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Balance Training

How It Works
Though it might not cross your mind, you need good balance to do just about everything, including walking, getting out of a chair, and leaning over to tie your shoes. Strong muscles and being able to keep yourself steady make all the difference in those and many other things you do every day.

Balance training involves doing exercises that strengthen the muscles that help keep you upright, including your legs and core. These kinds of exercises can improve stability and help prevent falls.

Doing balance exercises can be intense, like some very challenging yoga poses. Others are as simple as standing on one leg for a few seconds. Or you can use equipment that forces your body to stabilize itself, like a Bosu half-circle stability ball or a balance board you use along with a video game.

Examples of balance exercises include:

Standing with your weight on one leg and raising the other leg to the side or behind you
Putting your heel right in front of your toe, like walking a tightrope
Standing up and sitting down from a chair without using your hands
Walking while alternating knee lifts with each step
Doing tai chi or yoga
Using equipment, like a Bosu, which has an inflatable dome on top of a circular platform, which challenges your balance
Over time, you can improve your balance with these exercises by:

Holding the position for a longer amount of time
Adding movement to a pose
Closing your eyes
Letting go of your chair or other support
You can do balance exercises as often as you’d like, even every day. Add in two days a week of strength training, which also helps improve your balance by working the muscles that keep you stable.

Intensity Level: Moderate
To balance train, you don’t have to run, jump, or do any other high-impact or high-intensity exercises. Usually balance training involves slow, methodical movements.

Areas It Targets
Core: Yes. You need strong core muscles for good balance. Many stability exercises will work your abs and other core muscles.

Arms: No. Most balance exercises are about balancing on your feet. So unless you’re doing moves that involve your arms, or you’re holding weights, they don’t work your arms.

Legs: Yes. Exercises in which you balance on one leg and then squat or bend forward also work the leg muscles.

Glutes: Yes. The same balance exercises that work the legs also tone the glutes.

Back: Yes. Your core muscles include some of your back muscles.

Type
Flexibility: No. Balance training is more about strengthening muscles and improving stability than gaining flexibility.

Aerobic: It can be, but often is not. It depends on how intense the activity is. If you’re moving fast, then it may be aerobic. Slower balance exercises do not make you breathe faster or make your heart pump harder.

Strength: Yes. Many of these exercises will work your muscles, especially the muscles of your legs and core. Some moves may also use your chest and shoulder muscles, like the plank position in yoga.

Sport: No. Balance training involves a series of exercises. It is not a sport.

Low-Impact: Yes. There is no impact involved in doing balance exercises.

What Else Should I Know?
Cost. No. You can do balance exercises on your own, with nothing more than a chair. There is a cost if you want to take a tai chi or yoga class, or buy a stability ball, video, or other piece of equipment.

Good for beginners? Yes. Balance training is good for people of any age and fitness level. It’s recommended for older adults to help prevent falls.

Outdoors. Yes. You can do balance exercises anywhere: in your backyard, on a beach, in a park.

At home. Yes. You can do these exercises at home.

Equipment required? No. You only need your own body to do balance exercises: for example, by standing on one leg. Or you can buy a piece of equipment like a Bosu ball to challenge your balance even more.

What Dr. Michael Smith Says:
The beauty of balance training is that anyone can, and should, do it. Balance training improves the health, balance, and performance of everyone from beginners to advanced athletes, young and not-so-young.

If you’re new to exercise, it’s a great place to start. Focusing on your core and balance improves overall strength and gets your body ready for more advanced exercise. Start off easy. You may find that you need to hold onto a chair aft first. That’s absolutely fine.

If you’re an advanced exerciser, you’ll likely find you still need to start with somewhat simple moves if balance isn’t your thing. Then push yourself to perform more complex moves that both challenge your muscular strength and your aerobic stamina. If you think balance exercises are easy, you haven’t tried yoga’s warrior III pose.

Is It Good for Me If I Have a Health Condition?

If you have back pain, balance training is one of the best ways to strengthen your core and prevent back pain. If you’re recovering from a back injury, get your doctor’s OK and then start balancing. It’ll help prevent more problems in the future.

When you strengthen muscles, it also helps arthritis by giving more support to painful joints. You may need to adjust or avoid certain moves to decrease pressure on your knees. For example, a balance move that involves a lunge may be more than your knees can handle. Good news is there are many exercises to choose from.

If you have diabetes, high blood pressure, high cholesterol, or even heart disease, exercise is a must to help you get control of your condition. Balance training is an excellent place to start. The first step of resistance training should focus on core and balance exercises, according to the American Council on Exercise. As you get stronger and become able to perform more intense exercises, balance training can give you an aerobic workout that even helps control blood sugar, cholesterol, and blood pressure along with other aerobic exercise.

If you’re pregnant, choose your balance exercises carefully. Women can and should exercise during pregnancy. The main concern with exercise during pregnancy is falling, so moves that make you unstable are not a good choice. Choose balance moves that either keep both feet on the floor or that you do on all fours, like plank (you may need to support your body with one knee on the ground). As with any exercise, if you did it before pregnancy, you’re likely OK doing it after pregnancy. It’s always good to check with your doctor to be sure.

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8 At-Home Back Exercises for a Stronger Upper Body

Most people head into a workout focusing on the areas we consider the most noticeable—butt, stomach, legs, etc. But here’s a secret: Strong upper-body muscles (and back muscles, specifically) are not only key for an overall defined look, but they’re your best defense against pain, injury, and poor posture for years to come.

Try these eight back exercises at home or at the gym to sculpt a strong, sexy back, and shoulders all at once.

How it works: Three or four days a week, do 1 set of each of these exercises for back fat, with little or no rest in between moves. After the last exercise, rest 1 to 2 minutes and repeat the full circuit 2 more times (3 times total).

You’ll need: A pair of light-weight dumbbells and a pair of medium-weight dumbbells

T-Raises

This at-home back exercise proves that you don’t need huge weights to make some huge strength gains.

Grab a pair of light-weight dumbbells and stand with feet hip-width apart.
Take a slight bend in knees as you shift hips back and lower torso until it’s parallel to the floor.
Bring weights together and turn palms to face forward.
Keeping arms straight, lift weights up to shoulder height then lower back down. (Make sure to keep core and glutes engaged the entire time.)
Do 15 reps.

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Remedies for Nausea and Vomiting

Nausea and Vomiting: What’s Wrong?

Your child’s nausea has turned to vomiting, and you want to help him fast. Luckily, bouts of vomiting in kids aren’t usually harmful, and they pass quickly. Common causes are stomach viruses and sometimes food poisoning. Check in with your doctor if your child is less than 12 weeks old, acts sick, or if you are worried.

Signs of Dehydration

One of the best things you can do is watch for dehydration. Kids get dehydrated more quickly than adults. Watch your child for: acting tired or cranky, dry mouth, fewer tears when crying, cool skin, sunken-looking eyes, not urinating as often as normal, and when he does go, not peeing very much or urine that is darker yellow.

Treating Dehydration

To prevent and relieve dehydration, try to get your child to drink in very small amounts. Even if vomiting continues, she’s still absorbing some of what you give her. Try ice chips, sips of water, sports drinks, or oral rehydration solutions like CeraLyte, Enfalyte, or Pedialyte. After she vomits, start with a small amount: a few tablespoons every few minutes. Over time, give her more as she is able to hold it down. Make sure she urinates regularly.

What About Flat Soda?

For many years, parents used flat lemon/lime soda and ginger ale to help kids replace fluids, and many doctors still recommend those. But research has begun to show that oral rehydration solutions are better for kids. These drinks offer the right amounts of sugar and salt. An alternative can be a sports drink mixed with an equal amount of water.

Liquid Diet

When it’s been several hours since your child last vomited, you can begin a clear liquid diet beyond just water, electrolyte drinks, or oral rehydration solutions. Stick with liquids you can see through. They are easier to digest, yet they offer nutrients to give your child energy. Think clear broth, cranberry juice, apple juice. Popsicles and Jell-O can work well, too.

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Masks and Summer Heat: Expert Tips

Dr. Teresa Murray Amato rode the subway into Manhattan from Queens the other day and found that summertime and face masks aren’t an easy fit.

“It was a warm day. I definitely felt it was a little hot,” said Amato, director of emergency medicine at Long Island Jewish Forest Hills in Queens, N.Y.

Despite her discomfort, Amato resisted the urge to remove her mask — and she recommends that you do the same.

COVID-19 continues to spread even in the humid heat of summer, so it’s important to keep wearing masks and maintaining social distancing to prevent transmission, said Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City.

At least 10 states — Alabama, Arkansas, California, Florida, Nevada, North Carolina, Oklahoma, South Carolina, Tennessee and Texas — reached record levels of hospitalized COVID-19 patients on Sunday, the Washington Post has reported.

This was the risk of reopening, but public health officials have said it’s worth it if people wear masks.

Evidence has shown that masks can reduce transmission of the new coronavirus, if everyone wears one, Amato said.

Summer heat may make your mask feel stifling, but you should keep wearing it if you’re near other people or in enclosed spaces, she said.

“Even though we know it’s going to be a little uncomfortable, I really think the benefits outweigh the discomfort of being a little warm while wearing your mask,” Amato said.

Keeping both your mouth and nose covered is important. Folks struggling with their mask in the heat might try switching to a lightweight one that’s more breathable.

At this point, surgical masks are in good enough supply that people who are uncomfortable with a cloth face covering might consider buying a box, Amato said. Even grocery stores are carrying them now.

“A light surgical mask probably does the trick with the least amount of discomfort,” she said.

Sweat is another problem. If your mask becomes damp with sweat, its ability to screen out coronavirus is diminished, Amato and Javaid said.

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Cancer Drug Might Help Curb Severe COVID-19

Could a cancer drug spare hospital patients from the ravages of severe COVID-19?

Yale doctors think it can after giving the medication, known as tocilizumab, to severely ill patients back in March.

How does tocilizumab work? It has a long history of dampening the life-threatening immune system reactions cancer patients often experience while undergoing treatment. Since the same kind of dangerous response develops in many COVID-19 cases, the researchers thought the drug might make a difference for the sickest patients.

The result — while preliminary — appears to be a dramatically lower death rate among patients placed on mechanical ventilators.

How much lower? Among the first 239 COVID-19 patients treated at Yale New Haven Hospital, in Connecticut, during the early weeks of the pandemic, 153 were treated with tocilizumab, including all 48 patients who had been placed on ventilators. “Instead of survival rates of 10% to 50% reported elsewhere, it was 75% in [ventilated] patients treated with tocilizumab,” said study author Dr. Christina Price, Yale’s chief of clinical allergy and clinical immunology.

In addition, among those seriously ill patients who ultimately survived COVID-19, tocilizumab appears to have significantly shortened overall ventilation time. While hospitals around the country were having to keep patients hooked up for between 12 to 14 days, ventilations at Yale typically lasted only about five days.

How tocilizumab works against COVID-19

What accounts for its apparent success against COVID-19?

It all originates in the threat posed by a deadly immune system phenomenon known as “cytokine release syndrome” (CRS), an out-of-control inflammatory response that the virus triggers in some patients.

CRS is “when the body’s response to fighting the virus goes so unchecked it ends up being harmful, damaging the liver, the kidney, the lungs. You need an immune response. You can’t totally shut it down completely. But you can’t let it get out of control, which is what can happen to cancer patients undergoing treatment. And to COVID patients,” Price said.

The problem? “There were no [U.S. Food and Drug Administration]-approved medications for COVID in March,” she stressed.

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What Does Asymptomatic COVID-19 Look Like Under the Surface?

Asymptomatic individuals carrying SARS-CoV-2 shed the virus longer than those with COVID-19 symptoms, with other lab findings suggesting the symptomatic patients mounted more robust immune responses, a small study in China found.

Median duration of viral shedding among 37 asymptomatic patients was 19 days (interquartile range 15-26; range 6-45) versus 14 days among 37 matched symptomatic patients (IQR 9-22; log-rank P=0.028), reported Jing-Fu Qiu, PhD, of Chongqing Medical University, and colleagues, though viral shedding does not necessarily mean the patients were infectious.
Virus-specific IgG antibody titers and cytokine levels were also significantly lower among asymptomatic patients in the acute phase of infection, when viral RNA can be found in respiratory specimens, the authors wrote in Nature Medicine — both of which indicated that immune responses weren’t as strong in the asymptomatic group.

Asymptomatic transmission of COVID-19 is one of its biggest mysteries, with the World Health Organization recently reminding the public of the distinction between asymptomatic patients, who never develop symptoms, and presymptomatic patients, who go on to develop symptoms later in the course of disease.

Qiu and colleagues characterized asymptomatic carriers as the “silent spreaders” of COVID-19.

“However, our understanding of the clinical features and immune responses of asymptomatic individuals with SARS-CoV-2 infection is limited,” the researchers added.

For the study, they examined data from 178 patients with PCR-confirmed SARS-CoV-2 infection in the Wanzhou District in China, including 37 without symptoms. Median age in the latter was 41, and 22 were women. These individuals were matched by age, sex, and comorbidity with 37 symptomatic patients for antibody detection and cytokine measurement. Qiu and colleagues also included a group of 37 individuals who tested negative via RT-PCR for cytokine comparisons.

Lab values and imaging were not entirely normal for the asymptomatic group. Eleven had increased C-reactive protein levels and six had elevated levels of alanine aminotransferase. Chest CT found “focal ground-glass opacities” in 11 and “stripe shadows and/or diffuse consolidation” in another 10 of the group; in two-thirds of these 21 patients, the abnormalities were in only one lung. The remaining 16 showed entirely normal imaging.

Around 80% of both symptomatic and asymptomatic patients tested positive for IgG antibodies about 3-4 weeks after exposure. The difference was greater when examining IgM antibodies, with positive findings in 78.4% of symptomatic patients and 62.2% of asymptomatic patients.

In the early convalescent phase, defined as 8 weeks after hospital discharge, symptomatic patients had higher IgG levels, though both groups experienced over 90% decreases in IgG levels. A larger proportion of asymptomatic patients had decreases in neutralizing serum antibody levels versus symptomatic patients (81.1% vs 62.2%, respectively).

These findings should serve as a caution against assuming prior infection confers immunity to future infection, Qiu and colleagues said.

“These data might indicate the risks of using COVID-19 ‘immunity passports’ and support the prolongation of public health interventions, including social distancing, hygiene, isolation of high-risk groups, and widespread testing,” the team wrote.

Plasma levels of cytokines were also similar between asymptomatic patients and healthy controls, though significantly higher levels of stem cell factor and leukemia inhibitory factor were found in the asymptomatic group, the researchers noted, calling this a “reduced inflammatory response characterized by low circulating concentrations of cytokines and chemokines.”

Qiu and co-authors cited the varying sensitivity and specificity of antibody tests (obtained from a company called Bioscience) as a limitation to their study, adding that the results may be confounded by existing antibodies to other coronaviruses, such as SARS or MERS, as well as common cold viruses.

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Vaccine makers face biggest medical manufacturing challenge in history

Developing a COVID-19 vaccine in record time will be tough. Producing enough to end the pandemic will be the biggest medical manufacturing feat in history.
That work is underway.

From deploying experts amid global travel restrictions to managing extreme storage conditions, and even inventing new kinds of vials and syringes for billions of doses, the path is strewn with formidable hurdles, according to Reuters interviews with more than a dozen vaccine developers and their backers.

Any hitch in an untested supply chain – which could stretch from Pune in India to England’s Oxford and Baltimore in the United States – could torpedo or delay the complex process.

Col. Nelson Michael, director of the U.S. Army’s Center for Infectious Disease Research who is working on the government’s “Warp Speed” project to deliver a vaccine at scale by January, said companies usually have years to figure this stuff out.

“Now, they have weeks.”

Much of the world’s attention is focused on the scientific race to develop a vaccine. But behind the scenes, experts are facing a stark reality: we may simply not have enough capacity to make, package and distribute billions of doses all at once.

Companies and governments are racing to scale-up machinery to address a critical shortage in automated filling and finishing capacity – the final step in the manufacturing process of putting the vaccine into vials or syringes, sealing them and packaging them up for shipping.

“This is the biggest logistical challenge the world has ever faced,” said Toby Peters, an engineering and technology expert at Britain’s Birmingham university. “We could be looking at vaccinating 60% of the population.”

Several developers, including frontrunner Moderna, are experimenting with new ways to mitigate the extreme cold storage demands of their vaccines, which at present need to be kept at minus 80 degrees Celsius (-112 Fahrenheit).

SiO2 Materials Science is working on producing vials that won’t shatter at super-cold temperatures.

Travel restrictions, meanwhile, are posing more prosaic problems; Johnson & Johnson, which plans to start clinical trials this summer, has struggled to send its vaccine experts to oversee the launch of production sites, for example.

‘NEVER IN HISTORY’
By setting up massive clinical trials involving 10,000 to 30,000 volunteers per vaccine, scientists hope to get an answer on whether a vaccine works as early as this October. But even if they succeed, manufacturing in bulk, getting regulators to sign off and packaging billions of doses is a monumental challenge.

Seth Berkley, chief executive of the GAVI vaccines alliance, said in reality, the world is unlikely to go straight from having zero vaccines to having enough doses for everyone.

“It’s likely to be a tailored approach to start with,” he said in an interview. “We’re looking to have something like one to two billion doses of vaccine in the first year, spread out over the world population.”

J&J has partnered with the U.S. government on a $1 billion investment to speed development and production of its vaccine, even before it’s proven to work. It has contracted Emergent Biosolutions and Catalent to manufacture in bulk in the United States. Catalent will also do some fill-and-finish work.

“Never in history has so much vaccine been developed at the same time – so that capacity doesn’t exist,” said Paul Stoffels, J&J’s chief scientific officer, who sees filling capacity as the main limiting factor.

Emergent’s manufacturing plant in Bayview, Maryland, can accommodate four vaccines in parallel using different manufacturing platforms and equipment.

Funded by the government in 2012, the plant includes single-use disposable bioreactor equipment featuring plastic bags rather than stainless steel fermentation equipment, which makes it easier to switch from one vaccine to another.

This month, the company received an additional $628 million to make those four suites available to support any candidate the government selects, CEO Bob Kramer told Reuters.

BLOW-FILL-SEAL-REPEAT

As well as working with J&J, New Jersey-based Catalent signed a deal with British drugmaker AstraZeneca last week to provide vial-filling and packaging services at its plant in Anagni, Italy. It aims to handle hundreds of millions of doses, starting as early as August 2020 and possibly running through until March 2022.

It has ordered high-speed vial-filling equipment to boost output at its Indiana plant, where it is also hiring an additional 300 workers.

Michael Riley, Catalent’s North American president for biologics, told Reuters his biggest challenge was trying to compress work that normally takes years into months.

Adding to the challenge is that glass vials are in short supply.

To save glass, companies plan to use larger vials of five to 20 doses – but this raises new problems, such as potential waste, if not all the doses are used before the vaccine spoils.

“The downside is that after a healthcare practitioner opens a vial, they need to then vaccinate 20 people in a short, 24-hour time,” said Prashant Yadav, a global healthcare supply-chain expert at the Center for Global Development in Washington.

As part of the same drive, the U.S. Department of Health and Human Services and the Department of Defense have awarded ApiJect Systems up to $138 million to upgrade its facilities to be able to make up to 100 million plastic pre-filled syringes by the end of this year, and as many as 600 million in 2021.

The company plans to use a technology called Blow-Fill-Seal, where syringes are blown out of plastic, filled with vaccine and sealed in seconds. This will need Food and Drug Administration approval, CEO Jay Walker told Reuters.

BREAKING COLD CHAIN
SiO2 Materials Science is, meanwhile, ramping up capacity of plastic vials with a glass lining, which are more stable at ultra-low temperatures.

“You can bring us down to minus 196 Celsius, which none of the vaccines need,” Chief Business Officer Lawrence Ganti said. “You can throw it against the wall and it doesn’t break. Our founder has done that. He’s thrown frozen vials at me.”

The company expects to boost production from the current 5-10 million vials a year to 120 million within three-and-a-half months, he told Reuters.

Once packaged, many vaccines need to be kept cold – and some leading contenders made from genetic material such as messenger RNA need to be kept very cold – presenting another challenge that may limit access.

“People who work with mRNA store it at minus 80 degrees centigrade, which is not something you’re gonna find in most pharmacies or doctor’s offices,” said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and co-inventor of the rotavirus vaccine.

Peters of Birmingham university has been gathering data from poorer regions of Africa and Asia, and said breaks in the temperature-controlled supply chain – “cold chain” – are already frequent.

In some places, it is common to lose 25% or more of vaccines because of broken cold chains, he told Reuters.

“So if you’re looking to manufacture four billion, and you reckon you’re going to lose 25%, then you have to manufacture five billion,” he said. “It’s all the elements to move it from the point of manufacture to the point of aggregation, right down to the health centres and then out to the community.”

QUARANTINE QUAGMIRE
Companies developing mRNA vaccines, including Moderna and Translate Bio, which is partnering with Sanofi, are working to make candidates stable at higher temperatures.

Ron Renaud, CEO of Translate Bio, said he was confident this would happen “within a short amount of time”.

Colleen Hussey, a Moderna spokeswoman, said: “We are getting more confident that we could run our supply chain at -20C, which is an easier storage condition than deep freezing,” she said.

Moderna plans to add a small period of time in which the vaccine can be stored at normal fridge temperatures of 2 to 8 degrees Celsius in doctors’ offices or clinics.

“We will know more in the next 2-3 months,” she said.

The pandemic is also presenting obstacles of a less technical nature.

Catalent, which has some 30 plants globally, has had to write special permission slips in eight languages explaining that their workers are considered essential.

J&J is having trouble getting experienced personnel to far-flung labs to oversee the transfer of technology to contract manufacturers because they’re subject to 14-day quarantines.

“It is absolutely a factor,” said Stoffels. “If you have to send your people to the middle of India to get to filling capacity, that’s not easy at the moment.”

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Vegetarian and Vegan Diets Explained

The simplest definition of vegetarianism is a diet free of meat, fish, and fowl flesh. But eating habits of vegetarians cover a wide spectrum. At one end are lacto-ovo vegetarians, who avoid animal flesh but eat eggs and milk products. At the other end are vegans, who forgo eating (and often wearing) all animal-based products, including honey. Raw foodists are vegans who eat mainly raw fruits, vegetables, legumes, sprouts, and nuts.

There are also pescatarians, who eat fish and seafood; and lacto-vegetarians, who eat dairy products but not eggs. Fruitarians follow a diet that includes fruits, nuts, seeds, and other plant food. Those who follow a macrobiotic diet eat mostly grains but can also eat fish. They don’t necessarily identify as vegetarians.

Flexitarians refer to vegetarians who occasionally eat meat and fish.

Reasons for Becoming a Vegetarian

Many adherents of vegetarianism and veganism – former Beatle Paul McCartney and actor Alec Baldwin are two celebrities who happily promote the cause — regard a flesh-free diet not only as more healthful, but as a more ethical way to live. They point to the cruel practices and the high environmental cost of raising animals for food as reasons for excluding meat from the diet.
Most Americans, however, continue to eat some form of meat or fish. Ten percent of people consider themselves to be vegetarians, according to a 2013 Gallup poll.

Vegetarianism and Health
Most doctors and nutritionists agree that a low-fat diet high in fruits, vegetables, and nuts can be a boon to health. There’s also research suggesting that reducing or eliminating red meat from the diet may cut your risk of heart disease.

Research also has shown that a vegan or vegetarian diet may lower your risk of getting type 2 diabetes. And a 2011 study found that vegetarians had lower triglycerides, glucose levels, blood pressure, and body mass index (BMI).

Does Being a Vegetarian Lower Cancer Risk?
It’s difficult to say whether being a vegetarian or a vegan lowers cancer risk. This is mainly because of the diversity within the vegetarian population.

Many studies of the cancer-vegetarian relationship conclude that diets rich in fiber, vitamins, minerals, isoflavones (found in soybeans, chickpeas, peanuts, and more), and carotenoids (found in carrots, sweet potatoes, broccoli, kale, spinach, tomatoes, red peppers, and more), seem to protect against disease, including cancer, when part of a health-conscious lifestyle.

An 11-year study in Germany examined colon cancer among 1,900 vegetarians. Researchers noted fewer deaths from cancers of the stomach, colon, and lung in study participants than in the general population — particularly among those who practiced some form of vegetarianism for at least 20 years. They suggested, however, that other factors, like body weight and amount of exercise, likely affected mortality rates in the vegetarians they studied.

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Kettlebells

How It Works
Burn up to 400 calories in 20 minutes: That’s what you’ll get from a kettlebell workout.

A kettlebell looks like a cast-iron cannonball with a handle on top. They come in various weights. You’ll use them as you do things like lunges, lifts, and shoulder presses.

The workout gets your heart pumping and uses up to 20 calories per minute: about as much as running a 6-minute mile.

Kettlebell workouts offer a lot of flexibility. You can include a few of the moves in your own workout or do a dedicated kettlebell workout a few times a week.

Buy a DVD or sign up for a kettlebell class at the gym to learn how to do the moves safely. It won’t take long to understand why celebrities like Jennifer Aniston, Jessica Biel, and Katherine Heigl are huge fans of kettlebell workouts.

Intensity Level: Very High
You’ll work up a sweat doing a series of fast paced cardio and strength-training moves like kettlebell swings, lunges, shoulder presses, and push-ups.

Areas It Targets
Core: Yes. Most kettlebell workouts include squats, lunges, crunches, and other moves that work your abs and other core muscles.

Arms: Yes. The kettlebell is used as a weight for arm exercises like single-arm rows and shoulder presses.

Legs: Yes. Lunges and squats are among the most popular moves in a kettlebell workout.

Glutes: Yes. Your tush will be toned by using the kettlebell for added weight during lunges and squats.

Back: Yes. Using a kettlebell for a dead lift helps tone your back muscles.

Type
Flexibility: Yes. Working out with kettlebells will improve your flexibility.

Aerobic: Yes. This is a high-intensity workout that will get your heart rate pumping.

Strength: Yes. The kettlebell is an effective weight that will build muscle strength.

Sport: No. This is a fitness activity, not a sport.

Low-Impact: No. You can expect to be running, jumping, and doing other high-intensity moves.

What Else Should I Know?
Cost: The cost of a kettlebell ranges from $10 to $100 depending on the weight of the kettlebells (heavier ones are more expensive). You may want to buy DVDs or sign up for classes to learn the basics of a kettlebell workout.

Good for beginners? Yes, if you take a class or pick a DVD that’s for beginners and use a lighter kettlebell. There are also more advanced kettlebell workouts for those who are more fit.

Outdoors: You can do a kettlebell workout outside or indoors.

At home: You can use kettlebells at home.

Equipment required? Yes, a kettlebell. You can buy kettlebells in weights ranging from 5 pounds to 100 pounds at sporting goods stores and online retailers.

What Dr. Melinda Ratini Says:
Using kettlebells can be a great way to pump up your workout. You will be burning more calories in a shorter period of time.

Depending on the program, you may be getting both your strength training and your aerobic workout at the same time. Ask your doctor first.

Treat this workout with respect. If you choose a kettlebell that is too heavy or if you have poor form, you are likely to lose control of it. This can lead to a serious injury to your back, shoulders, or neck. Start out with an experienced trainer who can correct your technique before you hurt something.

Adding a kettlebell to your existing workout is great if you want to burn more calories in less time. It will quickly add muscle and stamina.

This type of high-intensity workout is not for you if you would rather do a more meditative approach to body sculpting, or if sweating isn’t your thing.

If you are trying to get into top form or keep in top shape, then swinging a kettlebell can help you reach your fitness goals.

Is It Good for Me If I Have a Health Condition?

With your doctor’s OK, you can include kettlebells in your fitness routine if you have diabetes. You will be building muscle while losing fat. Muscle burns energy more efficiently, so your blood sugar levels will go down. Depending on the workout, you may also get some cardio to help prevent heart disease.

This routine can also be a great way to help lower your blood pressure and your “bad” LDL cholesterol. Check with your doctor first, especially if you already have heart disease.

Using kettlebells in your workout puts some serious demands on your hips and back, as well as your knees, neck, and shoulders. It is a high-impact program. If you have arthritis or pain in your knees or back, then look for a less risky strength-training program.

If you have other physical limitations, ask an experienced instructor for advice on how to modify your workout.

If you are pregnant and have never used kettlebells, then this is not the time to start. If you worked out with kettlebells before becoming pregnant and are not having any problems with your pregnancy, then you will likely be able to continue using them — at least for a while. Check with your doctor first.

You will need to make some changes as time goes on. As your pregnancy hormones kick in, your joints will become looser. You can adjust by using lighter kettlebells and avoiding certain moves. Talk to your instructor and your doctor; they might suggest switching out your kettlebells during your last trimester.

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Talking to Your Child About Bedwetting: Dos and Don’ts

As many as one out of five children wets the bed at night. Also called nocturnal enuresis, bedwetting is as common as it is misunderstood.

How you, as a parent, handle your child’s bedwetting can have a big effect on how successful your child is at staying dry. When you’re ready to talk with your child about bedwetting, here are a few simple tips that can help.

Bedwetting: Talking to Your Child
Educate. In a class of 30 children, as many as six kids may wet the bed. Letting your child know that other kids have the same problem can take the weight off his shoulders and help him feel he’s not alone.
Tell your child if you used to wet the bed. Was bedwetting a problem for you as a kid? If you or a close family member used to wet the bed at night, let your child know. This helps them understand that bedwetting may be hereditary and is not completely their fault.
Tell them they’re not to blame. Even if there’s no family history of bedwetting, make sure your child knows they’re not to blame for wetting the bed. Explain what can cause bedwetting, including how some children have small bladders or are such deep sleepers they don’t feel bladder contractions in the night.
Tell your child a doctor can help. Talk to your child about seeing a pediatrician or other health care professional to discuss bedwetting treatments. An examination by a doctor can also help rule out medical causes for wetting the bed, such as urological problems or a reaction to certain medications.
Talk to your child about treatment options. Make sure your child understands what’s available to help him overcome wetting the bed, including enuresis alarms, medication, and lifestyle changes. Generally, treatments such as medication are used for children older than 6. Explain, too, how each option works and what to expect from each treatment.
Talk about changing habits. Going to the bathroom before bed, avoiding caffeinated and salty foods, drinking a little less fluid close to bedtime — these and similar changes can help your child achieve dry nights, so talk to him about how he can help himself.
Be encouraging. When your child successfully follows the bedwetting treatment you’ve chosen — whether he’s had a dry night or not — give him praise and encouragement.
Stay low-key. After a child wets the bed, be sure to remain calm and positive.
Encourage your child to go on sleepovers. Your child doesn’t need to miss out. With the use of absorbent pants, medication, and the help of other parents, let your child know they can go on sleepovers or away to camp.
Ask if it’s OK to share. Many kids don’t mind it if other adults know about their bedwetting — especially if that adult can help, such as a parent at a sleepover, or a counselor at camp. But do check with your child first.
Talk to your child about taking part in cleaning up. Sharing the responsibility of changing and washing the wet sheets helps a child actively tackle the problem of bedwetting. Help them with the activity, and praise them for taking part.

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