“Overall, the results of this study do not support the role of estrogen in the treatment of AD,” wrote study authors, led by Ruth A. Mulnard, R.N., D.N.Sc., of the Institute for Brain Aging and Dementia at the University of California, Irvine.

The study, the largest and longest of its kind, randomly divided 120 women with mild to moderate Alzheimer’s disease into three groups: one receiving a low dose of estrogen, another receiving a high dose of estrogen and a third receiving a placebo pill, which did not contain estrogen. Only women who had had a hysterectomy prior to enrollment were eligible for the trial. Ninety-seven women completed the study.

Researchers followed the progress of the patients for up to 15 months, regularly assessing their overall mental ability in addition to their mood, memory, attention, language skills, motor function and daily living activities.

Estrogen replacement therapy did not slow the mental decline of the Alzheimer’s patients studied. Eighty percent of the patients taking estrogen showed deterioration in their conditions compared to 74 percent of the patients taking a placebo. Low doses of estrogen were associated with some initial, short-term improvements in mental ability, consistent with earlier studies. This progress, however, was not sustained for the study’s duration.

In an interview with the American Council on Science and Health, Mulnard said she and her colleagues were surprised and disappointed by the findings. But, Mulnard added, “the results are very important to women. Positive or negative, the study is an important contribution.”

Alzheimer’s disease is estimated to affect more than 4 million people in the United States. The majority are women. The disease, which typically begins after age 60, is characterized by a progressive deterioration of memory, language ability, visuospatial skills and judgment. Currently, there is no cure for Alzheimer’s, although some medications are effective in easing certain symptoms.

While the latest study indicates that estrogen is not effective in treating existing AD, study authors remain optimistic that estrogen may still prove useful in preventing or retarding the start of AD.

“This is a definitive study for the kind of women we studied,” Mulnard said. “But, it does not answer questions for all women with Alzheimer’s disease.”

“One thing is very clear,” Mulnard stressed, “Estrogen could still play a very big role in preventing disease.” She noted that there are already several large studies underway examining whether estrogen may prevent AD.

In an editorial accompanying the latest report, Yale researchers emphasized that the findings could only be limitedly generalized. They also encouraged more research on estrogen and Alzheimer’s disease.

“The conclusions are valid only for a very specific population, women of advanced age (approximately 75 years) with AD of mild to moderate severity,” commented Bennett A. Shaywitz, M.D., and Sally E. Shaywitz, M.D. “It remains for future studies to determine the role of estrogen, if any, in preventing or delaying the onset of AD.”

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Interestingly enough, a study of the intensity of music was avoided, and physical movements involved were concentrated on instead. It was concluded that “jumping up and down” could potentially disturb the ciliated cells of the inner ear and that, in turn, could result in a decline in hearing. Such a relationship has never been substantiated and probably never will. However, the fact that the intensity level of the music was not studied is untenable in light of the subjective evidence that the music level in such environments is often found to be extremely high.

The study(3) that did examine average intensity levels of music in health clubs revealed intensity levels in one-hour aerobics classes that consistently ranged from 100 db to 120 db.

In one instance, the music reached a level of 122 db for a 20-minute period during a high-impact aerobics class.

This led this investigator to conclude that a more extensive study of intensity levels of music in aerobics and body-conditioning classes was warranted. Such a study could provide owners and managers of health clubs with information to protect the residual hearing of participants and aerobics instructors who may not be aware of potentially damaging effects of music at its present levels.

To build the $400,000 center, PGA transformed two racquetball courts and some extra hall space into a mini club. The facility includes a 1,600-square-foot aerobic room that also serves as a site for free fitness seminars, separate areas for cardiovascular and selectorized equipment, a stretching area, and a computerized fitness testing center.

In addition to seminars, a variety of classes are held at the new facility, including a couples stretching class, country line dancing, tennis aerobics, kick boxing and traditional aerobics and step classes.

To encourage clients to stick to their workouts, duplicate exercise machines were installed in the existing fitness center, allowing members to follow their personalized programs when not under the supervision of a trainer. “They’re really dedicated to sticking to it so that when they meet with their trainer, they’ll have improved,” Myers says. This commitment to exercise has also led to nearly 75 percent of the facility’s members being fitness tested in the past year.

Generating extra revenue

In addition to offering one-on-one training, the personal training center serves as host to corporate health-promotion programs, allowing it to bolster its status as a mega profit center. Its corporate team-building program, “Fitness Olympics,” awards participants for fitness ability and improvement, and motivates them to adhere to regular exercise.

“We try to break it down so that the people who maybe aren’t the greatest golfers — but who exercise — are getting recognized for working out,” Myers explains.

And like the centers’ one-on-one sessions, Fitness Olympics means big business to PGA, with each event generating between $3,000 and $4,000 in just three hours. It’s revenues like these that Myers says will help the center pay for itself in less than four years.

So what does the future hold for this now cutting-edge facility? According to Myers, PGA is hoping to open a physical therapy unit in the near future, and begin hosting more national industry events and conferences like the AFAA Academy, which was held there last July. Most importantly, Myers says the PGA fitness center wants to continue finding innovative ways to serve its members. “Our motto is to uphold the industry standards of a great commercial club with the service of a fine resort facility,” he says.

However, research reported in the February 2000 issue of the Journal of the American College of Cardiology suggests that while very high doses of vitamin E may be helpful in improving short-term changes in artery function after smoking, it cannot reverse established blood vessel abnormalities in smokers.

Smokers’ arteries are more likely to develop fatty deposits, or atherosclerosis, and become less elastic than arteries of nonsmokers. One aspect of arterial function that worsens with smoking is dilation, or expansion, of the arteries when blood flow through them increases. Smoking appears to decrease an artery’s ability to widen when necessary. Such a lack of arterial dilation could lead to diminished blood flow to the heart. If it continues, a heart attack might result.

The researchers, from the Universities of Innsbruck and Vienna, Austria, studied the arterial dilation of 22 healthy young men, with an average age of 27, who smoked about a pack of cigarettes per day. Eleven of the men took a high dose vitamin E supplement (600 International Units) every day for four weeks; 11 others took an inactive compound for the same period. These groups were also compared with a matched group of 11 healthy nonsmokers.

To measure arterial function, the researchers used a blood pressure cuff to compress each subject’s brachial artery, a large artery in the upper arm, and then released the pressure. Normal response to such manipulation is a widening, or dilation, of the artery after the pressure is removed. The widening was measured by an ultrasound technique, which produced an image of the artery.

Before the study began, the investigators measured the dilation response of the brachial arteries of both smokers and nonsmokers. They found that the smokers’ arteries did not expand to the same degree as did the arteries of nonsmokers.

After four weeks of high-dose vitamin E supplementation, the subjects were examined again — at least two hours after they had smoked a cigarette. In these tests, there was no difference between the arterial responses of smokers who had taken vitamin E supplements and smokers who had not.

The arterial responses were measured again 20 minutes after the smokers had smoked a cigarette, and in this case, vitamin E did seem to affect arterial dilation. In smokers who had taken vitamin E, the arterial dilation was more normal than in the smokers who had taken the placebo pills.

The authors interpreted these results as indicating that four weeks of vitamin E supplementation could not reverse the chronic arterial dysfunction that accompanies cigarette smoking. They did note that there seemed to be “a partially beneficial effect of vitamin E supplementation. … it prevented the transient further impairment of vasodilatation after acute smoking.”

“The potentially beneficial effect of high doses of vitamin E on arterial widening in smokers is so short-lived as to be a nonfactor,” commented Dr. David Kritchevsky, institute professor at the Wistar Institute in Philadelphia. “If smokers want to preserve their blood vessels and heart, the best way to accomplish this is by quitting smoking. It can’t be done with a pill. The best way to get vitamin E is from the grocery, or the cheap pharmacy,” he added.

It should be noted that the level of vitamin E supplementation in this study — 600 International Units — was quite high compared to the dietary amount recommended for healthy adults, which is 12 to 15 International Units per day.

To keep its business from giving way to mediocrity, PGA decided to renovate its existing fitness center, and in the process, devise a way to better serve its mostly 50-plus membership. The result is a new 4,000-square-foot personal training center that provides one-on-one exercise instruction to hundreds of clients per month — a service that is welcomed by many of the club’s clients who seek sport-specific training for activities like golf and tennis. “We’ve really had a phenomenal response,” says Myers. “The first year [the existing fitness center] offered personal training we brought in $30,000 in gross revenue, but now, with the personal training center, we’re bringing in $18,000 to $27,000 per month.”

The new center, which opened in March 1994, has also helped double daily usage of the existing fitness center, with an average of 320 people using the facility each day. Likewise, Myers says the center has gone from performing 40 personal training sessions per month to upwards of 750.

When planning the development of the center, PGA banked on three reasons why a personal training facility would work in a resort atmosphere: It was dealing with a population that was uneducated about fitness, its clients had discretionary time and, not least important, PGA members generally have sizeable incomes. Additionally, Myers says scheduled workouts are ideal for the club’s average client. “People like the commitment that’s involved,” he says. “They want to have a standing appointment to stay motivated.” To meet this need, the center sells clients 10 to 12 sessions in advance, thus creating a commitment for the client, and providing revenue upfront for the center. Judging by the facility’s two-week waiting list for one-on-one sessions, the method appears to be working. Since opening the facility, PGA has been able to hire an additional 16 full- and part-time trainers, with increased wages being off-set by a profit margin of about 58 percent per fitness service.

With any new mode of exercise there is concern related to its supposed training benefits.

Currently, the Human Performance Laboratory at Auburn University at Montgomery is investigating the effectiveness of slide board exercise.6,9,10,11,12,13.

This article will review research findings that specifically relate to this form of exercise.

Although natural male hormones, such as testosterone, are legally available only with a doctor’s prescription, there are some substances, sold as dietary supplements, which promise to have the same effects. One such supplement is the hormone androstenedione.

New research reported in the Feb. 9 issue of the Journal of the American Medical Association begins to clarify some of the results of androstenedione supplementation — at least on young men.

While marketers tout androstenedione (often advertised as “Andro”) as a “natural” bodybuilding aid, little solid scientific evidence exists to support either its effectiveness or its safety.

The adrenal glands, testes and ovaries produce androstenedione. The body can convert it to testosterone (the main male hormone), and also to the female hormones estrone and estradiol. It is the possibility of conversion to testosterone, responsible for men’s greater muscle mass, that is the basis for androstenedione’s use as a muscle-building, or anabolic, supplement.

Researchers from Massachusetts General Hospital in Boston, University of Massachusetts Medical School in Worcester and University of California Los Angeles Medical School collaborated to investigate the effects of androstenedione supplementation on hormone levels of 42 young, healthy men (average age 26 to 32). The subjects were randomly assigned to receive either 100 milligrams or 300 milligrams of androstenedione daily for seven days. Another, matched group received no supplement.

Blood samples were drawn on the first day of the study before supplements were taken, and at intervals for up to eight hours later. The sampling was repeated on the last day of the seven-day study. The blood levels of several hormones were measured — androstenedione, testosterone, estradiol and estrone.

The investigators found that the androstenedione supplements, even when taken for only one week, did significantly increase levels of testosterone in the subjects’ blood, but only at the 300-milligram-per-day level. The level of the female hormone estradiol was also significantly higher in the supplemented groups of men — at both the 100-milligram and the 300-milligram dose. After seven days of supplementation, 12 of 15 subjects in the 100-milligram group, and 10 of 14 subjects in the 300-milligram group had estradiol levels that were above the upper normal limit for men.

The authors noted that because of these alterations in sex hormone levels, high-dose androstenedione supplementation could have feminizing effects in men, and possibly have masculinizing effects in women. They also suggested that in children such supplementation ” … could cause precocious puberty … thereby compromising final adult height.”

Dr. Benjamin Leder, lead author of the study, commented, “Androstenedione supplementation causes a variety of hormonal imbalances, and we don’t know what the health effects of these would be over the long term. There is certainly a potential for adverse effects.” He continued, “Until a long term clinical trial is completed, people who use these supplements should be aware that we have virtually no information about their future effects.”

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In order to evaluate exercise intensity of slide board exercise, Auburn University’s Human Performance Laboratory evaluated the exercise intensity of 34 women while “sliding.”12 The average age of the subjects was 24.3 years old, and average weight was 132 pounds. The women performed the standard sliding technique on 5- and 6-foot slide boards. The standard sliding technique is a basic maneuver closely resembling the mechanics used while speed skating. Subjects started in a position with the knees and hips flexed, and then pushed off with the outside foot and slid to the opposite end of the board. They then performed the same maneuver and returned to their original position. This is a four-count movement that was monitored with a metronome.

Subjects completed 30, 40 and 50 slides per minute. Sliding from one end to the other and back constitutes one slide. The 30, 40 and 50 slides per minute were performed to a four-count beat which corresponded to a music cadence of 120, 160 and 200 beats per minute.

While performing the sliding exercise, subjects were connected by wiring and tubing to a metabolic measurement system. The metabolic system provided data indicating the subjects’ heart rate, oxygen consumption and number of calories per minute. Heart rate and oxygen consumption indicate the relative intensity of the exercise. While performing the basic slide technique, heart rates ranged from 143 beats per minute on the 5-foot board at 30 slides per minute, to 186 beats per minute on the 6-foot board at 50 slides per minute. The results of this study indicate that slide board exercise can meet, or exceed, the ACSM guidelines in terms of exercise intensity.

“The goal of Fitness Minute was to create a positive image among the over-35 age group via an educational forum,” says Briddell. “We’ve spread the message that people of all ages, shapes and fitness levels can feel comfortable exercising at our facility.”

When the club first opened in the winter of 1995, Briddell says there was a public perception that World Gym was a bodybuilding/powerlifting gym. “The Fitness Minute has unquestionably helped establish World Gym of Saratoga as a bonafide health club, not just a gym,” Briddell says.

To get Fitness Minute on the air, World Gym agreed to buy $3,900 of advertising throughout the year at WJKE The Jockey, the only radio station that broadcasts directly from Saratoga Springs.

The station airs the address every weekday morning, and has twice invited Briddell to represent the facility as the featured guest on a 30-minute talk show that airs Sunday mornings and evenings.

Because of the station’s large baby boomer audience, Briddell says World Gym has succeeded in increasing membership sales to individuals over the age of 30. “We knew our facility would automatically attract the younger market,” he says, “and although we aggressively marketed to this segment, we realized that we needed the baby boomers to truly maximize our business potential.” Currently, 57 percent of the club’s membership is over 30.

For most entrepreneurs, it doesn’t make sense to establish a Web site on their own computer system. The cost of putting in place a high-speed connection to the Internet in order to make the site available to the world can far exceed the relatively minor cost of locating it on someone else’s computer.

It’s also better that experts who know the technology are responsible for ensuring that the site is available 24 hours a day, seven days a week.

Internet service providers (ISPs) have long been a good choice for Web site hosting. They should have the experience, skills, support systems and infrastructure to ensure that the site is available on a consist basis.

Yet many alternatives to traditional ISPs are now emerging, with a variety of companies hosting Web sites. One example is NetNation Canada (http://www.netnation.ca), a subsidiary of a U.S. organization that focuses on this opportunity as its primary business.

NetNation services range from a basic Web site for a fee of $10.50 a month, to a “power site” of up to 100 megabytes in size for $65. Both options specify a maximum amount of Web traffic appropriate to their size — exceed this limit, and you pay an additional charge of a few pennies a megabyte. But in many cases, your site would have to be huge and extremely busy to exceed the limits.

In going after the Web hosting niche, NetNation offers a number of supplementary services, such as full-fledged on-line stores using a variety of technologies, a choice of operating systems to host your store and Real G2 servers for audio and video elements. This allows you to take advantage of many other specialized capabilities in the creation of your site.

As an alternative to hosting your site on someone else’s computer, you can still choose to use your own — simply place it at a company such as NetNation Canada or NetCom Canada. The “server co-location” services offered by these companies allow you to install your own computer hardware at their location.

They are then responsible for providing a link from your computer to the Internet, and for ensuring that your computer and Web site are accessible at all times. In other words, you use your own technology but take advantage of someone else’s high-speed Internet connectivity and expertise. Have a look at the NetCom Canada co-location site (www.nbc.netcom.ca/cbc/co-locate.html), which lists some of its benefits.

Finally, keep an eye out for new and innovative methods of hosting a Web site, such as the services offered by a U.S. company called Rackspace (http://www.rackspace.com).

You can visit its site, fill out a form specifying the type of computer you need for your site, the type of operating system you want and the bandwidth you require. It will quickly set you up with a dedicated computer and Internet connection for a monthly lease fee.

Services such as these provide the flexibility of having your own system with the best possible type of Internet connection.

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