David Dow thought he was having back problems, and that his legs were hurting as a result. As it turns out, that pain may have saved his life.
An otherwise healthy 57-year-old, he figured he just needed to learn some back-strengthening exercises, so he found a personal trainer to help him. But despite the workouts, his leg pain got worse making it hard for him even to walk from the car to the grocery store entrance. He and the trainer suspected something else was wrong and he sought the advice of his doctor.
Soon his doctor's tests revealed the true cause: blockages in the blood vessels of his legs. In fact, the arteries going to his lower extremities were nearly 100 percent blocked. The cause? Years of heavy smoking and high-fat meals, and other factors had caused cholesterol , scar tissue and blood clots to build up inside his blood vessels.
Most people think this kind of clogged artery disease, or arteriosclerosis, only happens in the heart. But as Dow's case shows, it can happen throughout the body. When it does, it's called peripheral arterial disease , or PAD.
And in some people, PAD causes leg pain that acts as an 'early warning' that someone is at high risk for a heart attack or a stroke , says a University of Michigan Cardiovascular Center expert.
"This is the hallmark of a disease that's all over," says James Stanley, M.D., a director of the U-M CVC and the vascular surgeon who operated on Dow. "It's like gray hair you don't just get it on one side of your head. So if you've got this kind of blockage in your leg, you're going to have it other places."
In fact, nearly a quarter of people who have leg pain due to PAD will be dead in five years, mostly due to heart attacks and other heart problems, Stanley says. For people like Dow, whose leg pain kept them from walking even short distances, the odds are even worse: as many as half will die by five years.
Fortunately, Dow got diagnosed and treated before that happened to him. Stanley performed a bypass operation to open his blocked leg arteries, similar to the bypasses that heart patients have. A recent checkup showed he's doing well.
"For sure, it's a wake-up call," says Dow, who has quit smoking and changed his eating habits. "You know that old saying, 'Where there's smoke, there's fire'? I'm sure that I not only have the vascular issues in my lower extremities, but I'm sure I have them in other parts of my body."
Dow isn't alone, says Stanley, who has operated on thousands of patients with severe PAD in his decades as a professor of vascular surgery at the U-M Medical School. Nearly 30 million people in the United States have some form of PAD, though the vast majority are "silent" cases that don't cause symptoms. Among people over age 70, nearly one person in five has PAD.
Who's most at risk for PAD? People over 50, smokers, people with diabetes , people with high blood pressure, people with high cholesterol, and people who are overweight or obese, Stanley explains. In other words, it's the same group of individuals who have a high risk of heart attack and stroke.

Preventing peripheral arterial disease
The advice for preventing PAD, or stopping it before it gets serious, is largely the same as the advice for preventing a heart attack or stroke: Quit smoking, eat healthier, get more exercise, control your blood sugar if you have diabetes, lose weight, and get your
blood pressure and cholesterol levels checked. And ask your doctor if you should take a daily aspirin to prevent clots, or drugs to reduce your blood pressure and cholesterol.
Even though PAD makes people's legs hurt or feel tired when they walk or exercise a symptom that doctors call '"claudication" which feels like a "Charlie horse" type cramp one of the best things to do is to walk more, says Stanley.
"The more a patient walks, the more likely it is that they will develop little 'detour' blood vessels, called 'collateral' vessels, around the obstruction," he explains. The large majority of people can develop these vessels that will ease the pain.
But in some people, PAD has already gotten bad enough to cause pain or numbness even when the person is sleeping something called "rest pain." Stanley says this pain often awakens patients from sleep. It most often occurs in the ball of the feet and may feel like someone has wrapped a bandage around the foot. This level of symptoms is ominous, he says, because it indicates a more severe blockage without adequate collateral vessels.
Another sign of severe PAD is the development of painful sores, or ulcers, on the feet and toes. These occur because the blood flow to the lower leg isn't enough to feed the tissue, and it begins to break down. People with diabetes, whose bodies have an especially hard time healing such ulcers, are most at risk. Left untreated, skin ulcers can get worse and even turn into
gangrene often leading to amputation.
The vast majority of PAD cases are nowhere near this serious. But people who don't get help for symptoms when they first start may find their problem becoming much worse over time.
So, Stanley recommends that anyone who has discomfort in their leg or legs, especially new pain that lasts more than a week, should talk to a doctor. She or he might perform a Doppler examination a painless, non-invasive ultrasound test that detects blood pressure in the extremity.
The Doppler test can tell whether someone has PAD and how bad the blockage might be. Depending on the result, the doctor might recommend an MRA (magnetic resonance arteriogram) of the leg, or a conventional arteriogram that involves injecting dye into the leg arteries through a device called a catheter.
If a severe blockage is found, like in Dow's case, there are several options. Two are similar to those for heart patients: a minimally invasive procedure like an angioplasty that opens blockages with a tiny balloon, or bypass surgery to place a new graft to carry blood into the blocked area.
There are also promising new options on the horizon, to help the body grow new blood vessels in the blocked area. The U-M CVC the first place in the world where patients with severe PAD can volunteer for an experimental new gene-therapy treatment called MultiGeneAngio.
The MultiGeneAngio trial takes cells from a vein in the patient's arm, adds in new genes that encourage the growth of blood vessels, and then injects the cells into the blocked artery using a minimally invasive technique. Right now, it's still being tested for safety and to find the right dose of cells, says Michael Grossman, M.D., the U-M interventional cardiologist who is leading the study at U-M. But if the study proves successful it may one day become a new treatment option for patients.
Until that day, the best weapon against PAD is better knowledge of the fact that pain in the legs is more than an inconvenience. "If one has PAD there are two issues," says Stanley. "What happens to your leg, and what happens to your life."

What is peripheral arterial disease (PAD)?
- Peripheral arterial disease, or PAD, is sometimes called peripheral vascular disease. Both names describe the blocking of blood vessels in the peripheral parts of the body, away from the heart.
- The blockages are caused by the buildup of cholesterol, scar tissue and blood clots within the blood vessel - the same thing that happens in the blood vessels that feed the heart.
- heart.
PAD interferes with the flow of blood to the legs and feet, which can cause pain or numbness in the legs. When the pain occurs while a person is walking or exercising, it's called claudication. When it occurs as a person is sleeping, it's called rest pain.
- Similar blockages in the heart or brain may cause a heart attack or stroke.
- People with PAD, especially PAD that causes pain, have a much higher than normal risk of having a heart attack or stroke. PAD is considered a warning sign for more serious, life-threatening problems.
- PAD is more likely to develop in people who have an inherited (genetic) tendency to develop blocked arteries, and in people over age 50. It's also much more common in people who smoke, people who have have diabetes, high levels of blood fat (for example, cholesterol) and high blood pressure, and in people who are overweight. African-Americans appear to have a higher risk than other groups.
- PAD can be diagnosed using an ultrasound test.
- People who have PAD should quit smoking if they haven't already done so.
- PAD can be treated using exercise, dietary changes, good blood-sugar control, and medications to reduce blood pressure and cholesterol. Severe cases are treated with minimally invasive procedures or surgery.

There are a number of health and lifestyle factors - obesity, smoking, air pollution - that are known to be risk factors for early mortality and receive considerable attention. New research has suggested that social connections should be added to this list, with a study finding loneliness and social isolation to be risk factors for all ages.
Psychologists from Brigham Young University in Provo, UT, discovered in a
meta-analysis that loneliness and social isolation better predicted premature death among populations aged less than 65 years, despite older people being more likely to be lonely and having a higher mortality risk overall.
"The effect of this is comparable to
obesity, something that public health takes very seriously," says lead author Julianne Holt-Lunstad. "We need to start taking our social relationships more seriously."
Previous research has demonstrated that social connections can have a positive influence on physical well-being as well as psychological and emotional well-being. Until now, no meta-analysis had been conducted where the effect of social isolation and loneliness on mortality has been the focus.
Although the two terms sound similar, loneliness and social isolation can be very different in appearance. An individual who is surrounded by lots of other people can still feel lonely while some people prefer to be alone and foster isolation from others.
Despite these differences, however, the study found that the effects on premature mortality were the same for both loneliness and social isolation.

Researchers predict a 'loneliness epidemic' in the future
For the study, the researchers analyzed data from 70 studies conducted between 1980 and 2014, featuring a total of over 3 million participants. The data included information regarding loneliness, social isolation and living alone.
After controlling for variables such as age, gender, socioeconomic status and pre-existing health conditions, the researchers found that social isolation was linked to an increased risk of premature mortality. Conversely, the presence of social relationships was found to have a positive influence on health.
The study did, however, utilize data from a narrow range of ages, with the majority of the data coming from older adults. The authors acknowledge that less than a quarter of the studies analyzed involved people with an average age of 59 or younger, and only 9% of studies involved participants younger than 50 at intake.
The researchers state that the effects on physical health caused by loneliness and social isolation are comparable to those caused by obesity, with current evidence indicating "that heightened risk for mortality from a lack of social relationships is greater than that from obesity." They write:
"The current status of research on the risks of loneliness and social isolation is similar to that of research on obesity 3 decades ago - although further research on causal pathways is needed, researchers now know both the level of risk and the social trends suggestive of even greater risk in the future."
Due to advances in technology and the evolution of the Internet, it may seem as though people are closer together than ever before. However, the number of people feeling lonely appears to be on the rise.

"Not only are we at the highest recorded rate of living alone across the entire century, but we're at the highest recorded rates ever on the planet," says co-author Tim Smith. "With loneliness on the rise, we are predicting a possible loneliness epidemic in the future."
Despite the limitations of the study, the authors believe that their findings justify raising a warning about increasing rates of social isolation.
Now that you've gotten back into shape, it's time to keep off weight gain and maintain your new body. It's a wonderful thing when you can fit into a pair of old jeans you wore years ago. However, you may find yourself slowly gaining back a pound or two if you're not careful. There are ways to prevent this from happening. Here are tips to keep off the weight you've already lost.

1. Snack Healthy and Eat Smaller Meals
After losing weight, you need to watch what you eat. It's easy to grab an unhealthy snack when you've lost weight. Keep weight gain at bay by eating healthy snacks. Low calorie cheese, yogurt, fruit and vegetables make great snack options. Also, eating 3 smaller meals a day help regulate your weight better than eating 3 larger meals. Along with consuming 2 healthy snacks, these smaller meals keep your metabolism working all day long.

2. Stay Hydrated
Staying hydrated is an important part of maintaining the weight you lost. Hydration helps you stay healthy. It's a good idea to drink 8 glasses of water a day. Water helps you burn calories by keeping your metabolism going. It's also a healthy alternative to diet sodas and sugary drinks. Water doesn't have calories, carbohydrates or fat. It also quenches your thirst faster and better than anything else. Try to avoid sports drinks and juice. They have a high sugar content as well.

3. Keep Exercising
Even if you exercise at the gym, it's a good idea to use every opportunity you have to work out. It's easy to slack off exercising after losing the weight. You can maintain your new weight by taking the stairs instead of the elevator. Also, take a walk during your lunch break. If you're a stay at home parent, then put aside 30 minutes a day for exercise. The best way to maintain your new look is to establish a routine and stick with it. The more active you are, the more likely you'll keep the weight off.

4. Stop Eating When You're Full
You can keep off the weight by only eating until you're full. Even if there are leftovers on your plate, stop eating when you feel satiated. Save the leftovers for lunch or another meal.

5. Shop Smart
Grocery shopping is a big event when you need to maintain your weight. Steer away from the sections that will tempt you. Make a list of foods that are healthy for you a head of time. Avoid adding cakes, candies and chips to the list. Choose lean protein, fruits, vegetables and low calorie snacks instead.

6. Take the Kids Outdoors
Your kids are your biggest champions. Take them outside for a few hours of play time in the afternoon or weekends. Choose games that require a lot of movement. Tag, jump rope, hide and seek and kick ball are all excellent games you can do with your kids.

Keep weight off by being active and eating right. Losing the weight was the hard part. Gaining it all back is a lot easier.
Have you ever wondered how your favorite celebrities got so fit and manage to stay that way? We did, so we compiled a list of interesting weight loss tips from some of the stars we all know and love. If it works for them, it could work for you too, right?

Jennifer Aniston
The former Friends star swears by her Vegan Cherry Smoothie. She even shared the secret recipe with POPSUGAR. With 10 grams of fiber and 30 grams of protein, it's as filling and tasty as a milkshake, but without the lactose and sugar. It might be a bit high in calories, but it's a great substitute for a midday snack.

Hugh Jackman
This Australian actor loves to wear a heart monitor while he's at the gym, as it helps him keep his heart rate above 140 BPM. Considering you can burn up to 1,000 calories per hour by keeping your heart rate above 125 BPM, this trick is definitely one of the reasons he's in such amazing shape.

Vin Diesel
The first thing he does when arriving at a new place, regardless of whether he's on vacation or shooting a film, is find a bicycle. Getting around may take him a bit longer, but it definitely helps with maintaining his excellent physique.

Halle Berry
While working out, she prefers to use dumbbells instead of weight machines. The fact that they are free weights means that your secondary muscles and stabilizers are used to keep them balanced, making for a much better, less limited workout.

Dwayne Johnson
Otherwise known as "The Rock," this celebrity credits his ripped body to the efficiency of his workouts. He uses a combination of circuit training (working out more than one muscle per day with little or no rest time) and supersets (performing multiple sets in a row without any rest time).

Heidi Klum
The model credits her beautiful derriere to time spent on the elliptical machine, as well as exercises that specifically target the butt, such as the Platypus Walk. She advises those looking to maximize the results from an elliptical workout to stick out their butt, as this focuses the workout on hamstrings, glutes, quads and outer thighs.

Jennifer Lopez
J. Lo recommends slowing down the pace of your steps while on the StairMaster. Quick-stepping, according to her, doesn't burn as many calories as taking long, slow steps, and you can definitely feel the burn after a slow climb.

Sylvester Stallone
He likes to keep things old school, especially when it comes to getting ripped arms. His advice: the basics are the best. Stick with exercises like push-ups (works your triceps, chest and shoulders) and chin-ups (works your biceps, back and shoulders).

Penelope Cruz
The "Spanish enchantress" prefers to spend her workout time outside, rather than being cooped up in a gym. An outdoor workout certainly has its benefits, and you may even find yourself enjoying a jog in the park much more than a session on the treadmill.

Catherine Zeta-Jones
This Welsh actress burns calories in an unusual way -- playing golf. It may be known as a recreational sport, but if you walk the course and carry your own bag of clubs, you can burn up to 300 calories per hour.

Cameron Diaz
She is known for her amazing body, but she'd much rather hit the waves or run along the beach than spend time in the gym. Playing sports is an excellent way to lose weight and get in shape without having to set foot in the gym.
We all know that the solution to weight loss is diet and exercise. By eating healthy and cutting calories, you get your body in a fat-burning state. Adding exercise into the mix will boost your metabolism and increase the number of calories you burn every day, making it easier to get rid of the calories stored as fat.
But, beyond these two "pillars" of weight loss, there are other options for shedding pounds. Here are a few of the more strange and unusual ways to lose weight:
1. Smell an apple -- Studies have shown that sniffing a green apple can suppress your appetite between meals. You don't even have to bite into the apple, but the smell alone does the trick! It works with bananas, too. If your stomach is growling but you know you shouldn't eat, get a whiff of a banana or apple to shut down your hunger.
2. Wear a ribbon -- French women have a simple trick for controlling their food intake: they tie a ribbon around their tummies, underneath their clothing. When the ribbon starts to feel tight, they know they've had enough to eat. This helps them to stay conscious of the amount of food they eat, making it easier to avoid overeating!
3. Take a picture -- Before you dig into your meal, take a picture of it and really look at the picture. As you study it, you'll notice things you didn't when you first prepared the meal. Perhaps you added too much dressing or your serving of potatoes is far larger than it looked. This is a simple trick that will help you be conscious of what you're eating.
4. Write it down - - This works similar to the last tip and makes you more aware of what you're putting in your body. Get a food journal and write down EVERYTHING you consume in a day: every cup of water, every bite of food, every snack no one sees you munching on. Every day, go over what you wrote down, and see if there is any way to improve your eating habits the next day.
5. Sit in front of a mirror -- Eating in front of a mirror can seriously help to reduce your food intake. You will be more aware of what you're eating, as well as how you look as you eat. One study found that people who eat in front of a mirror eat as much as 33% less.
6. Start big - - Always start the day with your largest meal! Make your breakfast a big one (at least 700 calories), and it will keep you going for hours. Make lunch the next largest meal, and make your dinner a small one. You'll burn a lot more calories that way.
7. Decorate with blue --Have you ever wondered why you've never seen the color blue in a restaurant? That's because blue is a color that suppresses your appetite. You will eat up to 33% less in a room decorated in blue. To cut back on your foot intake, eat on blue plates, with blue napkins and a blue tablecloth. Avoid bright, hunger-promoting colors like red, orange, and yellow.
8. Use vanilla -- Vanilla-scented candles can help to suppress your appetite, specifically your cravings for a dessert. Those with a sweet tooth should light up a vanilla-scented candle immediately after finishing the main course, and they'll be far less likely to want a post-meal treat.
For anyone who is wondering how to use a weighted vest in a fitness routine, the answer is both simple and complex - many different activities can be enhanced by using a weighted vest to provide an additional distributed weight load. The principle behind a weighted vest is simple: by adding distributed weight, the weighted vest makes the body work harder in pursuing various physical fitness activities. This builds more muscle, burns more fat, and helps get each individual on the path toward better fitness.

Weighted vests are popular for a variety of fitness activities. Here are some of the top training routines where participants use a weighted vest to challenge their body.

1. Running
A weighted vest can be a huge advantage to someone who is training for a marathon or other running event. Training with a weighted vest builds up the body capacity, so that when the user takes it off, she feels lighter and ready to go. Lots of runners prefer to use a relatively light vest, at least at first, so as not to overwhelm the joints or overtax the lung and cardio system that is already working strenuously.

2. Weight Lifting
Another very popular use of the weighted vest is in various types of weightlifting. The weighted vest is often more useful when lifting free weights. That's because many circuit weight training machines include seats, or keep the body in a static position. However, with using dumbbells or barbells, the weighted vest can play an important role. Some see the vest as providing a balance for the heavy weights that are held by the arms. As the limbs work on free weights, the torso works against the vest, helping to exercise a wide variety of muscle groups at the same time.

3. Squats and Lunges
Many fitness participants also use a weighted vest in various activities where they have to move their body up and down. Many of these activities are also adapted for fitness tools like the medicine ball or the kettlebell. Basic exercises range from the mundane to the exotic - for instance, a popular one called the "good morning" involves inclining the body in ways that challenge the core muscles. These kinds of activities will also build more body strength when the trainer wears a weighted vest.

4. Climbing
The weighted vest can also provide resistance for both machine-simulated and real climbing activities. It may seem odd to wear a weighted vest while actually climbing rocks, but these tools are definitely useful in indoor simulations, again, for developing the body to a greater extent and equipping it to handle greater challenges when they arise.

5. Sport Specific Exercises
From baseball, to football, soccer, basketball, tennis and many other competitive sports, specific training involves a focus on precise movements that will be used on the field. This is another instance where weighted vests can come in handy by building a more "explosive" body response through applied resistance.
These are just a few of the activities where trainers benefit from a weighted vest. The weighted vest tool adds a challenge that may not be right for some individuals, for instance, the elderly or those with cardio limitations. Ask a doctor if a weighted vest may be right for your fitness or weight-loss plan.
Summer is right around the corner. If you're struggling to get bathing suit ready, make sure you're following each and every one of these tips. They may seem simple, but they work.

1. Listen to Your Favorite Music While Working Out
Music affects your mood. Listening to your favorite beats while you work out gets you energized and will likely help increase the length of your work outs and/or the calories you burn.

2. Eat More Vegetables
Vegetables, especially those containing very little starch such as salad greens, tomatoes, and asparagus, are very low calorie but very high volume due to high fiber content. Most fiber is not digested and goes through your system, binding to excess cholesterol and other un-needed materials in the intestine.

3. Get Adequate Protein
Protein foods stay in your stomach longer than other foods. Protein foods help you feel satisfied longer, helping you eat less at your next meal or snack.

4. Eat Fruit for Dessert
It's possible to eat too much fruit. Fruit has many benefits but also is a natural sugar that if not burned off can cause weight gain. Think of fruit as a dessert food rather than other dessert foods which tend to be high in bad fat and have little nutritional value.

5. Avoid Starches and Sweets
These are foods that are quickly metabolized into blood glucose, your body's main source of fuel. If you don't use that fuel by exercising, the body stores it which can cause fat gain.

6. Weigh Yourself Often
Studies have shown that weighing yourself often, at least once a day, can help you understand your body and improve weight loss efforts. Foods affect individuals differently so weighing often can help you understand effective weight loss methods for your body.

7. Eat 5 to 6 Small Meals or Snacks Daily
An empty stomach can signal your liver to make and release glucose (sugar) into the blood for energy. Skipping meals or only eating once or twice a day can put your body in starvation mode, slowing your metabolism down, and causing your body to hold onto food when you do eat.

8. Sleep 8 Hours Every Night
Studies show sleep deprivation changes appetite hormones, increasing hunger and caloric intake. Sleep deprivation has also been associated with increased fat tissue and decreased muscle tissue.

9. Add Resistance Training to Your Workouts
Muscle burns more calories at rest than does other body tissues. This means, if you build more muscle, your will be burning more fat while just sitting!

10. Drink Less Alcohol - or NO Alcohol
Alcohol calories are prioritized; you must burn off all alcohol calories before you burn food you ate. Alcohol increases your appetite so you eat more if you drink, and is metabolized like a fat in the body. You wouldn't drink fat if you are trying to lose weight would you?!