Bariatric Athlete Fuel Guide Without Carb Loading

We often hear that in order to fuel workouts and races an athlete needs to carb load. And for good reason, carbohydrates are the body’s main fuel source. However, this practice could be a threefold problem for bariathletes. For one, the word ‘load’ alone is not recommended for a small pouch. And when looking at the post-op macronutrient breakdown, protein is in the lead. Lastly, for those who have had the gastric bypass often can not tolerate carbohydrates because they induce dumping syndrome. So what is a bariathlete to do?

Although the body does prefer carbohydrates, loading per se may not be needed. More and more athletes are beginning follow a more balanced diet and continue to perform competitively. We recommend eating well throughout the day with a balance of carbohydrates, protein and fat at each meal.

First, take a look at the micronutrient density of your foods. Are you eating nutrient rich foods or are they many processed and stripped of its vitamins and minerals? Athletes often look past this because they tend to focus on calories and carbohydrates. Bariathletes also tend to forget about this but more due to thinking all their needs are covered in their vitamin and mineral supplements. The supplements cover your bariatric needs, but your nutrient needs increase when you start exercising. And no, we don’t recommend taking more supplements to cover this, we recommend whole foods because your body is able to absorb and utilize these nutrients so much more efficiently from its natural sources.

Because a bariathlete can only eat so much at a given time it is important that meals and snacks do not have more than 4 hours between them. Eating frequently assures your fuel takes are full and can eliminate the need to ‘load’. The key a again is a mix of carbohydrates and protein to meet both your bariatric and athletic needs.

So remember, you are now an athlete and food is the fuel that allows you to live the new and exciting lifestyle you choose. Opt for more mixed meals while still maintaining adequate protein intake. Select more whole, fresh, nutrient rich foods to provide you with the vitamin and minerals you body needs to perform optimally. Good luck and have fun!

*For more specific details for your individual needs, contact us today for a personalized meal plan. LeaCrosetti@BariAthletes.com

Modern Methods For Biochemistry Analysis

A biochemisty analyser is a device designed to perform a variety of biochemical tests. Invented by Hans Baruch, they were introduced to the medical community, commercially, in 1959, and allowed medical laboratories and hospitals to process more samples more quickly and effectively than before. With this automated testing process, the testing time went from days – sometimes weeks – to mere minutes.

Before then, the most common form of biochemical analysis involved open test tubes placed in racks which were then either moved along a track or spun in a carousel. To protect the samples from contamination, and the laboratory staff from illness or injury, closed tube sampling soon followed. The automated biochemistry analysers did not remove the need for clinical lab technicians, however, but it did make working in the labs safer, and helped reduce errors.

There are a variety of tests a biochemistry analyser performs. They can range from testing enzymes for liver function tests, to testing ions for sodium and potassium levels. Blood glucose, creatine, and serum albumin – a plasma protein – among others, can also be analysed.

There are three categories of biochemistry analysers: The wet type, the dry type and the bio sensor. The wet type method involves mixing a test sample with a reagent to encourage a chemical reaction. A reading device, such as a spectrophotometer or a calorimeter can then be used to read the color change before and after the reaction, allowing for analysis. However, this form of testing requires expensive instruments and the ability to keep the reagents valid for long periods of time.

The dry type biochemistry analyser requires the application of a chemical reagent to a test strip, such an antibody or enzyme, which will react directly with the test sample. With the dry type of testing there is a greater risk of oxidation of the test strip which can allow for faulty readings.

When using a biosensor type biochemistry analyser, the test sample may be oxidized and placed on a thin film which is placed onto the surface of an electrode, such as pillar hydrogen peroxide, which is among the most common, and then a polarized potential is applied to the anode and cathode, which releases elctrodes, which may be measured. However, the pillar electrodes require constant maintenance which can lead to cross pollution which can lead to mistaken readings.

Some tests require more specialized tests and require a separate biochemistry analyser. This analyser may be used for several tets, or a single test. Some of these are performed frequently, but others are not, and the majority are expensive to perform, as well as time consuming. Due to the shortage of skilled clinical laboratory professionals, manufacturers are working to develop automated systems for these rare tests.

With the recent contributions in biology, chemistry and genetics, the biochemistry analyser has been evolving and improving. Biochemical research is being pushed, and is now moving from the study of a few molecules to the functional study of all biomolecules. Today, biochemical analysers are being used to help tag proteins and nucleic acids with special dies thhat allow scientists to make great headway in their quest to sequence the human genome.

Things You Should Do When Getting Pharmaceutical Supplies

The health industry is one of the most sensitive. It is supposed to extend solutions to improve health and the slightest overlook could be the thin line between life and death. Pharmaceutical supplies are important and they should be handled with the seriousness they deserve. If you are a supplier you will only manage to create a good reputation in the market only with quality products that are approved by the right bodies.

This is something that you should be able to do by taking the right measures when getting your supplies, especially when dealing with manufacturers offering the supplies online. There is more emphasis on checking out the credibility of the manufacturer or supplier before trusting them with your orders and any other medical supply needs you may have.

Find out whether the manufacturer adheres to good manufacturing practice

There are set standards when it comes to manufacturing pharmaceutical products and your manufacturer should be compliant in every sense. The GMP requirements should not only be met in the manufacturing plant, but also with the products that the company produces. With such requirements being met, you at least have assurance that you can trust in the quality of your products.

Find out whether the manufacturer works with a product line you are interested in

Health products are numerous and come in different categories. Whether you are looking for specific drugs, supplements or steroids and hormonal products, you want to be sure that your manufacturer does produce them and can meet with your requirements. Some manufacturers may specialize in one category, whereas others may deal with more than one product. Choose a manufacturer you can trust with your current supply needs as well as any future needs that you may have.

Ensure the products are cleared and approved by the relevant health bodies

FDA seems to be the most recognized body and only high quality products that meet global standards are approved and cleared. It is actually very important even for consumers to ensure that they buy only health products that have been approved by this body or any other relevant body depending on where they are located. You do not want to put the health of others at risk by getting products whose quality is unknown.

Make queries about the product you are about to buy

Finding out as much as you can about a product is important, especially if it is a product you are not very familiar with. From the information given by the supplier or manufacturer, you will be able to make an informed decision that you won’t regret. You should also not forget to check dates, especially the expiry date so you know the shelf-life of the products you are buying. If you are a patient trying to buy your products directly from manufacturers it is best that you get some insight from your doctor. Doctors are among the first to know about new health care products and may prove beneficial guiding you to the right ones.

Healthy Eating – Four Reasons to Take Probiotics

If you are someone who is interested in maximizing your health, one thing you might be considering is your intake of probiotics. These healthy bacteria live in the stomach and help keep your immune system strong, promote optimal digestion, and keep your entire body working in proper order.

While everyone needs to be consuming a healthy dose of probiotics on a regular basis, there are particular times when you need to increase your dose.

Let’s take a closer look at the main times when serving yourself a little extra dose of probiotics is a wise move…

1. When You Are Ill. Because probiotics play a vital role in keeping your immune system in top shape, it is important you focus on consuming these probiotics when you are struggling with your health.

If you are currently ill, an extra dose can give you the power your body needs to fend off whatever it is fighting: helping you get back to optimal health. When you have a common cold or the flu, as well as when you are struggling with a health issue, an additional dose could be helpful.

2. After You Have Completed The Prescribed Antibiotics. While you are sick and need antibiotics, they can be useful. What they won’t be good for is your gut health. Antibiotics will kill any harmful bacteria currently residing in your system. However, they will also take out all the “good” bacteria.

Serving yourself an extra dose of probiotics during this time can help bring your gut environment back to optimal, ensuring your immune system stays strong.

3. Before And During Travel. The next time it is a smart move to add a few extra probiotics to your daily menu is before and during travel. Before travel, the goal is to make your immune system as healthy as possible, which will help fend off any viruses present in the area you are going.

During the traveling period, taking the probiotics will help keep your system as healthy as possible, and help you avoid any digestive woes that may occur due to eating foods, not your typical dining choices. If you are all about trying local cuisine when you travel, your taste buds may enjoy this, but your stomach may feel otherwise. Using a probiotic may help prevent unwanted issues from occurring.

4. Throughout Pregnancy. Finally, the last time to make sure a probiotic is present in your life is throughout pregnancy. Keeping your body extra healthy at this point is important, and a good quality probiotic may help to reduce your risk of suffering from birth-related complications such as Gestational diabetes.

As you can see, a probiotic is not something you want to slough off and take lightly. It is a must-have in any diet plan aiming to keep you as healthy as possible.

Pathological Eating Disorders and Poly-Behavioral Addiction

When considering that pathological eating disorders and their related diseases now afflict more people globally than malnutrition, some experts in the medical field are presently purporting that the world’s number one health problem is no longer heart disease or cancer, but obesity. According to the World Health Organization (June, 2005), “obesity has reached epidemic proportions globally, with more than 1 billion adults overweight – at least 300 million of them clinically obese – and is a major contributor to the global burden of chronic disease and disability. Often coexisting in developing countries with under-nutrition, obesity is a complex condition, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups.” The U.S. Centers for Disease Control and Prevention (June, 2005), reports that “during the past 20 years, obesity among adults has risen significantly in the United States. The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older – over 60 million people – are obese. This increase is not limited to adults. The percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight.”

Morbid obesity is a condition that is described as being 100lbs. or more above ideal weight, or having a Body Mass Index (BMI) equal to or greater than 30. Being obese alone puts one at a much greater risk of suffering from a combination of several other metabolic factors such as having high blood pressure, being insulin resistant, and/ or having abnormal cholesterol levels that are all related to a poor diet and a lack of exercise. The sum is greater than the parts. Each metabolic problem is a risk for other diseases separately, but together they multiply the chances of life-threatening illness such as heart disease, cancer, diabetes, and stroke, etc. Up to 30.5% of our Nations’ adults suffer from morbid obesity, and two thirds or 66% of adults are overweight measured by having a Body Mass Index (BMI) greater than 25. Considering that the U.S. population is now over 290,000,000, some estimate that up to 73,000,000 Americans could benefit from some type of education awareness and/ or treatment for a pathological eating disorder or food addiction. Typically, eating patterns are considered pathological problems when issues concerning weight and/ or eating habits, (e.g., overeating, under eating, binging, purging, and/ or obsessing over diets and calories, etc.) become the focus of a persons’ life, causing them to feel shame, guilt, and embarrassment with related symptoms of depression and anxiety that cause significant maladaptive social and/ or occupational impairment in functioning.

We must consider that some people develop dependencies on certain life-functioning activities such as eating that can be just as life threatening as drug addiction and just as socially and psychologically damaging as alcoholism. Some do suffer from hormonal or metabolic disorders, but most obese individuals simply consume more calories than they burn due to an out of control overeating Food Addiction. Hyper-obesity resulting from gross, habitual overeating is considered to be more like the problems found in those ingrained personality disorders that involve loss of control over appetite of some kind (Orford, 1985). Binge-eating Disorder episodes are characterized in part by a feeling that one cannot stop or control how much or what one is eating (DSM-IV-TR, 2000). Lienard and Vamecq (2004) have proposed an “auto-addictive” hypothesis for pathological eating disorders. They report that, “eating disorders are associated with abnormal levels of endorphins and share clinical similarities with psychoactive drug abuse. The key role of endorphins has recently been demonstrated in animals with regard to certain aspects of normal, pathological and experimental eating habits (food restriction combined with stress, loco-motor hyperactivity).” They report that the “pathological management of eating disorders may lead to two extreme situations: the absence of ingestion (anorexia) and excessive ingestion (bulimia).”

Co-morbidity & Mortality

Addictions and other mental disorders as a rule do not develop in isolation. The National Co-morbidity Survey (NCS) that sampled the entire U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. population, or some 43 million people (Kessler, 1994).

McGinnis and Foege, (1994) report that, “the most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). Acknowledging that the leading cause of preventable morbidity and mortality was risky behavior lifestyles, the U.S. Prevention Services Task Force set out to research behavioral counseling interventions in health care settings (Williams & Wilkins, 1996).

Poor Prognosis

We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions?

Diagnostic Delineation

Thus far, the DSM-IV-TR has not delineated a diagnosis for the complexity of multiple behavioral and substance addictions. It has reserved the Poly-substance Dependence diagnosis for a person who is repeatedly using at least three groups of substances during the same 12-month period, but the criteria for this diagnosis do not involve any behavioral addiction symptoms. In the Psychological Factors Affecting Medical Condition’s section (DSM-IV-TR, 2000); maladaptive health behaviors (e.g., overeating, unsafe sexual practices, excessive alcohol and drug use, etc.) may be listed on Axis I only if they are significantly affecting the course of treatment of a medical or mental condition.

Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field, when the latest DSM-IV-TR does not even include a diagnosis for multiple addictive behavioral disorders. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictive and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals’ life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable.

New Proposed Diagnosis

To assist in resolving the limited DSM-IV-TRs’ diagnostic capability, a multidimensional diagnosis of “Poly-behavioral Addiction,” is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging – psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences.

Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 – month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances – nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously.

New Proposed Theory

The Addictions Recovery Measurement System’s (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions.

The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.

The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory.

The ARMS continues to promote Twelve Step Recovery Groups such as Food Addicts and Alcoholics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. The beneficial effects of AA may be attributable in part to the replacement of the participant’s social network of drinking friends with a fellowship of AA members who can provide motivation and support for maintaining abstinence (Humphreys, K.; Mankowski, E.S, 1999) and (Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M., 1997). In addition, AA’s approach often results in the development of coping skills, many of which are similar to those taught in more structured psychosocial treatment settings, thereby leading to reductions in alcohol consumption (NIAAA, June 2005).

Treatment Progress Dimensions

The American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition”, has set the standard in the field of addiction treatment for recognizing the totality of the individual in his or her life situation. This includes the internal interconnection of multiple dimensions from biomedical to spiritual, as well as external relationships of the individual to the family and larger social groups. Life-style addictions may affect many domains of an individual’s functioning and frequently require multi-modal treatment. Real progress however, requires appropriate interventions and motivating strategies for every dimension of an individual’s life.

The Addictions Recovery Measurement System (ARMS) has identified the following seven treatment progress areas (dimensions) in an effort to: (1) assist clinicians with identifying additional motivational techniques that can increase an individual’s awareness to make progress: (2) measure within treatment progress, and (3) measure after treatment outcome effectiveness:

PD- 1. Abstinence/ Relapse: Progress Dimension

PD- 2. Bio-medical/ Physical: Progress Dimension

PD- 3. Mental/ Emotional: Progress Dimension

PD- 4. Social/ Cultural: Progress Dimension

PD- 5. Educational/ Occupational: Progress Dimension

PD- 6. Attitude/ Behavioral: Progress Dimension

PD- 7. Spirituality/ Religious: Progress Dimension

Considering that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the ARMS philosophy promotes that positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power,” that spiritually elevates and connects an individuals’ multiple life functioning dimensions by reducing chaos and increasing resilience to bring an individual harmony, wellness, and productivity.

Addictions Recovery Measurement – Subsystems

Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed – how should we effectively manage poly-behavioral addiction?

The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The “ARMS”- systematically, methodically, interactively, & spiritually combines the following five versatile subsystems that may be utilized individually or incorporated together:

1) The Prognostication System – composed of twelve screening instruments developed to evaluate an individual’s total life-functioning dimensions for a comprehensive bio-psychosocial assessment for an objective 5-Axis diagnosis with a point-based Global Assessment of Functioning score;

2) The Target Intervention System – that includes the Target Intervention Measure (TIM) and Target Progress Reports (A) & (B), for individualized goal-specific treatment planning;

3) The Progress Point System – a standardized performance-based motivational recovery point system utilized to produce in-treatment progress reports on six life-functioning individual dimensions;

4) The Multidimensional Tracking System – with its Tracking Team Surveys (A) & (B), along with the ARMS Discharge criteria guidelines utilizes a multidisciplinary tracking team to assist with discharge planning; and

5) The Treatment Outcome Measurement System – that utilizes the following two measurement instruments: (a) The Treatment Outcome Measure (TOM); and (b) the Global Assessment of Progress (GAP), to assist with aftercare treatment planning.

National Movement

With the end of the Cold War, the threat of a world nuclear war has diminished considerably. It may be hard to imagine that in the end, comedians may be exploiting the humor in the fact that it wasn’t nuclear warheads, but “French fries” that annihilated the human race. On a more serious note, lifestyle diseases and addictions are the leading cause of preventable morbidity and mortality, yet brief preventive behavioral assessments and counseling interventions are under-utilized in health care settings (Whitlock, 2002).

The U.S. Preventive Services Task Force concluded that effective behavioral counseling interventions that address personal health practices hold greater promise for improving overall health than many secondary preventive measures, such as routine screening for early disease (USPSTF, 1996). Common health-promoting behaviors include healthy diet, regular physical exercise, smoking cessation, appropriate alcohol/ medication use, and responsible sexual practices to include use of condoms and contraceptives.

350 national organizations and 250 State public health, mental health, substance abuse, and environmental agencies support the U.S. Department of Health and Human Services, “Healthy People 2010” program. This national initiative recommends that primary care clinicians utilize clinical preventive assessments and brief behavioral counseling for early detection, prevention, and treatment of lifestyle disease and addiction indicators for all patients’ upon every healthcare visit.

Partnerships and coordination among service providers, government departments, and community organizations in providing treatment programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. I encourage you to support the mental health and addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on pathological eating disorders within poly-behavioral addiction.

For more info see:

Poly-Behavioral Addiction and the Addictions Recovery Measurement System,

By James Slobodzien, Psy.D., CSAC at:

[http://www.geocities.com/drslbdzn/Behavioral-Addictions.html]

Food Addicts Anonymous: http://www.foodaddictsanonymous.org/

Alcoholics Anonymous: http://www.alcoholics-anonymous.org/

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,

Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731.

American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the

Treatment of Substance-Related Disorders, 3rd Edition,. Retrieved, June 18, 2005, from:

http://www.asam.org/

Bandura, A. (1977), Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review,

84, 191-215.

Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765-782.

Centers for Disease Control and Prevention (CDC). Retrieved June 18, 2005, from: http://www.cdc.gov/nccdphp/dnpa/obesity/

Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web

Healthy People 2010. Retrieved June 20, 2005, from: http://www.healthypeople.gov/

Publications. Retrieved June 20, 2005, from: http://www.tgorski.com

Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40.

Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A.

Marlatt & J. R. Gordon (Eds.), Relapse prevention (pp. 250-280). New York: Guilford Press.

McGinnis JM, Foege WH (1994). Actual causes of death in the United States. US Department of Health and Human Services, Washington, DC 20201

Humphreys, K.; Mankowski, E.S.; Moos, R.H.; and Finney, J.W (1999). Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse? Ann Behav Med 21(1):54-60.

Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H. H,-U, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United

States: Results from the national co morbidity survey. Arch. Gen. Psychiat., 51, 8-19.

Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M (1997). Affiliation with Alcoholics Anonymous after treatment: A study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 65(5):768-777.

Orford, J. (1985). Excessive appetites: A psychological view of addiction. New York: Wiley.

Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the boundaries of therapy. Malabar, FL: Krieger.

Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5.

Whitlock, E.P. (1996). Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-based Approach. Am J Prev Med 2002;22(4): 267-84.Williams & Wilkins. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandria, VA.

U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.

World Health Organization, (WHO). Retrieved June 18, 2005, from: http://www.who.int/topics/obesity/en/

Fitness And Nutrition For Health

In the age which we live there is an unprecedented focus on getting and staying healthy. As more and more research points to the effect of fitness and nutrition on our overall health, the findings become more difficult to ignore. There is no doubt that the food that we eat and the physical activity that we perform significantly impact our weight and our body’s overall health and longevity.

When you look at fitness and nutrition and the consequences of ignoring their importance, it is not difficult to see how large a role they play in our health. First and foremost, it is important to understand how powerfully diet can affect us. Natural, whole foods – such as fresh vegetables, fruits, whole grains, and lean proteins – give our bodies the vitamins that it needs to function effectively. We have energy when we eat right. And when we have energy we burn fat. Eating properly allows us to maintain a healthy weight and keep undue stress off of our hearts; it also allows us to keep our blood pressure and cholesterol levels in the healthy range. Most importantly, good nutrition keeps our bodies stocked with antioxidants that fight off a range of illnesses including cancer.

But nutrition does go it alone; fitness and nutrition go hand in hand for achieving good health. When we keep our bodies active through a consistent exercise program, we are adding to our body’s ability to metabolize food and keep weight down. Further, good fitness means strong and limber muscles and a strong cardiovascular system. Exercise also lowers blood pressure and reduces stress levels.

Learning how to pair fitness and nutrition for optimum health means a commitment to a particular lifestyle. It is essential that you revamp your diet to eliminate fatty, high-sodium, and processed food and replace it with fresh, natural – and even organic – choices. But remember, fitness and nutrition work best as a team. Implement a consistent regime of physical activity into your daily schedule including cardiovascular work, stretching, weight training, and even yoga or Pilates.

When you truly understand the importance of fitness and nutrition in your life, you will understand how crucial these lifestyle changes are in order to live a long and healthy life.

Red Manhood Protection From Cold Weather

Now that cold weather is blowing through, winter is definitely here. While even warm weather aficionados can find some things about the cold they like (hot chocolate, roaring fires, an excuse to stay inside and binge watch), it’s equally true that even cold weather fans can find drawbacks. And for men, that includes getting a red manhood from freezing temperatures and bitter icy winds. Finding ways to keep the member sufficiently warm during these winter months is part of good male organ care.

Red manhood

Now, there’s usually nothing wrong with a red manhood. Men who are fair-skinned tend to get a red manhood when it becomes firm, as the blood rushing into the engorged member causes a change in coloration. But sometimes a red manhood can signal a problem, such as being far too cold.

Anyone who has ever jumped into a pool of cold water has witnessed a cold red manhood � and one that is usually shriveled. But when the male organ is exposed to extreme cold temperatures for a prolonged time, it may actually get a little swollen and can experience extreme pain.

In some severe cases, a red manhood may be an indication of frostbite (or frostnip, an early stage condition of frostbite). Frostbite is accompanied by a numbness (lack of feeling or deadened feeling), swelling, blistering and fever, although not all men may experience all of these symptoms. If a man suspects he has a frostbitten member or other body part, he should seek medical attention. Severe frostbite can destroy tissue and in extreme cases may lead to amputation.

Keeping warm

To help fight that winter cold, there are several ways to keep the manhood warm during the winter.

�Don’t go commando. First and foremost, men who habitually walk around without underwear should suspend that habit when venturing out into winter weather. The cold weather can be too dangerous to male organ health, no matter how nice the feeling of freedom may be.

�Stand in front of a fire. Spending a few minutes in front of a fireplace can help warm up a member so it withstands the cold better during its first minutes outside.

�Give the member a rub. Similarly, taking a couple of minutes to rub and massage the manhood before tackling the cold can be beneficial. This will get the blood circulating and help deflect the initial cold.

�Tuck it in. If he is only going to be outside for a few minutes, a guy can try tucking his manhood between his legs for extra warmth. However, since it will pop out relatively quickly, this is a very short term solution.

�Layer up. Doubling up on underwear is strongly advised. Just as a guy may wear a shirt, sweater and coat to combat the cold, so should he consider wearing more than one pair of underwear. The bottom layer should be tight briefs, an athletic supporter or compression shorts, each of which will fit the male organ more snugly.

�Go thermal. It can also help to wear thermal underwear, which may add an extra layer of warmth to the region.

�Investigate wind briefs. Many runners wear wind briefs, specially designed underwear with an extra layer of protection in the midsection.

�Wear a member warmer. A man can invest in an actual knitted member warmer � or simply wear a (clean) sock over the organ when temperatures get frosty.

Taking steps to prevent a red manhood due to cold weather pays off. So does taking steps to ensure overall male organ health, such as regularly applying a top drawer male organ health crme (health professionals recommend Man1 Man Oil, which is clinically proven mild and safe for skin). For best results, a guy should select a crme that is going to �cover all the bases� by including the major vitamins necessary for member health promotion � A, B5, C, D and E. In addition, the crme should include L-arginine, an amino acid which helps manhood blood vessels expand so they can accommodate a greater flow of blood.

Skin Care Treatments For Rejuvenating Aging Skin – DIY Gets Results

What are the best OTC skin care treatments that effectively rejuvenate aging skin?We all wonder if there really is a “face lift in a jar” and, if so, what is it and where can I get some- right now! Of course, we all would love such a simple remedy that can miraculously provide us with the fountain of youth right in our own little pot of face cream. But, unfortunately, the truth of the matter is a bit more complicated than a face lift miracle in a jar.There are a variety of signs of aging that we see occur as the years march along that can include- (just to name just a few)- sun damage, dry, scaly skin, dark age spots, fine lines, wrinkles, mottled skin tone, enlarged pores, sagging facial skin, ruddy skin texture, loss of skin elasticity and a decrease in the skin’s healing abilities.Obviously, even if you have just a few of these aging skin symptoms, don’t you think it is rather unlikely that just one simple, little face cream- the miracle in a jar- is going to effectively address such a range of issues? A magic wand, maybe, but who has one of those?Don’t despair! Effective skin rejuvenation is possible with accurate information and a well thought out strategy.

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The first and foremost in creating an effective skin rejuvenation regimen is to use clinically proven anti-aging skin care treatments. Although the market is saturated with products that claim to banish wrinkles forever, firm sagging skin and make those age spots just up and disappear right before your very eyes; there are in actuality, only a handful of anti-aging treatments that have been independently clinically proven to be effective.Start your skin rejuvenation regimen with clinically proven skin care treatments. For example, some of the more popular favorites are Vitamin A-(better known as retinol), glycolic acid- (an alpha hydroxy acid, AHA), Vitamin C Ester, and Vitamin K. The trick is to make sure that the active ingredient(s) in products you select have incorporated an appropriate percentage of the anti-aging treatment.If you review the ingredient list and the product only has a 1% concentration of glycolic acid, then why bother? An effective concentration of glycolic acid should be at least 8%. (Although, any product with a concentration of glycolic acid over 15% should only be administered by a professional, you don’t want to harm your skin!)Vitamin A, retinol products should have at least a .15% concentration. The strongest over the counter retinol product that you can buy without a prescription is 1%. The higher concentrations of both glycolic acid and retinol can be rather strong so start very, very slowly so your skin has a chance to get use to them.Just these two skin care treatments can accomplish a great deal in rejuvenating aging skin including exfoliating dead skin cells, stimulating skin cell repair, encouraging new skin cell growth, improving fine lines and wrinkles, stimulating collagen production, improving skin tone and texture, decreasing enlarged pores and can actually significantly improve acne or outbreaks of blemishes.You’ll see great results with just two anti-aging treatments! Not bad for beginning a new skin rejuvenation regimen.Layering different anti-aging treatments is also an important strategy to use if you want to achieve significant results.

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Adding a powerful antioxidant such as a stable form of Vitamin C Ester will help protect the skin from further damage and improve the skin’s healing ability.A “Super” Vitamin K product is well known for improving those dark circles under the eyes and is helpful is reducing the redness from broken capillaries that can give the skin a red, ruddy appearance.Although DMAE hasn’t been clinically proven to firm sagging skim, preliminary studies have been quite promising. Hydroquinone in concentrations of 1% to 2% can be used to bleach those stubborn age spots that can blossom with wild abandon as we age.There are simply hundreds of combinations for skin care treatments that can be tailored to address your own aging skin care needs so don’t be afraid to experiment a little bit to find the best combination that works for you! Facial rejuvenation treatments will produce great results.You just need to make sure you choose products with proven anti-aging ingredients in a concentration that will be effective for your skin care treatments.

Invoice Factoring As A Short-Term Cash Flow Solution

Invoice factoring refers to the practice where smaller companies sell invoices in order to receive money today. IN this case they do not have to wait for a credit period of 30, 60, or 90 days. Thus by selling invoices smaller companies do not create debt. This practice of invoice factoring is basically used as a finance management tool.

This practice of invoice factoring is usually adopted to avoid any loans or giving any collateral against availing any loan. The fee for invoice factoring is paid in terms of discount. This discount can ranger anywhere between 2.5% to 7%. As a result of invoice factoring the smaller companies avoid exhibiting any loans on their balance sheets plus they also do not have to pay any interest for the money taken. This results in better profit figures.

Various agencies also help small companies in invoice factoring. These agencies set up the company with the right factor for a particular factoring situation. If someone has an invoice or any receivable to be factored then these agencies come out to help in the same.

These agencies help the manufacturers, distributors, importers, exporters, wholesalers, contractors, suppliers etc equivocally. They also help truckers in construction invoice factoring. These agencies help to locate best factor for a particular situation within the area or can also help to choose from nationwide factoring companies to avail the best rates. They usually customized solution as per the clients need. To avail the services of such companies firstly a form needs to be filled out stating the type of receivables and other details required for invoice factoring. Then these companies approach the probable paying parties that avail invoice factoring. Some of these agencies assume the risk in the deal for non-recourse factoring where the client is not required to pay back.

There are different types of companies with different types of rates for factoring. Any invoices or receivables to the amount of $100,000 can be factored immediately. The average rate payable for discount in such cases is 2-5%.

Some agencies specialize for a certain category of invoice factoring. For example, some agencies indulge only in invoice factoring for medical industry. Some agencies, which cater to small and medium businesses for invoice factoring, create invoices online and receive immediate funding. They usually give a 24 hours turnaround. Other types of agencies also give funds to small businesses for their day to day operations against collateral of their invoice or purchase order. These kinds of agencies also buy mortgage notes, structured settlement annuity or medical receivables.

Back Pain Management and Relief

Well now, I’ve done a lot of research on back pain management and I’m as confused as you are. As if it’s not enough that one has to endure back pain, one must also, all the experts agree, manage it. Odd. They never talk about managing toothache.

So, why back pain management? Although it’s never said in so many words, I suspect that back pain is one of those rather nasty disorders that, while not socially unacceptably nasty, doesn’t ever really go away. We’re not talking here about your wife’s pregnancy back pains or back pain caused by a tumour; we’re talking your average Joe’s back pain that just … won’t go away.

The bad news is that this sort of general back pain is usually caused by bad posture and incorrect back health. The good news is that essentially general back pain is a consequence of bad back pain management and can be managed by good back pain management. Make sense?

When back pain treatment doesn’t work, it’s time to start managing the pain. Back pain management, like back pain, varies for different individuals. For some, back pain management means learning to put up with it and maybe taking a pain killer when it becomes really unbearable. But that’s not good back pain management.

Good back pain management starts with changing your lifestyle and your attitude towards your body, particularly your back and spine.

–Your spine supports you; without it, you’d be a a floppy toy. Your spine is supported by the muscles of your back. When they’re weak and / or inflexible, your spine strains to perform even the most simple movements, including bending and carrying. So, the first step in managing back pain is to develope a gentle exercise program to keep your muscles fit, supple and healthy.

–There are many types of exercise that are good for your back muscles, including yoga, walking and swimming. Water aerobics, for instance, is fun, inexpensive and recommended by most doctors and experts in the field of back pain management.

–Adopt a healthy lifestyle. This includes eating correctly, exercising and substituting cigarettes and punishing exercise routines with homeopathic herbal and vitamin supplements.

–Learn about good posture, particularly if you have a job that has you always sitting at a desk or if you are on your feet all day. Always bend the knees when bending or lifting; always hollow the back when kneeling; when carrying, distribute weight evenly; when standing for long periods stand with your feet slightly apart; when pushing or pulling try to keep your back straight and take the strain on your arms.

Back pain management should be seen as a long-term investment in good health.

A long soak in a hot tub, the steam delicately scented with the fragrance of oil of lavendar. Candles throw thin shadows on the damp walls. Music plays softly in the background. You’re content, relaxed, following a delicious meal including oysters and just a few wicked drops of champagne. Your partner has promised you a sensuous back massage when you get out of the tub … and then, who knows?

An erotic fantasy? No, just sure-fire back pain relief.

Back pain relief doesn’t have to be only about traction or exercise routines thought out by a particularly sadistic ex-marine (probably on the run) or vile-tasting herbal back pain relief remedies created by Hyde’s evil twin – the chemist from hell.

Back pain relief should be pleasant, relaxing, relieving, simple, enjoyable and effective.

Visualization techniques, massage, hot or cold therapy treatments, good posture training programs, light exercise routines, a sensible diet, yoga for back pain relief, hynotherapy, acupuncture and the purchase of a good bed will all contribute to relieving your back pain.

Unless, of course, your back pain is caused by a seemingly unrelated disease; but most Americans suffer some form of backache at some stage in their life and the reality of back pain is that it is most often caused by poor posture, too little exercise, work-related back strains and stresses, sports injuries or a touch of arthritis.

For these conditions, back pain relief involves a variety of sensible treatments that include stopping smoking, learning new posture habits, taking the dog for a walk every night and pampering your back with regular massage.

I suffer with severe upper back pain, caused by sitting over a typewriter most of the day, even when I’m not working. I relief it by massaging my shoulders when I take a break; I swim every day and then lie on the firm grass and do some gentle yoga; I make a conscious effort to sit with my legs comfortably and firmly on the ground when I’m at my desk; I treat myself to a hot bath once a week that includes an infusion of garden herbs; I take vitamins daily and I make sure I walk around every half hour to relieve muscle tension.

My oldest friend (in both senses of the word) suffers with what she calls her ‘bad knees’. She can hardly climb a flight of stairs. And so she avoids exercise. Fatal mistake. Back pain relief is a matter of practicing good back health; just as you shower or bath every day to keep your skin healthy. Exercise is vital to keep the muscles of your spine supple and strong to enable them to perform their job – keeping you upright.