ANATOMY of FITNESS

FADS MAY COME and go, but the tide of health and fitness just keeps on rising. Lonely narcissism about exercise is out; the social approach is in. No longer are we exercising just to lose a few pounds or meet somebody at a health club. Now, it’s a community issue of optimal body fat and low cholesterol. When someone asks, “How are you?” they probably really mean it. The health and fitness trade has even got a grip on our corporate love handles-In-house fitness programs are growing at a trot of 10 to 25 percent each year.

All this has led to the rise of a new breed: healthy urban fitness fanatics who can play the fitness market as well as the stock market. These 25- to 44-year-olds-the major targets of the health and exercise market-already account for more than a quarter of the nation’s population. And in four short years, 32.6 percent of all of us will be in this age group, lacing up our Reeboks and stretching the Spandex before and after work.

The following pages are a compendium of health and fitness facts-and fads-plus a look at the latest equipment and good-health gadgets. Your body beautiful may be just a bench press away.

from HEAD to TOE

“NO RUIN. NO GAIN’ AND OTHER MYTHS



Admit it: You avoid exercise because it takes too long and you simply don’t have the time. Besides, the workout will have to hurt to be any good. You just have one teensy-weensy problem area to work on, anyway, so why not opt for a sauna suit and lose 10 pounds or 10 inches, whichever comes first?

Sound familiar? These scattered myths and half-truths have persisted for years as convenient, convincing ways of ignoring the call to fitness. “You’ll be lucky if you don’t overheat or suffer heat stress in those sauna wraps,” says Margie Hallstrand of the Health Institute at St. Paul Hospital. “It’s like being in a plastic bag. Your body can’t breathe, plus it doesn’t work. The only weight loss is through dehydration and is potentially dangerous.”

Contrary to popular belief, exercise does not require a lot of time (aerobic exercise takes just 20 minutes to offer benefit); if exercise starts to hurt, stop (your body is telling you something); and there is no such thing as “spot” reducing (fat comes off the total body, not isolated areas).

Other pesky myths, says Hallstrand, are those that encourage people to eat extra protein if they do extra exercise and those that say muscles will turn to fat if you stop working out. Women, she says, won’t become muscle-bound by lifting weights-if they do it correctly and with the right number of repetitions. Of those famous women body builders: “A lot of muscle comes from synthetic hormones,” she sayS.

There are no shortcuts to fitness, says Dick Verstraete of Harris Hospital in Fort Worth, which offers SHAPE: Specialized Health Fitness Assessment and Personalized Exercise Program. The goal of serious health and fitness centers, he says, is to help their clients achieve optimal well-being-a state he describes as “a combination of three important components: physical, mental and spiritual fitness.”

■ Man, it seems, does not live by Nautilus and wheat germ alone.



ON THE HEALTH HORIZON



The next yogurt, the next sugar substitute, the next tofutti will be any product that reduces chemical exposure, intake or ingestion, says Michael Farino, manager of Esprit de Cure, a health food/restaurant/ pharmacy/grocery/ bakery/ nutritional counseling center on Upper Greenville. The store aims for total environmental purification by selling products that are “as natural as can be determined.”

In today’s environment, that takes a lot of determining. So to help whittle down the mountain of pollutant-packed products out there, the store provides information on those foods that contain sizable amounts of pesticide, insecticide and artificial coloring. (An apple a day probably won’t keep the doctor away-it’s one of the fruits flagged as often contaminated with poisonous residues.) Esprit de Cure even carries Radical Fighters, pills specifically designed to combat those chemicals that we can’t seem to escape.



ALONG WITH THE folks at Esprit de Cure, the staff of the Environmental Health Center regards the pollution of our environment as a clear and present threat to the health of America. If you’ve ever had a cold that won’t go away, you’ll probably understand what they’re talking about.

The center maintains that many health problems can be the result of chemicals, radiation, inhalants, electrical fields and microorganisms in the environment. These problems, they say, can run the gamut: heart irregularities, shortness of breath, headaches, eczema, hives, depression, learning disorders, muscle ache, chronic infection, abdominal and chest pain, arthritis, constipation, sleep disturbance, dizziness, fatigue, upset stomach, joint pain, anxiety, swelling and spontaneous bruising.

The center at 8345 Walnut Hill Lane has equipped its clinic with a specially designed “depollution” system. The ceilings, for example, have built-in less-voltage ionizers to eliminate solid particulates from the air. Among the treatments offered by the clinic are varied diets, nutritional supplementation, osteopathic manipulation and immunotherapy. Surgery and medication are used when indicated but the center’s goal is to decrease their use as much as possible.

EYEING THE OPTIONS



The introduction of soft contact lenses brought hope for legions of teary-eyed hard contact wearers. For a majority of the fuzzy-eyed, the light was clear. But many of those with astigmatism (misshapen corneas) were still in the dark. These would-be contact-wearers need the rigidness of hard contacts but the comfort of soft.

Now, new hope has arrived in the form of extended-wear lenses that are 58 percent water. They’re thinner, very permeable and can be worn for up to two weeks at a time. The latest development, report ophthamol-ogists, is Saturn II, a lens that affords crisp vision and soft fit at the same time. The center, which fits over the iris, is a semipermeable disk surrounded by a soft skirt.



AND NOW YOU can see well and look good, too-with an Accent or Natural Eye micro-pigmentation instead of manual applications of mascara-based eyeliner. The procedure, which permanently lines the eyes with color, is akin to tattooing. But, says one beauty seeker, it alleviates the hassles and messiness of eyeliner. “And it’s great for rushed mornings.”

This is cosmetic surgery and the province of plastic surgeons. The surgeons we surveyed weren’t overly thrilled with the operation but did admit the cosmetic benefit to certain patients. The procedure costs around $575 for both upper and lower lids.



BLOWING SMOKE



You think you’ve tried everything-a gradual cutback, nicotine gum, cold turkey-and nothing has worked. Two packs a day for 20 years has brought you to the butt-end of your tobacco road. Your mother nags about the cough, your wife nags about the expense, your children nag about the smell. And your favorite restaurant has just banned you from lighting up. Feeling persecuted, you watch remorsefully as the world puts up a “no smoking” sign. (Since 1978, smoking has dropped 30 percent in the United States.)

If you’re ready to join the ranks of the smokeless but need a little extra help, you might give the following methods a shot:



OF PUFFS AND NEEDLES

The ancient cure-all of acupuncture calls for needles to be inserted in strategic pressure points (ears, wrists) that supposedly control smoking urges. This, says Italian acupuncturist Marco Biancardi of Acupuncture Associates, allows the nervous system to calm down and suppresses the nicotine and food appetite. With two treatments, along with some mild electrical stimulation, pack-a-day smokers can kick the habit, says Biancardi, who estimates his success rate at 70 percent. Those who smoke more than a pack a day may need more treatments, he cautions. Each visit is $50.



MORALE BOOSTING

Doctors at the Nicotine Withdrawal Clinic carry the “pressure point” theory a step further by using injections of vitamins and minerals to react to the nerve ends. The vitamin compound stimulates the production of endorphins, the secretion that satisfies the urge for nicotine. It’s a one-time-only procedure, but patients take home supplies of calcium and vitamin compounds to be taken four times daily from two to two and a half weeks {the time, says a clinic spokeswoman, it takes for the body to rid itself of nicotine cravings). The $195 procedure, says the spokeswoman, is safe for “anybody who puts nicotine into his or her body-no matter how it gets there.” (The five-year-old clinic boasts a 71-percent success rate.)



MINDS OVER MENTHOL

Hypnosis has proven to work in kicking the demon nicotine, says Gloria Wilburn at the Self-Help Hypnosis Center. The key to quitting, she says, is to reach the memory banks, where the smoking habit is stored, then restructure the habit pattern. “We can’t erase,” she says, “but we can reeducate.” Clients receive a cassette tape to take home to help reinforce the message. The one-time visit, including a reinforcement tape, is $75; in a group, it’s $55.



NOTE: Several clinics in Dallas offer acupuncture and medical injections. These procedures are termed “preventive” and smokers will have better luck with insurance agencies if they can get a prescription from their family doctors stating that they need to stop smoking for health reasons.



THE NAKED TRUTH ABOUT BOO FAT



First the good news: You’re supposed to have body fat, different percentages depending on your gender. The bad news: You’ve probably got too much.

Unfortunately, those height/weight tables don’t do us much good when it comes to finding out about how fat we are. The tables are based on height and frame, not on body composition (muscle mass). The most reliable resources for determining body fat are caliper and underwater testing. Caliper testing involves the pinching of certain folds of skin, usually on the upper arms, with a plier-like instrument that measures fat. This relatively painless procedure is the most widely used method. Underwater testing, more expensive and time-consuming, uses the displacement theory in gauging the body’s fat content.

Average American men over 30 carry around about 25 percent of fat and their female counterparts cart around an average of 31 percent. Uh-oh. A few of the undesirable consequences of too much fat: a higher death rate, especially in a younger age group; a higher incidence of arteriosclerosis, hypertension, diabetes and cirrhosis of the liver; increased risk of accidents and surgical complications; and increased risk of chronic back problems.

But on the opposite end of the scale, Gloria Vanderbilt isn’t completely right, either. You definitely can be too thin. Researchers have found that there seems to be a biological limit below which a person’s body weight should not drop. Harvard researcher Dr. Rose Frisch, in Evaluation of Body Composition, considers 17 percent fat to be the critical number for an adult. Reducing below this weight, she says, triggers hormonal and metabolic disturbances.

All of us know about Bad Fat, but you may be surprised to learn that there is Good Fat as well. Good (essential) Fat is stored in the marrow of bones as well as in the heart, lungs, liver, spleen, kidneys, intestines, muscles and central nervous system. We need this fat for normal physiologic functioning.

The staff members at the Las Colinas Preventive Medicine Center are body fat specialists. They caution clients to know their ratio of lean to tat tissue before embarking on an exercise or diet plan. Knowing how much of you is fat is a better way to gauge your fitness than mere body weight, they say. The fit have more weight in lean muscle and less in body fat than the unfit.

Body weight can be divided into fat weight and lean body weight (LBW). which is composed of muscle, bone and connective tissue. Your optimal (ideal) weight is determined by keeping your current LBW constant and getting your fat to an ideal level.

If you’re just five pounds shy of your ideal weight, don’t worry about dropping from a heart attack, say counselors. But don’t sign up for the Boston Marathon, either. Your capacity for endurance activities might be greater at a weight lower than what you consider your optima) poundage to be.

Body weight remains constant when you exercise off the same number of calories that you put in. So. to gain or lose one measly pound of flesh, you’re fighting 3,500 calories. More bad news: There are no quick fix-its. The most effective weight-loss program combines diet and exercise. Regular exercise not only drops calories, it keeps you lean. (Dieting alone ignores muscle tone.) Las Colinas’ staff recommends that you bump up your workout to sweat off another 250 calories per day.

Here’s how:

FIGHTING THE DANGERS WITHIN US

We may still be in the 20th century, but current advances in medical technology- along with their price tags-are definitely futuristic. Witness the emergence of Magnetic Resonance Imaging (MRI), a radiation-free screening procedure that can help diagnose soft-tissue and brain disease-most notably multiple sclerosis.

Last May, we reported that two of the country’s 100 $1.7-million MRI machines were in Dallas at the University of Texas Health Science Center and Baylor University Medical Center. Now there are three, with the December installation of the latest at MRI Associates of Texas, a private diagnostic facility, managed by Radiology Consultants of North Dallas. (By the end of 1986, the number of scanners in the United States is expected to grow by an additional 100.)

In MRI, harmless radio waves and magnetic fields create images of the body’s internal organs and other body tissues (sort of a medical Zap Mail). No x-rays, radioactive tracers or intravenous radiographic dyes are presently used. The magnetic forces stimulate the hydrogen atoms in a person’s body. A receiver within the machine absorbs the emitted energy. With the help of a computer, sharp images of the body’s soft tissue are created.

“Virtually everything in the entire world of diagnostic radiology is taking a back seat right now because of the fantastic advances of MRI,” says Dr. Philip Shalen of MRI Associates.

To be “studied” with MRI, you’re placed in a large, cylindrical-shaped scanner (like a giant thermos). The study usually takes from 15 to 60 minutes, depending on what part of the body is under scrutiny. At MRI Associates of Texas, patients are provided with stereo headsets. You can select certain radio programs or bring your own cassettes. Some patients just opt for a short nap.

Much of the enthusiasm for MRI is based on its diagnostic ability in helping to eliminate the necessity for other tests, including surgical exploration. MRI is also capable of discovering some diseases-such as asymptomatic brain tumors-even before symptoms have started.

Some may balk at the expense of MRI (a routine screening runs approximately between $600 and $650), but the staff at MRI Associates believes that a MRI study is a valuable preventive measure. In the long run, they claim, MRI can save patients innumerable dollars in alternate testing, possible hospitalization and treatment.

An interesting note on medical imaging procedures: Many insurance companies encourage out-patient diagnostic services because they are more cost-effective than in-patient services.



SILICON OH BUST



Big breasts are still big business. Augmentation mammoplasty, more commonly known as breast enlargement, is performed more often than any other cosmetic surgical procedure, edging out nose jobs, face lifts, tummy tucks and others.

More than half a million women a year are augmented in the United States, and the numbers are growing. So is society’s acceptance of artificial enlargement. Whether for aesthetic reasons or for reconstructive purposes following a mastectomy, a woman’s decision to receive silicon implants is no longer met with raised eyebrows.

As a leading plastic surgeon in Dallas, Dr. Vasdev Rai sees all sides of the issue. His office is filled with photograph albums of “be-fores” and ’’afters.” Rai carefully screens his patients, sometimes refusing the operation if he thinks a patient is trying to substitute breast enlargement for achievement or self-worth. “Some women think that breast augmentation will change their life,” he says. ’They’ve been trying to find an excuse because they can’t achieve something.” Often, says Rai, these women will ask, “Hey, doc, what can you do for me?” “They don’t know what’s wrong with them, but they want me to fix it,” he says.

But for others who sincerely want to enhance their appearance and have talked of a breast operation for years, Rai is supportive. He walks his patients through the process, explaining each step, confident that “it’s going to make them feel good about themselves.”

Rai finds that some women simply demand too much of his specialty, unaware that no surgical magic can turn Carol Burnett into Dolly Parton. “Many patients don’t realize that plastic surgery has its limitations,” he says. “They bring in a picture that they want to look like. I can only improve on what they have.”

America’s perception of “perfect” breast size appears to grow larger from east to west. According to Dr. Fritz Barton, chairman of the plastic surgery department at Southwestern Medical School, East Coast surgeons on the whole use smaller implants than Midwestern surgeons, and Midwestern surgeons use smaller implants than those on the West Coast. (In layman’s terms, that means a B cup in New York and a C in the Midwest, rounding out with a D in California.)

While breast augmentation may get all the headlines, it’s only a part of the picture. Breast reduction, uplifts and recontouring are gaining ground, and not just for cosmetic reasons. Heavy and large breasts can pose several health problems, including shoulder and back pain and poor posture as well as difficulty in self-examination for cancer. (Since these operations may be undertaken for health reasons, insurance companies may cover the cost.)

In recontouring, the breast is neither enlarged nor reduced but the shape is changed, resulting in a more youthful, firmer look. Augmentation or reduction can be combined with this operation. The cost for cosmetic breast surgery ranges from $2,000 to $3,500.

In the area of reconstructive surgery, breast surgery is more than a medical procedure-it’s a vital step to help a woman put her life back together after a mastectomy or double mastectomy. In this surgery, one or two breasts (including nipples) are actually created by the doctor, using silicon implants and the patient’s own skin and tissue.

Rai cautions women to know who their plastic surgeons are. Many doctors practicing various plastic surgery procedures have not been certified by the American Society of Plastic and Reconstructive Surgeons (ASPRS). “Ask if they are board-certified,” he says.



AEROBICS AND AEROBICS



With every action there is a reaction. So it is with the fitness boom. The parable, “overindulge and pay the price” is becoming a reality for the swelling ranks of amateur runners, joggers and aerobic dancers who lack the necessary strength and stamina or who ignore vital warm-up for intense exercise. Hard isn’t necessarily better, as strained hearts and throbbing legs testify.

But that doesn’t mean aerobic exercise has to be crossed off everybody’s fitness lists. Low Impact Aerobics (LIA), a softer approach to cardiovascular exercise, is treading lightly into America’s fitness routine. Locally, Aerobics to Go, an aerobic dance studio, has incorporated LIA into its program.

American Health magazine reports that “LIA is a less jarring method of burning fat and enhancing cardiovascular fitness. It takes the jogging, jumping and other potentially injurious moves out of the dance routines, replacing them with steps that don’t force the joints and stretches that aren’t ballistic or bouncy.”

Some of the LIA steps include side steps and dance/walk combinations. One foot stays on the floor to reduce the jarring impact of most hops and jumps. Heart rates don’t go up as high and movements are more fluid.



IS CELLULITE FATTY FICTION?



The answer to one of the most-contested issues of the 20th century turns out to be somewhat of an anticlimax. Cellulite, we find, does exist, but it’s fat-just like we’ve always suspected. It’s lumpy (no surprises here) and is harder to dissolve than most fat, but scientists don’t know why. “Under the microscope,” says one local plastic surgeon, “there is no difference. Cellulite cells look like all other fat cells.”

We can thank the French for bringing this tissue issue to our attention: In 1973, beauty expert Nicole Ronsard coined the term “cellulite,” describing it as localized accumulation of fat on an otherwise proportioned figure. Scientifically, cellulite is described as abnormal fat due to accumulation of metabolites-located on the arms, back, belly, buttocks, thighs and knees-and is distinguished by a ripply appearance when grasped between the thumb and forefinger.

Despite the world’s recognition of what some call “dimples” and others call “chubb,” the term has yet to make the dictionary. That doesn’t stop most of us, however, from considering it a national epidemic and clamoring for special diets, massage and exercise-which the mail-order beauty business has been more than happy to provide.

Alas, most women (and some men) find that cellulite won’t go away despite intense exercise and questionable beauty aids. But read on: You still may be able to win the battle of the bulge.

SADDLE BAGS: LOVE ’EH OR LEAVE ’EM?



We can thank the French, again, for their fixation on fat. Welcome to the world of liposuction. The “sucking of fat” from trouble spots was introduced in France around 1977 and has been slowly introduced in the United States since 1982.

Cosmetic surgeons across the country are quickly adding the procedure to their repertoires. Dr. James Fowler of the Cosmetic Surgery Center of North Dallas became trained in the art of liposuction in France soon after the procedure was publicized. Most often, he performs liposuctions on the upper thighs and buttocks (“saddle bags”) and on the abdomen and lower back (“love handles”). He is enthusiastic about its applications: “It won’t make a 10 out of somebody,” he says, “but it can help some women to lose up to two dress sizes and feel better about themselves.” (Some of us feel better just knowing about it.)

The operation’s relative newness and promising results naturally fuel rumors that the fat reduction is only temporary and the procedure is dangerous. Fowler dismisses such talk. The fat cells that are “sucked” off a particular location will not return. “You are born with a certain number of adipose tissue cells (fat). When they’re gone, they’re gone.” (It’s possible, of course, to lose total dietary control and gain weight. But often, says Fowler, patients report weight loss after the surgery in other parts of their bodies.) “What surprises many patients.” says Fowler, “is that although inches are removed, the procedure may not result in significant weight loss.”

The risks associated with liposuction surgery are low. As with all surgery, there are certain risk factors such as bleeding and infection, says Fowler. And he mentions slight possibilities of irregularities and numbness of the skin in isolated areas. But after thousands of documented operations, no significant risk has been identified. The benefits of liposuction surgery, say local doctors and patients, definitely outweigh (so to speak) the disadvantages.

The surgery is ideally for those in their teens through age 40, although age is not a limiting factor. But after 40, says Dr. Fowler, the skin may have lost some elasticity and won’t snap back as well.

Generally, liposuction surgeries are cosmetic procedures and run in the neighborhood of $2,000. The operation, warns Fowler, is not intended as a substitute for diet or exercise.

THE INVISIBLE PAIN

Your shoulders ache, your neck throbs and you’re thinking about throttling your doctor. He says that nothing’s the matter with you. Ha!

The methods of acupuncture, long embraced in the Orient and Europe, are finally becoming accepted in the United States as a way to cure pain. According to medically certified acupuncturist Susan Ho of the Acupuncture Therapy Clinic, people with no structural damage to their backs are the best candidates for treatment. Acupuncture, she says, can cure soft-tissue damage and sports-and accident-related injuries but not pinched nerves or ruptured discs. (Acupuncture, however, can help relieve the pain of these ailments, she says.)

Usually two or three visits relieves it, she says. The first visit costs $60; each subsequent visit is $50.

Much of the skepticism about acupuncture exists, says Ho, because the biological basis ’or the procedure couldn’t be proven scientifically. X-rays could show the physical pan of the body but not the energy (or “Chi”). Ho says that changed in 1939 when a Russian scientist named Semyon Kirlian captured the body’s energy in the Kirlian Photographs, a series of photographs that allegedly show pathways of electrical energy in the body. Acupuncturists believe these photos “are the first things that can visually prove that Chi flows in the body,” says Ho.

The theory of acupuncture maintains that the body system is an electricity field, with pathways of electricity (positive and negative) continually flowing. Pain occurs when a pathway is diverted. Acupuncturists locate the control centers along the pathways (also called meridians) and insert needles to put the electricity back on track.

The Kirlian Photographs have been widely recognized in Europe and hospitals in the Orient. Ho is optimistic about the current acupuncture research under way in this country.

KNEELING FOR MERCY

More than two years ago, we reported on arthroscopic surgery, a technique in which a tiny fiberoptic telescope (super-thin glass tubes that transmit light) is inserted into the knee joint through a small incision as a second incision allows surgical instruments to enter the joint. All this is watched on a miniature color TV, which is also recording the procedure.

Used primarily as a diagnostic tool, arthroscopic surgery can also determine different types of arthritis and remove and repair torn cartilage. (Cartilage tears account for more than 60 percent of all knee problems.)

“It’s definitely the state-of-the-art method for most knee problems,” says Dr. Carl Highgenboten, an orthopedic surgeon who estimates that he has performed more than 3,500 procedures since 1975. Most surgeries take less than an hour and the recovery time is just a few days. There is no age limitation tor the surgery, says Highgenboten, who has seen patients ranging in age from a four-year-old to a 85-year-old competitive tennis player. With age, though, the bones and cartilage become more brittle. “After a person goes through the teens and 20s,” says Highgenboten, “it’s not hard to tear cartilage.”

The near future, predicts Highgenboten, will see the development and widespread use of arthroscopic surgery on shoulders.

Dr. John B. Gunn, an orthopedic surgeon who frequently performs arthroscopic surgery, cautions that the procedure is not a panacea. Often, says Gunn, arthroscopic surgery is chosen when less costly, more traditional orthopedic procedures could serve as well. The short recovery time is one factor in the proliferation-and possible abuse-of arthroscopic surgeries, he believes. “People don’t want to wait to recover. They want to get up and go.” Arthroscopic surgery generally runs in the neighborhood of $1,800.

Gunn, who has practiced orthopedics for 25 years, has seen just about every type of knee injury possible from private patients to professional athletes. Football, he adamantly believes, is the biggest culprit in mangling knees. But over-enthusiastic joggers (especially those over 30) can count on their share of damaged or worn-out cartilages, too.



AT WHAT PRICE HEALTH?

All this getting-and staying-fit is not cheap. We might be healthy as horses, but the health and fitness boom is leaving some of us poor as paupers. Shape magazine reports that in 1983 (latest compiled figures) Americans spent about $1 billion on exercise equipment, leaping up 33 percent from 1982. We forked over an additional $50 million on diet and exercise books, $1 billion for athletic footwear, $8 billion for ac-tivewear and another $5 billion on health foods and vitamins. And in response to our enthusiastic embrace of the fitness boom, health clubs and corporate fitness centers spent an estimated $5 billion to get our business. Meanwhile, sports medicine has become a $2 billion-a-year specialty.

Industry experts predict that the billions will continue to flow for at least a decade as America continues to firm up, slim down and eat right.