Page 2 – Ravalli Republic, Friday, January 30, 2009
Research shows exercise saves you money RAVALLI REPUBLIC
In today’s uncertain economy, families are looking to cut back on any expenses that seem like a luxury or even the slightest bit frivolous. One of the items receiving scrutiny in many households is gym memberships. Yet a growing body of evidence suggests that cutting that gym membership may be exactly the wrong move for even the most cashstrapped family. According to the Centers for Disease Control and Prevention, inactive adults have significantly higher direct medical costs than active adults, and the costs associated with physical inactivity increase with age. “To put it in perspective,” said Diane Johnson, owner of the Curves women’s fitness center in Hamilton, “For every dollar you spend on wellness, you save as much as $5 on illness.” Curves has partnered with major health insurance and third party providers, in various states – including Healthways SilverSneakers, AARP, and Blue Cross Blue Shield – who see huge financial benefits in wellness programs and offer reimbursements and incentives on Curves gym memberships to their plan members. For example, Blue Cross Blue Shield of Minnesota recently completed a landmark study that found that people who went to the gym at least eight times a month had significantly lower healthcare costs than those who did not. These frequent gym attendees had: • 39 percent fewer visits to the emergency room • 41 percent fewer hospital admissions • 18 percent lower overall claims costs In an era where many have no health insurance at all and those who do have higher copays, a gym membership may be the most affordable way to keep healthcare dollars in consumers’ pockets. This will become even more important in the near future, according to researcher IBISWorld: As baby boomers pass through their 40s and 50s, healthcare costs are forecast to rise dramatically. Everyone knows that the human body thrives on regular
exercise, and that staying fit and maintaining a healthy weight can contribute to significantly reduced risks for various cancers (by as much as 60 percent!), diabetes, heart disease, hypertension and many other debilitating conditions. Here are some other great reasons to head to the gym: • Exercising with others can “greatly improve your exercise adherence.” It’s much easier to stick to an exercise program when you have accountability – from trainers and coaches, friends, or both. (University of Georgia Department of Kinesiology and Health) • Exercise is like Miracle-Gro for your brain and can make you smarter by releasing chemicals that cause neurons to branch and connect in new ways. New junctions between neurons are the basis of learning. (Kristin R. Wehner Keffeler, Entrepreneur. com) • Exercise may make you a better worker – by as much as 15 percent according to a study presented to the American College of Sports Medicine – and enhances time-management skills, mental performance, ability to meet deadlines, mood, and interactions with co-workers. (MSNBC.com) • Exercise directly reduces stress by decreasing the production of stress hormones and increasing the production of endorphins – your brain’s “feel good” neurotransmitters. (MayoClinic.com) • Exercise pays you back double: Each hour of exercise adds two to your life. (Harvard Alumni Study) “The research is clear: Exercising regularly and maintaining a healthy weight can save not only your life but your money as well,” said Diane Johnson. “Your health is your most precious asset, and not taking care of it is going to cost you more in the long run.” To help women save even more money, Curves of Hamilton is offering 50 percent off the service fee, 30 days free, a New Member Kit which includes a chance to win one of the “Circle of Service” Diamond prizes being raffled by Soroptimist of Hamilton to help raise funds for the following programs and entities:
SAFE, Bitterroot Literacy, Bitterroot Attention Home, Chemo Candy, Christmas Candy, Christmas Families, Genesis House, Emmas House, Mammogram Program at Daly Hospital, One to One, Options,
ProTech Award, Making a Difference for Women Award, Fellowship Award, Violet Richardson Award, Women’s Opportunity Award, Relay for Life, Community Baby Shower, Race for the Cure, Womens
Cardiac Health and Children’s Library Summer Program through Feb. 28. For more information, contact Curves at 363-0393 or brcvs@ outdrs.net.
How some stay fit in these lean times COURTNEY PERKES The Orange County Register (MCT)
SANTA ANA, Calif. – When business slowed at Michael Beresford’s advertising company in the fall, he replaced his personal trainer with www. hundredpushups.com, a free Web challenge. He also dropped the fancy gym membership to jog the hills of his Laguna Beach, Calif., neighborhood. He misses the push of trainer-led calorie burns and weight-training sessions, but his Blackberry is keeping him accountable to exercising on his own. “Working out is still very important to me for relieving stress, but paying $500 a month for a nice club and trainers adds even more unnecessary stress,” said Beresford, president of Net-Scope. com. “So I went for the free activities that benefit me just as much.” In these lean economic times, folks are finding ways to pinch their pennies without pinching more flesh around their waistlines. They say they’re figuring out how to keep fitness a priority, while cutting out luxury. And in this season of New Year’s resolutions, gyms and fitness centers are slashing costs to attract members. Soul At Home, a Tustin yoga studio, is discounting one-year memberships from $649 to $389 through the end of the month. Linda Krall, a self-employed illustrator, said although her business is hurting, she couldn’t pass up the deal. “That’s been a gift in terms of the economic challenges,” said Krall, 49. “Going to yoga is keeping me grounded, hopeful and optimistic. It’s given me that inner peace and contentment amidst the craziness of the world right now.” Gil Yurly, owner of Body Wise Fitness in Costa Mesa, Calif., lowered his rates after re-reading Sam Walton’s “Made in America.” “Three months for $99,” Yurly said. “It’s a good deal and people recognize that. We just need to get bodies in the gym, keep the energy up.” At the Saddleback YMCA in Mission Viejo, Calif., applications for financialneed scholarships have increased by 25 percent in the past few months. New and current members can receive a discount of up to half off their monthly dues. “It’s really helped a lot of people who would have had to quit,” said
Elizabeth Bishop, the club’s marketing director. “The first thing you hear on the news on how to save money is drop your gym membership.” While bargains are out there, some are sticking with free options. After Vicki Orgill’s husband was laid off from his job in the computer industry, the Laguna Beach, Calif., couple wrote up a budget. “I was quite shocked when I went through and realized what I was spending on things,” said Orgill, 51. Not only did she pay $80 a week for semi-private Pilates classes, but she went to a yoga studio a few times a week. Then she spent more money on lunch with girlfriends after class. Orgill knew she had to give all that up. Now she records workout routines from FitTV. She was thrilled when she discovered free yoga classes offered through Irvine Valley College Emeritus Institute. There are some drawbacks, though. The classes, geared toward older adults, are less challenging and she’s not going as often. “If I pay for something, I don’t like to miss,” Orgill said. “I don’t push myself unless I get pushed.” Diane Sabba, 55, and her husband stopped taking swing and waltz lessons after his work in construction slowed. “I went out and bought some DVDs like ‘Dancing with the Stars’ and boot camp. That’s a big savings,” she said. Sabba also considers Huntington Beach, Calif., her personal gym for brisk walking with an ocean view, volleyball and cycling, all for “no money down.” Beresford, 39, said he doesn’t miss the 30-minute drive to exercise at Equinox in Newport Beach, Calif. His recession workouts have given him more time outdoors and he sees his neighbors more often. “It’s also nice to be outside and enjoy where I live,” he said. “I enjoy that just as much as the nice gym and the facilities and amenities.” © 2009, The Orange County Register (Santa Ana, Calif.). Visit the Register on the World Wide Web at http://www.ocregister.com/ Distributed by McClatchy-Tribune Information Services.
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Get motivated for the new year ANTARA CROFT Antara Sports
Have you been struggling with weight year after year? Do you start a workout program and quit in two weeks? Are you waiting until the kids are away at college to take time for yourself? Does life get in the way of working out? What is most important in your life? Can you care for your family if you are ill? Can you focus at work if you are not well? Can you enjoy quality of life if you have no energy to enjoy various activities? Your physical well being influences every aspect of your life. It influences your mood, quality time with your family, how you function at work, how your body utilizes food as fuel and your ability to get out and enjoy the great outdoors. So if this is the year that you really want to make some physical changes, even if you don’t
have a lot of weight to lose, just feeling more energetic, muscles stimulated, and going on a hike doesn’t send you to bed for a few hours, please read on and allow me to help you get on track with a little motivation to get fit and to make it a part of your lifestyle. First, it is all in your head – that fight to start, to keep with it, to decide to be committed. Just like quitting smoking, you have to make that decision to change. And yes, change is scary, but we know it is for the best. You have probably been in shape before and you know how good you felt? But, you say you are older now? You can feel good again. Exercise keeps you younger! Or you say you are too old to quit smoking? Your lungs will heal themselves if you keep that smoke out of them. Every seven years, every cell in our body is replaced. Your lungs will be pink again in
less than seven years. List your reasons on a 3x5 card WHY you want to change; the benefits you’ll receive and read it again and again when you need it … tuck it in your wallet. Second, get started. What are you going to do? Do you need to find something you like doing? In the winter, you might want to join a club, women’s workout center or even yoga. You may have to experiment. That is good. Try different activities. My belief for losing weight is to do three different aerobic activities. That way your body doesn’t get used to any one repetitive action. (Note: triathlons – swim, bike, run. I lost 20 pounds doing them and have not gained any back in almost three years.) Aerobic activity 20-plus minutes begins to burn fat and will continue burning fat for a period of time after you’ve worked out. Are you uncomfortable walking into a club because you haven’t been there in years and you are embarrassed that you are too out of shape to walk in? Sure, it will be strange at first. But no one is judging you. Regulars at the club actu-
ally congratulate you if not verbally then in their head because you are there. And they know how many people that aren’t that could be. Also, be ready to sweat. It is good for you! Wear the right clothes and shower after. Cotton will make you feel hot immediately. Athletic technical clothes, like what Antara Sports carries, will allow your body to breathe and look good, of course. Third, keep it going. This is a lifestyle. It is just something you do like brushing your teeth … doing something good for your body at least four-to-five times per week. If you have to work up to five, that is fine. Start at three. You can have an easy day, medium, and more vigorous. Make a schedule for your workout. Mix up your aerobic activities: cycling, jogging, walking (vigorously), swimming, aerobics, floor exercises, tennis, aerobic machines. If you need music, get it. Whatever it takes. You need an accountability partner. Find one at the club, friend or family. Once you get going to the club, people will ask you where you have been if you miss. Plus, don’t over do
it so you keep coming back. Muscles sore? Excellent! You know you worked. Fourth, think about your nutrition. Are you eating nutritiously and drinking water? The more greens you eat the better. Cut out breads, sugars, processed foods, white rice and no soda! Yes, I know it is difficult. Just start decreasing and get a book to eat more nutritiously. You don’t need that extra starch turning to sugar. You want to burn, burn, burn calories and fat. Fat grams are more important; decrease as much as possible in what you fuel your body with. Last thoughts: Do watch the Biggest Loser on Tuesday evenings. It is inspiring even if you are nowhere near their weights. Also, an inspiring book will help to keep you on track. Get your kids involved too. You are their example for a healthy lifestyle. Good luck and if you get off track, get back on it again! For a free body fat test stop by Antara Sports. Also, a new weight loss support group will begin Wednesday, Feb. 4 at 6:30 p.m. at Antara Sports. Come to be motivated and stay on track.
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Senior living centers offer many options RICK BUCHEIT Director Center
Nursing, Discovery Care
It could be an emergency that tells you that your aging parent is no longer safe at home. A fall that causes injury, a medical crisis resulting from missed medications, increasing forgetfulness and searching for words – all of these are common stories that bring senior citizens to a senior living environment. Different levels of service are available for a variety of needs. Some homes simply provide a safer environment, while others resemble a scaled-down version of hospital care. Each facility has criteria the applicant must meet in order to be successful in that environment. Independent Living is the least expensive, and provides the least support, of senior facilities. Apartment-style liv-
ing in a senior community provides the security and comfort of knowing that help is available at the push of a Hotline button. Seniors feel comfortable in this setting as they interact with people in their own age group, sharing memories and a slower pace of life. Equipped with independent kitchens and a recreation hall for gatherings and parties, this kind of living is best for the senior citizen who remains active and capable of taking care of themselves. Assisted Living provides a greater level of support for seniors with higher needs. These are often beautifully decorated centers with individual living spaces and a community feeling promoted by helpful and smiling staff. Residents are encouraged to live active lives within a structured environment. This is known as the “social”
model of assisted living. Depending on individual needs, support services such as meals served in-room, nursing care and medication assistance are available at extra cost. There is also a “medical” model of assisted living, a hybrid between ordinary assisted living and a skilled nursing home. Many seniors prefer this setting because it means that the licensed nursing staff are present around the clock. It is often populated by seniors with medical challenges such as diabetes, stroke, post-surgery or very advanced age. Recreation, full-service meals and personal care are all included in a service plan price. Blood draws for lab work are performed on-site and physicians will make scheduled visits into the resident’s home. As medical conditions become more
complicated, the center can offer focused care based on need. In some facilities this service is referred to as “transitional” senior care. Skilled Nursing homes are more sophisticated and equipped to manage complex or fragile medical needs. Long term care may include wound healing, tube feeding, rehabilitation, management of infections, medication monitoring and care for patients with dementia. It is not uncommon for seniors to have a short stay in a skilled nursing facility until their condition improves. They can then transition back to assisted living care when they are ready. The atmosphere is often pleasant and home-like with busy levels of activities and events that encourage families to be part of their parents’ care. How to decide what level of care is right for your parent
is a sensitive decision. First, look at your resources, as the financial burden can be substantial. It can be reduced by private insurance or supplements or by Medicaid, but without coverage the costs range from $1,500 to over $5,000 per month. Purchasing long term care insurance can help you plan ahead for these expenses. Next, contact the parent’s physician for their recommendations. Also contact the admissions coordinator at selected locations. Finally, visit the facilities in your area. You can call for an appointment to take a tour or, better yet, just show up unexpectedly with no appointment for a more candid look at how those residents live day-to-day. Choose for your parent what you would choose for yourself.
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Hibernate for better weight loss DIANE JOHNSON Owner, Curves
You know that eating well and exercising go hand in hand for weight management, but what about sleeping? Have you ever thought that sleep deprivation might be thwarting your weight loss efforts? Current research shows that sleep has several profound effects on your body’s hormones and metabolism. According to Diane Johnson, owner of Curves in Hamilton, sleep restriction increases your body’s cortisol levels. Cortisol is a stress hormone, and elevated levels of this hormone promote fat storage. Obesity typically increases cortisol while weight loss typically decreases cortisol. This increase in cortisol as a result of sleep deprivation could promote increased fat storage. Sleep restriction also mirrors certain characteristics of Type 2 diabetes. Individuals with Type 2 diabetes produce insulin, but their insulin is not effective at pulling carbohydrates (glucose) from the blood into the cells. This is often referred to as “insulin resistance” and results in high blood sugar. Since sleep-deprived individuals exhibit a similar insulin resistance, it is believed that lack of sleep can increase the risk for Type 2 diabetes. “Sleep deprivation increases your appetite by several mechanisms. At the most basic level, individuals tend to eat more when they are sleeping less, simply because there is more time in the day to eat. Tired individuals also tend to combat exhaustion by eating more food,”
Johnson said. Most recently, research has revealed that a lack of sleep also affects two hormones that regulate hunger and satiety. Sleep restriction increases ghrelin and
decreases leptin. Ghrelin is a hormone that increases before meals and falls after eating, so it is believed to stimulate appetite. The opposing hormone, leptin, suppresses appetite and increases metabolism. Because the lack of sleep increases ghrelin (appetite) and decreases leptin (satiety and metabolism), you are more likely to overeat and gain weight if you aren’t sleeping enough. According to the National Sleep Foundation, the average American sleeps an average of 6.9 hours per night compared to the recommended eight hours needed for good health. In fact, only 37 percent of Americans get the recommended eight hours per night. Approximately 70 million Americans are affected by a sleep problem and it is estimated that sleep disorders and sleep deprivation cost Americans more than $100 billion annually in medical expenses, loss in productivity, sick leave and property damage. “If you consistently have trouble getting eight hours of sleep per night, you should consult your doctor. Otherwise, this winter is the perfect time to start getting your Z’s. It’s healthy, and it may even help you lose a few extra pounds,” Johnson said. This year it’s time for a workout that really works to promote a good nights sleep and healthy eating habits. For more information on Curves of Ravalli County, call 363-0393.
Ravalli Republic, Friday, January 30, 2009 – Page 9
Which exercise machine counts calories best? JULIE DEARDORFF Chicago Tribune (MCT)
Problem: You are trying to lose weight and want to know many calories you’re burning while on cardio equipment. Which provides the most accurate calorie count: a stationary bike, a treadmill or an elliptical machine? Solution: Caloric expenditure is mostly (but not entirely) a function of distance covered and body weight. While the machines will never be 100 percent accurate, they can all give you a general idea of how many calories you burn, provided you input your correct weight. “The bicycle predictions are the easiest to make, because the variation in people’s mechanical efficiency is relatively low, and it’s very easy to convert work [in watts] into calories, given what we do know about cycling efficiency,” said exercise physiologist Ross Tucker, co-author of the exercise science blog The Science of Sport, sportsscientists.com. On the treadmill, the efficiency of an individual’s stride is more vari-
STEPHEN M. DOWELL – Orlando Sentinel/MCT
An LCD screen displays information on a Nautilus TreadClimber at Precision Fitness Equipment in Altamonte Springs, Florida, January 17, 2007.
able, Tucker said. “Assuming you’re within 5 percent of the ‘true value,’ if your reading says you burned 600 calories per hour (or 10 calories per minute, a fast walk or slow run),
then your range is probably within about 570 calories to 630,” he said. Unlike the treadmill, there are no standardized equations for caloric count on elliptical machines, said
Doug Durnford, a senior product manager with Precor, which manufactures fitness equipment. So the accuracy “depends on the amount of due diligence performed by the manufacturer.” Precor has funded a study looking at whether its equation – which measures calories using gas exchange measurements – is valid. If you’re concerned about precision, then “ask the manufacturer to confirm the method used to calculate calories expended and whether that method has been validated by independent study,” said Durnford. The real question, however, is whether the numbers mean anything. Yes, you’ll lose weight if you burn more calories than you take in. But someone who burned 600 calories in one hour needs to consider what happens in the remaining 23 hours of the day. © 2009, Chicago Tribune. Visit the Chicago Tribune on the Internet at http://www.chicagotribune. com/ Distributed by McClatchy-Tribune Information Services.
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Going for a walk, the everyman’s exercise Marcus Daly Memorial Hospital
From the time we take our first wobbly baby steps, through childhood, adolescence, adulthood and with any luck, well into our retirement years, our legs are there for us. They are our own personal mode of transportation. Your legs, made of bone, muscle and ligament, can carry you anywhere and can also help bring you both mental and physical health. Walking is the everyman exercise. It is easy, it costs nothing, you can walk anywhere and you can begin at any level. We’ve got plenty of science to tell us what we need to do … Get moving. Did you know that walkers have fewer incidences of cancer, heart disease, stroke, diabetes and other killer diseases? They live longer and get mental health and spiritual benefits as well. Walking, like other exercise, can help you achieve a number of important health benefits. Benefits of Walking • Lower low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol) • Raise high-density lipoprotein (HDL) cholesterol (the “good” cholesterol) • Lower your blood pressure • Reduce your risk of, or manage, type 2 diabetes • Manage your weight • Improve your mood • Stay strong and fit To increase the overall health benefits of walking, add a pair of walking poles, and use them much like you would when cross country skiing. This gets the upper body more involved and increases the exercise benefits. The Bitterroot Valley provides many great places to walk. With hiking trails, rivers paths, country roads, the new US 93 bicycle path and charming neighborhoods, most of us have unlimited choices when deciding where and what kind of walking routine to begin. It is important to contact your medical provider for a check-up or consultation before you begin your walking program. If you are healthy enough to begin a walking routine here are some tips to consider: • Don’t take on too much too soon. Break into any new exercise routine slowly to let your muscles and joints adjust to the new activity. • Schedule your walking just like you would any other appointment in your day. • Think about finding a walking partner. • Decide on a route and find out how long it will take you to complete it at your current walking pace. • Living in Montana means dealing
with a variety of weather conditions. Be prepared and/or make necessary modifications for changing seasons. The internet provides unlimited resources for devising your personal walking routine. A good source of information on the internet, among many others, is http:/www.walking.about.com. This site is packed with a ton of helpful information such as how to start walking, proper walking technique, shoes and gear, walking in winter, and how to improve fitness, speed and endurance. Another good Web site is http://www. mayoclinic.com/health/ walking. Both of these sites provide very detailed information to help you keep the “routine” in your walking routine and really make it pay off. Keeping a regular routine is very important to the success and benefits that are achievable through walking, just the same as any exercise routine. The US Surgeon General recommends 30 minutes of aerobic exercise everyday. “We’ve got plenty of science to tell us what we need to do – get moving!” said Richard Carmona, Surgeon General of the United States. “The enemy is within us – being sedentary,” and he adds “Walking is the biggest bang for our buck. Thirty minutes a day of walking will prevent many cases of diabetes, hypertension, and other chronic diseases. Walking is the simplest, easiest way for most people.” Let’s walk together and build a healthier community. – Energize Daly, the wellness committee of Marcus Daly Memorial Hospital.
Ravalli Republic, Friday, January 30, 2009 – Page 11
Prevent or reverse heart disease RANDY ASH The Canyons Athletic Club
Heart disease prevention should be a top priority for everyone. Cardiovascular disease claims over 900,000 lives each year in the United States, and has been the number one killer every year for the past 90 years. What most people don’t know is that heart disease prevention and even reversal is now a reality. It used to be believed that atherosclerosis, or hardening of the arteries, was a condition that everyone would get as they became older; however recent scientific research has shown that does not have to be the case. The health of your endothelium (inner lining of the blood vessels), and the blood vessels themselves, directly affect cardiovascular health. It is also known that a healthy endothelium produces nitric oxide (NO), which provides many benefits to blood vessels. Some of these include increasing blood flow, preventing fatty deposits from sticking to the blood vessel wall, inhibiting hardening of the vessel wall, and reducing the chances of blood vessels constricting. Most of you may not have given much thought to your cardiovascular health until now, but you are not alone. Many internists, and even cardiologists do not know much when it comes to blood vessels and vascular health. Part of this is due to the fact that there are relatively few medical schools where vascular medicine is taught. Most doctors’ cardiovascular training has been spent focusing on the heart, but not on the 100,000 miles of blood vessels in our body. There are many risk factors for heart disease, including hypertension or high blood pressure, high cholesterol, diabetes, and tobacco use. Through a healthy diet, proper nutritional supplements, and
regular exercise, you have an excellent chance of preventing heart disease from happening, if you are currently a healthy individual, and even reversing heart disease if you are one of the many who is already afflicted. The time is now for heart disease prevention. There are many natural ways to improve your cardiovascular health. If you go to www.heart-diseaseprevention.net, there is valuable information that can get you started on the road to a heart healthy lifestyle. If you are currently on blood pressure medication or statins for high cholesterol, following some of these easy steps outlined on this Web site may allow you to get off your medications with their potential side effects. Heart disease can be prevented and even reversed, so take advantage of this information so you can live a longer, healthier life. Nitric oxide (NO) is one of the most important discoveries ever regarding the advancement of cardiovascular health, which includes the health of our blood vessels and endothelium. However, NO suffers from an identity crisis. If you asked a roomful of people what NO is, most would probably either have no idea, or think it is laughing gas you get at a dentist’s office. Even many doctors are not aware of the recent research regarding nitric oxide and how it can benefit your cardiovascular health. Back in 1860, Alfred Nobel successfully caused nitroglycerin to explode. Six years later, he invented dynamite by using nitroglycerin as the active ingredient. Even back then, scientists knew that small amounts of nitroglycerin helped relieve chest pain (angina), but they didn’t understand how it worked. They just knew that small doses relaxed the blood vessels, which allowed them to dilate. The research of the three
scientists, who won the Nobel Prize in Medicine in 1998, showed that a healthy endothelium releases its own form of nitroglycerin, a powerful vasodilator and muscle relaxant that is essential for cardiovascular health. A healthy endothelium is like having a life-long supply of nitroglycerin, only much better. Nitroglycerin exposes your blood vessels to a blast of NO all at once, where endothelium produced NO is released specifically where it is needed. This NO production is controlled by nerve stimulation, circulating hormones, and the tissue served by the vessels. This research regarding cardiovascular health is shedding some much needed light on the importance of nitric oxide. It is now known that eating the right foods, along with proper nutritional supplements, and daily moderate exercise
can have a dramatic effect on keeping your endothelium and blood vessels healthy. A healthy endothelium will produce the amount of nitric oxide that is necessary to keep your blood vessels smooth, like Teflon, as opposed to sticky, like Velcro. If your endothelium produces the proper amount of NO, then you can eliminate cardiovascular disease risk factors, such as high blood pressure, high cholesterol, and high homocysteine levels. By having relaxed, dilated blood vessels, the rest of your body and organs will receive proper blood flow and the nutrients needed for optimal cardiovascular health. To find out more information about nitric oxide and its benefits for your cardiovascular system, go to www.argi9health. com/cac3.