American College of Sports Medicine A Quarterly Publication of the American College of Sports Medicine • FIT SOCIETY ®PAGEA Quarterly Publication of the
American College of Sports Medicine
by Lisa K. Lloyd, Ph.D.
If you are like most people, starting an the American College of Sports Medicine exercise program may seem intimidating, (ACSM) suggests that aerobic activities time consuming, and difficult. However, should be performed three to fives times the fact that you're reading this article each week for 20–60 minutes at an shows that you've already begun to com- intensity that is equivalent to 65 percent mit to exercising. There are lots of good to 90 percent of your maximal heart rate.
reasons to exercise, such as improving Aerobic activities include walking, jog- physique, losing weight, increasing physi- ging, in-line skating, dance aerobics, cal fitness and improving your health swimming, cross-country skiing, and bi- (reducing the risk of heart disease, adult- cycling. Calculation of 65 percent and onset diabetes and certain forms of 90 percent of maximal heart rate involves cancer). Though many people are aware the following three steps: of the benefits of exercise, few are familiar with the proper guidelines regard- ing the quantity and quality of exercise.
1. Max HR = 220 - [your age] = _ beats per minute
This is important because one of the keys 2. 65% of Max HR = 0.65 x [max HR] = _ beats per minute
to beginning a successful exercise 3. 90% of Max HR = 0.90 x [max HR] = _ beats per minute
program is to follow exercise guidelines that have been proven safe and effective For instance, by following these three in meeting people's health and fitness steps, 65 percent maximal heart rate for goals. In general, an exercise program a 32-year old person would be 122.2, should include a variety of physical activi- whereas 90 percent maximal heart rate ties that will improve cardiorespiratory would be 169.2. Therefore, this person endurance, muscular endurance and should perform an aerobic exercise hard strength, flexibility, and body composition.
enough that his or her heart rate reachesat least 122 beats per minute, but not Cardiorespiratory endurance refers to the perform the exercise so hard that the body's ability to deliver oxygen and nu- heart rate exceeds 169 beats per minute.
trients to and remove wastes from tissuesover sustained periods of time. Good Muscular strength refers to the ability of cardiorespiratory endurance indicates a muscle, or a group of muscles, to exert that you are at reduced risk for develop- force over a brief period of time. Muscu- ing heart and lung disease. In order to lar endurance, however, refers to the enhance cardiorespiratory endurance, A Quarterly Publication of the American College of Sports Medicine • Letter from the Editor American College of Sports Medicine Welcome to the summer issue of the ACSM Fit Society Page. The American College of Sports Medicine recently completed its 48th Annual Meeting, and it was a Fit Society Page Editorial Board: tremendous success. ACSM members from around the world presented new and Jeffrey Potteiger, Ph.D, FACSM, Editor
exciting information about exercise and sports medicine. Some of that information is Virginia Commonwealth University contained in this issue of ACSM Fit Society Page.
Katherine A. Beals, Ph.D., R.D.
Ball State University With summer here, active people need to think about dealing with the heat for out- Lisa K. Lloyd, Ph.D.
door exercise and recreation. Several articles in this issue address specific concerns Southwest Texas University related to body temperature regulation and dehydration. This is important because Bryan W. Smith, M.D., Ph.D.
increases in body temperature and loss of body water can lead to serious health University of North Carolina problems. For those of you taking advantage of the long summer days to begin an Dixie L. Thompson, Ph.D., FACSM
exercise program, we have included information that may help make your start easier University of Tennessee and more enjoyable. As always, we have the Athlete's Kitchen and our ever-popularQuestion and Answer section.
ACSM is the world's largest association devoted to sports medicine and exercise science. The College's mission is to promote and integrate scientific research We hope you enjoy this issue of ACSM Fit Society Page and find information that and practical applications of sports medicine and you can use to enhance you and your family's health and wellness. If you have any exercise science to maintain and enhance physical questions or comments please be sure to contact us.
performance, fitness health, and quality of life.
For more information on subjects discussed in this issue Jeffrey A. Potteiger, Ph.D., FACSM
and/or a catalog of all ACSM publications, please send a Editor, ACSM Fit Society Page
self-addressed, stamped envelope to: American College of Sports Medicine, c/o ACSM Fit Society , P.O. Box 1440, Indianapolis, IN 46206-1440.
Q&A with ACSM
by Bryan W. Smith, M.D., Ph.D.
Q: What are some tips for parents
Q: What are some tips to prevent heat
Q: Why are the elderly more prone to
regarding water safety for children? A: Have your child learn to swim! How-
A: Optimizing fluid intake by consuming
A: While both children and the elderly
ever, don't rely on swimming lessons eight to 16 ounces of fluid pre-exercise are prone to heat illness, there are alone to protect your child from drown- and six–eight ounces of fluid every different reasons to explain each group's ing. A child may panic, particularly when 15 minutes during exercise. Taking 10– susceptibility. For the elderly, their thirst confronted with an unfamiliar situation, 14 days to acclimatize for children and response is decreased. The elderly have and forget what they have learned. Never seven to 10 days for adults. Being well decreased cardiovascular capacity, leave children alone in a swimming area conditioned physically. Wearing the appro- which is more evident in the less trained and never take your eyes off your child priate light-colored clothing. Avoiding individual. Many have a history of chronic while he/she is swimming. Drowning can exercise during times of maximal heat medical illness such as hypertension or be quick and silent. In all boating situa- diabetes and are on many medications tions, children should wear approved life that can increase the potential for heat jackets, even when sleeping. Learn CPR! Q: Is taking salt tablets a good idea when
illness such as diuretics, beta-blockers, training in the heat? antihistamines, antidepressants, and Q: At what age should you have your
anticholinergics. It is important to discuss child take swimming lessons? A: With exercise, the majority of the
exercising in the heat with your physician.
body's sweat loss comes from water. The A: By age four, most children have the
more trained the person, the more dilute Q: What is the optimal fluid for exercis-
motor skills and attention span necessary their sweat is. There is no need for salt for organized swimming. They are more tablets. However, since our bodies do likely to be interested as well.
lose some salt in sweat, these small A: This fluid must be readily emptied
amounts can be adequately replaced just from the gut into the circulation. Usually by using salt with meals.
for activities of one hour or less, chilledwater is optimal. For longer events, asports drink is preferred.

A Quarterly Publication of the American College of Sports Medicine • SUMMER EXERCISE TIPS by Ingrid C. Frey, M.S. and William B. Farquhar, Ph.D.
Now that summer is is heat stroke. Heat stroke is a medical The general recommendation is two cups emergency requiring immediate medical of fluid two hours before exercise and a some special con- care and cooling by whatever means pos- cupful every 15 minutes of exercise.
siderations to take sible. Many of the symptoms are similar Importantly, fluid intake during exercise into account when exercising outdoors.
to heat exhaustion but also may include should match sweat rate. For every one- These will include some of the following: disorientation, loss of consciousness and pound reduction in body weight, at least What effect does high temperature have seizures. Sweating generally is absent in one pint of fluid should be consumed.
on my ability to exercise? What is heat heat stroke, but the skin may be moist What is the best fluid replacement? injury? What can I do to prevent heat from earlier sweat production.
Water is probably most important when injury? How important is fluid intake dur- exercise duration is less than one hour.
Certain diseases may impair the ability However, some find that the increased to regulate body temperature and in- palatability of various sports drinks helps Exercising in the heat puts significant crease susceptibility to heat injury: high them to more fully replace the amount of stress on your cardiovascular system to blood pressure, cardiovascular disease, fluid lost during exercise. Fluids cooler maintain core body temperature and fluid and diabetes can reduce sweat rate and than room temperature (59–79 degrees balance. As you exercise, most of the skin blood flow, thereby increasing heat Fahrenheit) also seem to increase energy produced from working muscles stress during exercise. Some medica- palatability. Those who exercise longer generates heat and therefore increases tions taken for these diseases such as than one hour, or exercise very intensely body temperature. This increase in core diuretics (e.g., furosemide/lasix), beta for slightly less than an hour, may ben- temperature causes the blood flow to the blockers (e.g., metoprolol/lopressor), va- efit from fluids containing carbohydrates skin to increase, and stimulates sweat sodilators (e.g., lisinopril/zestril) and oth- and electrolytes.
glands. Increased skin blood flow ers also can impair the ability to regulate coupled with evaporation of sweat at the body temperature. Be sure to ask your The majority of heat-related problems skin surface cools the body by allowing physician if any of the medicines you take occur during the first few exercise heat to be transferred from the core to affect your ability to exercise in the heat.
sessions in the heat. This highlights the the skin and to the environment. How- importance of heat acclimation. There ever, environmental factors such as Fortunately, following some common are a number of benefits to heat accli- bright sunlight, high humidity, and lack sense guidelines can minimize the risk mation (including an increased sweat of wind challenge your ability to dissipate of heat injury. Preventing dehydration not rate) that make exercise in the heat safer heat to the environment and maintain only reduces the risk of heat injury but and more tolerable. It generally takes body temperature. For example, high also leads to improved exercise perfor- 10–14 days to fully acclimate. Continu- humidity reduces the evaporation of mance. What is generally not appreci- ing to use the same target heart rate sweat on the skin surface, thus reducing ated by recreational and competitive ath- training range is recommended and will its cooling effect. Many of these concerns letes is that even a small (1 percent to require that you decrease the absolute are exaggerated in older adults, particu- 2 percent) reduction in body weight from intensity of exercise (e.g. walking pace).
larly less fit adults who are not accus- excessive sweating can lead to impaired Shortening the duration of exercise for tomed to exercising in the heat.
exercise performance and can increase the first few exercise sessions in the heat cardiovascular strain. Simply drinking also is recommended. Those with a high When exercise is performed in hot envi- fluids when thirsty is never enough to fitness level acclimate faster and in ronmental conditions, an excessive in- offset the fluid lost during exercise. This general can better tolerate heat stress.
crease in body temperature (hyperther- has been referred to in the scientific lit- mia) can result in heat injury. Heat ex- erature as "voluntary dehydration." This Following these guidelines should allow haustion, one form of heat injury, is caused concern is heightened in older adults, you to minimize the risk of any heat-re- primarily by dehydration, and less often, where the drive for thirst is even less lated problems. Should you experience salt depletion. Some of the symptoms sensitive. Therefore, proper fluid intake any of the aforementioned symptoms of include chills, nausea, dizziness, and pro- prior to, during, and after exercise is criti- heat illness, be sure to immediately stop fuse sweating. A more serious form of cal in reducing the risk of heat injury and exercising, find a cool shaded area, and heat injury, and fortunately less common, optimizing exercise performance.
drink plenty of fluids.

A Quarterly Publication of the American College of Sports Medicine • FeatureA HOT ISSUE FOR SUMMER EXERCISERS by Matthew J. Comeau, Ph.D.
As the temperature Heat exhaustion occurs when body tem- come acclimatized to hot temperatures.
starts to increase, perature is elevated due to excessive Wearing loose-fitting clothing allows exposure to the heat; its sweating mecha- more air to pass by the body, thereby people move their nism becomes overwhelmed. A person allowing for more evaporation of sweat exercise regimen outside. This can experiencing heat exhaustion will appear and greater cooling. By wearing a hat, present a problem if the temperature ashen. The skin may become cool and one can limit exposure to the sun and outside is hotter than what an individual clammy. Dizziness, weakness, and dis- decrease the overall effect of the sun on is accustomed to. With exercise in a orientation can accompany pale, cool, body temperature. Exercise should controlled environment, exposure to the and clammy skin.
occur in the morning or late evening stress of heat and humidity is minimal.
because of the cooler temperatures This could become a major problem to The last and most severe heat-related associated with those times of day.
the exercising individual, especially if they illness is heat stroke. An individual ex- Exercising in the afternoon, especially are not used to changes in temperature periencing heat stroke will have flushed late in the afternoon, will expose the body and humidity. Therefore, it is important skin, minimal or no sweating, and skin to the hottest time of day. Finally, wear- to identify problems someone exercising that feels hot to touch. Confusion and ing sunscreen will reduce the possibility in the heat may experience.
fainting also may accompany the hot, of sunburn, and not affect the ability of flushed, dry skin. Unlike heat exhaus- the body to cool itself.
Heat Related Problems
tion, heat stroke is a severe problem and Heat-related illness falls into a hierarchy must be dealt with quickly. It can be life Fluid Intake Recommendations
of increasingly problematic categories: The following are recommendations for heat rash, heat cramps, heat exhaustion, fluid intake when the possibility of heat- and heat stroke. Anyone is susceptible Recommendations for Decreasing
related illness is present: to a heat-related illness. However, those the Risk of Heat Illness
who are informed and take steps to mini- Adequate intake of fluid is the best way • Two to three hours prior to exercise, mize risk factors associated with heat to prevent heat illness. However, not all drink approximately 20 ounces of related problems could greatly reduce beverages aid the body in replacing lost water or a sports drink.
fluid. Caffeinated beverages should be • Ten to 20 minutes before exercise, avoided. These beverages (caramel drink approximately 10 ounces of Those who sweat excessively generally colored soda, coffee, tea) actually work water or a sports drink.
experience heat rash, but any individual against the body and cause it to get rid • During exercise, drink at least 10 can be vulnerable to this condition. Tight of fluid. Recommended fluids include ounces of water or sports drink every fitting and sweat-saturated clothing usu- water, sports drinks, and fruit juices.
10 to 20 minutes. Remember not to ally is a great combination for the forma- These allow the body to replenish lost drink based on thirst alone. It is not tion of heat rash. Heat rash will appear fluid without causing excessive fluid loss.
the only predictor of decreased fluid as areas of small red pimples or blisters.
Other methods to decrease the risk of This condition usually is not uncomfort- heat illness include becoming acclima- able, but if severe enough, burning and tized to the outside temperature, wear- • After exercise, drink approximately 20 itching may occur. While this is uncom- ing loose-fitting clothing, wearing a hat, ounces of water or sports drink per fortable, it does not present so serious a exercising in the morning or late evening pound of weight lost during exercise.
problem to an individual's health as do versus in the middle of the afternoon, and When is it too hot to exercise?
the other three heat illnesses.
wearing sunscreen to prevent sunburn.
There are times when the heat and Sunburn decreases the body's ability to Heat cramps are associated with exces- humidity are so high that exercise should cool itself. When becoming acclimatized sive sweating during exercise. Cramps be avoided. The greater the risk for heat to the outside temperature, one should usually are caused by the depletion of salt illness, the more attention should be gradually increase exposure to the out- from the body during the sweating process.
given to fluid intake, and the utilization of side elements. As air temperature rises, Involuntary muscle cramping can be pain- other precautions.
exposure should be increased slowly.
ful depending on the severity of the cramp.
It usually takes seven to 14 days to be- A Quarterly Publication of the American College of Sports Medicine • Starting Exercise (Continued from page 1) ability of a muscle, or a group of muscles, Flexibility refers to the ability to move increase your likelihood of successful to sustain repeated contractions or to joints and use muscles through their full weight loss and long-term maintenance continue applying force against a fixed range of motion. Good flexibility en- of weight loss.
object. Simply put, muscular strength is hances quality of life and reduces risk of used to lift heavy objects, while muscular musculoskeletal injuries and low back In conclusion, those who are waiting to endurance is used to carry groceries from pain. When stretching, one should per- "feel" like exercising usually never do.
the car to the house. Well-developed form slow, sustained stretches of large Beginning an exercise program involves muscular strength and endurance can muscle groups with minimal or no bounc- a conscious decision to incorporate ex- improve a person's body composition and ing. To achieve optimal flexibility, com- ercise into one's daily routine, whether general quality of life, and prevent plete at least four repetitions per muscle you "feel" like it or not. After all, it only musculoskeletal injuries, low back pain, group of 10 to 30 seconds in duration at takes an hour workout a few days per and osteoporosis. ACSM suggests that least two to three days each week.
week to achieve the health-related ben- performing one set of eight to 10 exer- efits of exercise. Begin your workout with cises targeting major muscle groups (i.e., Body composition refers to the makeup a five to 10-minute warm-up of light in- back, shoulder, chest, abdominal, thigh, of body tissue in terms of lean mass (e.g., tensity exercise, such as walking and hamstring, buttock or gluteal, triceps, bi- muscle, bone, vital tissue, and organs) slow jogging, and gentle stretching ex- ceps, and calf muscles) two to three days and fat mass. An optimal ratio of fat to ercises of large muscle groups. Then each week will enhance both muscular lean mass is an indication of fitness, perform at least 20 minutes of continu- strength and muscular endurance. It is which reduces the risk of chronic dis- ous aerobic exercise and at least 20 to recommended that most healthy young to eases and musculoskeletal problems.
30 minutes of muscular strength and middle-aged adults perform eight to 12 Combined with appropriate dietary in- endurance training. End your workout repetitions of each exercise. For older (50 take, physical exercise training con- with a five to 10-minute cool down of slow years of age and above) and more frail ducted at least three days per week at walking, followed by stretching exercises individuals, it is recommended to perform recommended intensity and duration will geared toward increasing your flexibility.
10 to 15 repetitions of each exercise.
expend at least 250 to 300 calories and Which School Will Fit All Your Needs?
Two indispensable ACSM references will help you decide:
ACSM's 2001 Directory of Graduate Programs in Sports Medicine and Exercise Science
ACSM's 2002 Directory of Undergraduate Programs in Sports Medicine and Exercise Science

Are you looking for a way to find out exactly which school fits your needs? The American College of Sports Medicine(ACSM) invites you to learn about both undergraduate and graduate programs in the ACSM's 2002 Directory of Under-graduate Programs in Sports Medicine and Exercise Science and the ACSM's 2001 Directory of Graduate Programs inSports Medicine and Exercise Science.
In their 11th year of publication, these directories are widely recognized as the best information source for graduate andundergraduate programs in sports medicine and exercise science. Because ACSM is the world's-largest, most-re-spected sports medicine and exercise science organization, more than 300 academic institutions participated in the2000 editions. ACSM's directories are the best way to help determine your next career move.
To order either directory, please call the Public Information Department at the ACSM National Center at TEL: (317) 637-9200, ext. 127. Each publication is only $20 and may be ordered using check, purchase order or credit card. Take stepsto improve your future today! A Quarterly Publication of the American College of Sports Medicine • FeatureKNOWING RISKS OFTEN PREVENTS SERIOUS SPORTING INJURIES by Michael R. Bracko, Ed.D., FACSM There are several Men and Women
cising, may put a person at greater risk Differences between men and women in cause sports-related terms of getting injured have more to do 4. Stretching may increase tolerance for injuries. For some- with traumatic injuries such as torn liga- pain — that is, it has an analgesic one who exercises for physical or ments in the knee than muscle/tendon effect. Therefore, it does not seem mental fitness, a "fitness athlete," one of strains or pulls. Generally speaking, men prudent to decrease one's tolerance the most prominent risk factors for injury and women and boys and girls must take to pain, weaken the muscle, and then is level of fitness. Generally speaking, the same precautions when starting an exercise a weakened, anesthetized the less "fit" a person is, the greater exercise program.
chance he or she has of getting injured.
ACSM recommends stretching two to A beginning exerciser must start an Behavioral risk factors for getting injured three times a week. Regular stretching exercise program with low intensity (how include: lack of sleep, emotional stress can improve other aspects of health, "hard" the exercise is), moderate dura- (a major cause of back injuries), smok- including flexibility. It may be better tion (how long the exercise lasts), and ing (risk factor for back injuries), fatigue— to gently warm up the body with low- moderate frequency (days per week).
specifically a lack of muscle endurance, intensity muscle contractions for approxi- After three to five weeks of regular exer- overuse (tendinitis) or too much exercise mately 10–15 minutes, or until you are cise, the intensity and duration may be (not enough days off). Some injuries sim- sweating, then engage in higher inten- increased, with the frequency staying the ply are of unknown cause, and some in- sity exercise or sport.
same (three days a week). In order to juries simply are caused by exercising prevent injury in the initial stages of an too hard, too fast, or doing too much.
exercise program, a "fitness athlete" muststart "low and slow" (low intensity and Stretching and Warm-up?
• Ten to 20 half squats with no weight, slow pace) and gradually increase the There is now some controversy over five to 15 push-ups, five to 15 curl-ups, amount of exercise.
whether stretching before exercise pre- 10 arm circles, 10 heel raises, 10 ankle/ vents muscle and tendon injuries. It has toe circles with each leg, 10 hip circles, After two to three months, intensity, been a long-standing philosophy that then slowly run or ride a bike for 10 duration, and frequency may be stretching immediately prior to exercise increased again according to the will prevent injuries. However, there is • Weight training: using a light enough person's age, time constraints, and new research with practical application weight that you can easily do 10 to 15 motivation. But waiting weeks, then that shows stretching prior to exercise or repetitions, perform the following exer- months, to increase intensity, duration, sports participation may not prevent cises: bench press, lat pull-down, shoul- and frequency can decrease the risk of muscle or tendon injury. The research der press, seated cable row, five to 15 injury as well as the risk of dropping out.
provides four possible reasons why curl-ups, five to 15 back extensions, stretching may not prevent injury: squats, leg press or lunges, knee exten- 1. A more flexible muscle and tendon sion, and knee flexion.
Age is a key factor for potential injuries.
doesn't mean that it has a greater • Before running: walk for five minutes, The older we are, the more susceptible ability to absorb forces that may cause jog for five minutes, then start our muscles and tendons are to injuries.
An older adult who is starting an exer-cise program must absolutely follow the 2. Many injuries are not caused by "over- The best way to prevent an injury is to guideline of "low and slow" in the initial stretching" the muscles. Injuries can gradually increase your fitness level: stages of an exercise program. Even an occur within a normal range of motion.
warm up the muscles; stretch after exer- older "fitness athlete" who has been ex- Therefore, a more flexible muscle may cise; use proper form, especially when ercising for a long time must be careful not prevent injury.
weight lifting; get plenty of sleep; de- with his or her intensity, duration, and 3. Mild stretching has been found crease the intensity and duration of ex- especially frequency, making sure there to weaken the muscle for about ercise when under stress; and refrain are days off from exercise.
15 minutes. So stretching, then exer- from smoking.
A Quarterly Publication of the American College of Sports Medicine • The Athlete's Kitchen DO THEY CRAMP YOUR STYLE? Nancy Clark, M.S., R.D., FACSM "I get excruciating What about nutritional remedies? Previ- milk on cereal and yogurt for a snack. This cramps when I play ous theories have suggested cramping good nutritional practice certainly will not tennis in the heat.
is related to fluid loss and electrolyte hurt, and may possibly help.
Could something be imbalance. These theories do not always wrong with my diet?" hold true. For example, musicians, who Theory #3: Lack of sodium. Many
do not often get sweaty, complain of health-conscious athletes restrict their "I cramped so badly during the marathon muscle cramps. Yet, if you are plagued salt intake on a daily basis, believing this I had to quit a few yards from the finish by cramps, you should at least rule out will help prevent blood pressure prob- line. I just couldn't go any further." any possible factor that might contribute lems. However, if these athletes are los- to getting them. Here are a few food tips ing a significant amount of sodium "Should I drink pickle juice to prevent to help you rule out theoretical nutritional through sweat, they may be putting them- selves at risk for developing a sodiumimbalance that could contribute to If you've ever experienced the excruci- Theory #1: Lack of water. Cramps
cramps. This situation is most likely to ating pain of a severe muscle cramp, you often occur when an athlete is dehy- occur in extreme sports such as an may fearfully wonder if it will strike again.
drated. (Although even athletes who are Ironman triathlon or 100-mile trail run, You also may wonder if nutrition imbal- well hydrated get cramps.) To reduce the particularly if the athletes have consumed ances are at the root of the problem and risk of dehydration-associated cramps, only plain water (no sodium-containing if diet changes would be the simple simply drink more than enough fluids food or beverage) during the event.
before, during, and after you exercise.
On a daily basis, drink enough fluids so Theory #4: Lack of potassium. Athletes
Muscle cramps are poorly understood. His- you have to urinate every two to four who sweat heavily may lose some potas- torically, no one has been able to predict- hours. Your urine should be pale and sium, but they are unlikely to become ably cause a muscle to cramp, hindering copious. During extended exercise, drink potassium-depleted. And if they did, the the ability to study the underlying mecha- as much as tolerated, optimally eight whole body would be affected, not just one nisms that contribute to these unpredict- ounces every 15–20 minutes.
muscle. Still, eating more potassium-rich able spasms. Just recently, researchers fruits and vegetables will hurt no one.
found a way to cause cramps. This may Theory #2: Lack of calcium. Calcium
open the door for more research on ways plays an essential role in muscle contrac- Theory #5: Lack of pickle juice. Some
to prevent them from happening.
tions. Anecdotal stories suggest that football players and athletic trainers athletes who eliminate calcium-rich dairy swear two ounces of pickle juice taken We know that muscle cramps commonly products can become plagued by muscle 10 minutes before exercise prevents occur among athletes who work their cramps. For example, a ballet dancer who cramps. The reasons are unknown and muscles to the point of exhaustion. The added yogurt and skim milk back into her untested, but there is no harm in trying! overexertion theory of muscle cramps diet reports her cramps disappeared.
goes like this: When a muscle gets tired, A mountaineer resolved his muscle These are only suggestions, not proven the numerous muscle fibers that com- cramps by taking calcium-rich Tums.
solutions. You might want to experiment prise the muscle fail to contract in a syn- Exercise scientists question the validity of with these dietary tips if you repeatedly chronized rhythm. This likely is related these anecdotes, believing a calcium suffer muscle cramps. Adding extra to over stimulation from the nerves that imbalance is unlikely to be the cause of fluids, low-fat dairy products, a sprinkling trigger the muscles to contract.
muscle cramps. After all, the bones are a of salt, extra fruits and vegetables, and calcium reservoir and can supply what is even some pickle juice certainly will not What to do
needed for proper muscle contractions.
harm you and may possibly resolve the What should you do if you get a cramp? Nevertheless, to rule out any possible link worrisome problem. I also recommend Popular remedies include massage, between a calcium-poor diet and muscle you consult with a physical therapist, stretching, accupressure (relaxing the cramps, I recommend that athletes athletic trainer or coach regarding proper affected muscle by applying pressure to plagued by cramps consume calcium-rich stretching and training techniques.
it), and giving yourself a hard pinch foods at least twice a day, such as low-fat Nutrition may play no role at all.
squarely on the upper lip.



Abstr_Bookl_Symp_SEG_Paris:Abstract_Booklet_Symp_ESC 17.09.2007 11:06 Uhr Seite 1 SymposiumOral contraception and women's wellbeing Friday 12th October 2007,11:10 a.m. to 12:40 p.m., room no. 262 7th Congress of the European Society of Gynecology - 10th to 13th October 2007, Paris, France Abstr_Bookl_Symp_SEG_Paris:Abstract_Booklet_Symp_ESC 17.09.2007 11:06 Uhr Seite 2

Mathematics: traditions and [new] practices

MEASURING ACADEMIC NUMERACY: BEYOND COMPETENCE TESTING University of Southern Queensland Academic numeracy consists of three critical elements: competence, confidence, and critical awareness of students' own mathematical knowledge and the mathematics used in students' future professions. This definition is used to frame pre-test assessment in a first year nursing program. Competence and confidence were measured using a paper and pencil test. Critical awareness was measured via students' reflections on their own performance, their relationship to mathematics, and their understanding of how mathematics relates to nursing. Results show issues related to professional numeracy practices including relatively low understanding of the connection between mathematics and nursing.