional problems. They're "Automatic" in that they seem to occur "just like that", popping into the person's head as if from nowhere. Indeed, unless the person specifically focuses his attention on what he's thinking - as in the thought-recording exercise - they may pass unnoticed. All that the person would then be aware of is a sudden feeling of anxiety and a desire to leave the situation.

These Negative Automatic Thoughts (or NATs) cause emotional problems (in this case, social anxiety). Thinking in this way triggers the "Fight or Flight" response to perceived threat, leading to the physical symptoms of anxiety such as a racing heart and nausea. If the person didn't have these NATs (i.e. he didn't think thoughts such as "I'm going to faint") then the "Fight or Flight" response would not kick-in. No physical symptoms of anxiety would result, and he would be free to enjoy the social do.

Having identified the client's NATs, the next step is to find alternative, more helpful ways of thinking about the situation. This is best done by examining the NATs for their rationality or "truthfulness". A CBT therapist (along with the client) does this by conducting a "trial" for a particular NAT. In this example I will take the NAT "I'm going to faint and make a fool of myself" - this NAT was described by the client as the most distressing thought (in CBT parlance, this would be called the "Hot Thought").

In a trial, evidence is presented "for" and "against" the party concerned. It's the same in a trial for Negative Automatic Thoughts. So what evidence is there that the statement "I'm going to faint and make a fool of myself" is true? Very little - the client felt physically unpleasant and was anxious. And the evidence that says the thought is false? Much greater - he didn't actually faint, he's never actually fainted in all the times when he's felt anxious, and it's a well known fear of people experiencing anxiety that they will faint. And besides, there seems little evidence to suggest that even if he did faint, his colleagues would be anything other than concerned about him.

The verdict? That his NAT "I'm going to faint and make a fool of myself" is irrational and false.

Next, it's time to identify an alternative thought that does actually fit with the evidence. How about "My heart is racing and I feel uncomfortable because I'm anxious, but I won't faint and my anxiety will pass with time"? This seems a more accurate statement of the situation, and is clearly less likely to exacerbate his anxiety symptoms. Thinking in this way will reduce his anxiety and enable him to stay out longer with his colleagues, which in turn will help to reduce his anxiety.

Cognitive Behavioural Therapy (CBT) says that "we feel the way we think". An important first step in the recovery from emotional problems is to learn to identify and challenge our irrational thoughts (or "NATs"). As a Psychiatrist and therapist in Edinburgh I have found this to be an effective (and surprisingly quick) way of relieving some of the burden of difficulties such as depression and anxiety. But it is just a first step, and most clients will benefit from a more in-depth CBT approach that addresses not just their Negative Automatic Thoughts but also their Negative Core Beliefs. Please see my other articles on this subject.

Dr Steve Last is a Psychiatrist and therapist based in Edinburgh. He uses CBT techniques to treat common problems such as depression, anxiety, and OCD. Please visit for further information about emotional problems and CBT.

About the Author: Dr Steve Last is a Psychiatrist and therapist based in Edinburgh. He uses CBT techniques to treat common problems such as depression, anxiety, and OCD. Please visit for further information about emotional problems and CBT.

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How Experts Erase Heel Pain

How Experts Erase Heel Pain

By Nathan Wei

The diagnosis of heel pain is best done by looking at the location of the pain… “where does it hurt?”

Heel pain can occur in two major locations: the back of the heel and the bottom of the heel.

Pain at the back of the heel has three major causes.

Achilles tendonitis is the most common. It is usually the result of injury or overuse. An example is the weekend warrior who decides to go out and run 4 or 5 miles going up hills… or a person who goes on a long walk in flat shoes, shoes with little or no heel. In both cases, stress is placed on the Achilles tendon- the large thick cord located in the back of the heel.

This tendon- the largest in the body- connects the gastrocnemius (calf) muscle to the back of the heel.

The likelihood of Achilles tendonitis developing is increased if a person has flat feet. Older patients taking corticosteroid medications and people treated wtih quinolone antibiotics like ciprofloxacin (Cipro) also are at increased risk of Achilles tendonitis and even Achilles tendon rupture.

Haglunds syndrome presents with a bony bump located at the back of the heel. A bursa (small sack of fluid) located near the bump may contribute to the swelling. The Achilles tendon insertion near the bony swelling may become inflamed. Because of the location, this syndrome is often referred to as “pump bumps” and the cause often attributed to womens’ shoes.

Inflammation of the Achilles tendon at its insertion into the heel can be seen with certain types of arthritis, specifically the spondyloarthropathy group which consists of Reiter’s disease, psoriatic arthritis, and ankylosing spondylitis. Other signs of disease such as low back pain and stiffness, rash, and joint swelling may provide clues to diagnosis.

Pain in the bottom of the heel is usually due to plantar fasciitis.

Pain in the plantar fascia presents with sharp stabbing pain in the bottom of the heel. Plantar fasciitis is a common problem that is due to repetitive trauma to the soft tissue in the heel.

Typically a patient will feel fine so long as they are lying down or sitting. But if they get up to walk, the pain feels like an ice pick is being jammed into the bottom of the heel.

This pain gets better over several minutes but occurs again after inactivity followed by weight-bearing.

Causes of plantar fasciitis include:

• An abrupt increase in activity
• Worn footwear,
• Footwear with no arch support (eg., flip-flops)
• Obesity
• Recent rapid weight gain such as with pregnancy
• Overuse as in excessive running and over-training
• Systemic inflammatory arthritis (particularly ankylosing spondylitis and other spondyloarthropathies such as Reiter’s disease and psoriatic arthritis).

Treatment involves first establishing the diagnosis. Most of the time, the diagnosis can be suspected by the history and physical examination.

Imaging tests such as diagnostic ultrasound and magnetic resonance imaging can confirm the diagnosis, if necessary. X-rays may reveal the presence of a heel spur. A heel spur, by itself, is not the cause of pain in the bottom of the heel and heel pain should not be attributed to “a heel spur”.

Once the diagnosis has been made, treatment options include:

• Identifying likely causative factors such as excessive weight, inappropriate footwear, and errors in training.

• Non-steroidal anti-inflammatory drugs (NSAIDs) sometimes provide symptomatic relief.

• Therapeutic taping gives short-term symptom relief.

• Exercises to stretch the heel cord and plantar fascia.

• Orthotic devices can help in the short-term reduction of pain. These can be off-the-shelf or custom made. For people with Achilles tendonitis, having the patient wear a lift in the shoe to elevate the heel will help reduce symptoms.

• Glucocorticoid (steroid) injection may also work for plantar fasciitis and should be used if the patient has not responded to conservative measures. The use of diagnostic ultrasound to guide the injection is recommended.

Caution should be observed with the Achilles tendon as far as steroid injection. The tendon can be weakened if steroids are directly injected. This then can lead to Achilles rupture.

The bursitis that occasionally accompanies Achilles tendonitis (retrocalcaneal bursitis) will respond to steroid injection.

If a patient is taking a quinolone antibiotic (such as ciprofloxacin), it should be discontinued and the patient should be monitored for tendonitis and tendon rupture.

Night time braces are sometimes used for plantar fasciitis.

Often the best treatment for heel pain, whether it is located in the back or on the bottom, is rest.

A surgical solution should be considered for those patients with intractable pain which remains despite conservative treatment.

About the Author: Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: Arthritis Treatment

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This Week's Top Stories



Pneumonia More Likely To Kill People With High Blood Sugar - Find out why a common respiratory condition can be deadly to people with hyperglycemia.

Fatty Acid Supplements Don't Benefit Type 2 Diabetics with Heart Disease - A controversial study finds that fish oil has little effect on heart health. Read the article to learn more.

Statins Increase Fatigue, Study - A class of cholesterol regulating drugs has a surprising side-effect on people when they exercise. Read the article to find out more about it.

Liposuction Triggers Fat Build Up Around The Organs, Study - People who undergo liposuction may be trading one type of fat for another. Read the article to find out why.

Walking Tips For Arthritis Sufferers - Our partners at Every Body Walk! have some helpful exercise tips for arthritis sufferers. Read the article to find out more.


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