Targeted Drug Shows Promise Against Advanced Kidney Cancer

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — A targeted cancer drug appears to be effective against advanced kidney cancer, although its side effects may keep it from becoming widely used, researchers report.

The drug, cabozantinib, proved more effective across-the-board in kidney cancer patients than another targeted drug called everolimus, said lead researcher Dr. Bernard Escudier. He is chair of the genitourinary oncology committee at the Institut Gustave Roussy in Villejuif, France.

Overall, cabozantinib provided “almost a 50 percent improvement in progression-free survival” over everolimus, Escudier said.

Cabozantinib works by interrupting several different cellular processes that help cancer grow and spread, Escudier explained. Unfortunately, that widespread approach also creates worrisome toxic side effects, he added.

“Based on this multi-targeted action, we have quite a lot of side effects. Toxicity has been an issue with this drug, leading to a decrease in the dosing in many patients,” he said. Diarrhea, fatigue and nausea are the most common side effects, the study found.

Escudier believes that cancer doctors likely will choose another drug, nivolumab, over cabozantinib as a follow-up option if initial chemotherapy treatment doesn’t work. Nivolumab works by spurring the immune system to attack cancer cells.

“I think people are going to use nivolumab as a second-line in most patients and keep cabozantinib for nivolumab failure,” he said. Nivolumab’s side effects aren’t as serious, he explained.

Escudier and his colleagues presented their findings Monday at the American Society of Clinical Oncology (ASCO) meeting in San Francisco. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Cabozantinib (Cometriq) is currently FDA-approved for treatment of patients with a specific form of thyroid cancer, the researchers said. But, it’s also being tested for many different cancer types, they added.

The current trial included more than 650 people with advanced renal cell carcinoma — the most common form of kidney cancer. They were randomly assigned to receive cabozantinib or everolimus. All of the patients had been previously treated with drugs aimed at blocking the spread of nourishing blood vessels into cancerous tumors.

The study found that cabozantinib kept cancer from progressing an average of 7.4 months. That was nearly double the 3.8 months achieved with everolimus, the researchers said.

Cabozantinib proved effective for patients facing a number of different problems, including the spread of the cancer to bone and other organs, the prior failure of other drugs to help, and an overall poor prognosis.

In addition, three out of four patients treated with cabozantinib experienced tumor shrinkage. Only half of those treated with everolimus had a reduction in their tumor size. An early look at overall survival showed a trend for improved survival for patients receiving cabozantinib compared to everolimus.

“The magnitude of benefit that patients get from cabozantinib far exceeds, in my opinion, what we’ve seen to date in this setting, in terms of both delay in tumor growth and in improving survival,” said Dr. Sumanta Pal, an ASCO expert and an oncologist at City of Hope in Duarte, Calif. “Patients who received cabozantinib had nearly double the delay in cancer growth.”

Because of the drug’s effectiveness, Pal disagreed with Escudier over whether cancer doctors will choose cabozantinib as a second-line rather than third-line treatment.

“I would perhaps tend to favor that as a second-line option, as compared to nivolumab in that setting,” Pal said. “The data for cabozantinib truly speaks for itself.”

The clinical trial received funding from the drug company Exelixis, which makes cabozantinib.

Cabozantinib is a costly medication, with prices running around $13,000 for a several month supply, according to information from the manufacturer. However, the actual price someone pays will vary depending on insurance. The manufacturer also offers assistance plans for those having difficulty paying for the medication (with or without insurance), according to the drug’s website.

More information

For more about kidney cancer, visit the American Cancer Society.

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Side Effects Seen With One Method of Weight-Loss Surgery: Study

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — While most people who undergo a type of weight-loss surgery say their well-being has improved, high rates of side effects and hospitalization are also reported, a new study finds.

Roux-en-Y gastric bypass surgery reduces the size of the stomach to a small pouch. This pouch is then attached directly to the small intestine, which affects how the digestive tract absorbs food, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Surveys completed by more than 1,400 people in Denmark who underwent Roux-en-Y surgery between 2006 and 2011 showed that only 7 percent reported reduced well-being after their procedure.

But 89 percent of patients reported one or more side effects such as abdominal pain and fatigue almost five years after surgery, and 29 percent of patients were hospitalized, the study found.

Sixty-eight percent of the patients sought health care due to their symptoms. The most common reasons for seeking health care were abdominal pain (34 percent), fatigue (34 percent), anemia (28 percent) and gallstones (16 percent), the study authors said.

Patients most likely to have symptoms after surgery were women, smokers, those younger than 35, those who were unemployed and those with symptoms before surgery. The more symptoms patients had, the lower their quality of life.

The study was published online Jan. 6 in the journal JAMA Surgery.

“Focus on the [quality of life] among patients with many symptoms may be required since such patients are at risk of depression. Development of new weight-loss treatments with less risk of subsequent symptoms should be a high priority,” study leader Dr. Sigrid Bjerge Gribsholt, from Aarhus University Hospital in Denmark, and colleagues wrote.

But one U.S. expert noted there were some caveats to the finding.

The patients were not compared against a control group, said Dr. Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York City.

Roslin also said that newer types of weight-loss surgery are being used more often, and these are “procedures that will provide better long-term results” than Roux-en-Y.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about weight-loss surgery.

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Can Early Menopause Trigger Depression Later in Life?

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — Premature menopause may increase a woman’s later risk of depression, a new review suggests.

If further studies confirm the findings, doctors might try to identify women most likely to need psychiatric or hormonal treatment after their periods end, the researchers said.

For the study, published online Jan. 6 in the journal JAMA Psychiatry, researchers analyzed the results of 14 studies that included nearly 68,000 older women.

Those whose menopause began when they were 40 and older had a lower risk of depression later in life than those with premature menopause, the study found.

Women who are older when menopause begins and have a longer reproductive life have greater exposure to the hormone estrogen, the study authors said in a journal news release.

The findings suggest “a potentially protective effect of increasing duration of exposure to [natural] estrogens as assessed by age at menopause, as well as by the duration of the reproductive period,” wrote Dr. Eleni Th Petridou, of the National and Kapodistrian University of Athens, Greece, and colleagues.

“These findings could have a significant clinical effect by allowing for the identification of a group of women at higher risk for depression who may benefit from psychiatric monitoring or estrogen-based therapies,” the researchers concluded.

While the study found an association between early menopause and depression, it did not prove cause-and-effect.

In the United States, the average age of menopause is 51, according to the American College of Obstetricians and Gynecologists.

More information

The U.S. Office on Women’s Health has more about menopause.

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Single Parents Struggle Most to Get a Good Night’s Sleep: Study

By Karen Pallarito
HealthDay Reporter

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — Single parents — moms in particular — operate on fewer hours of sleep and have poorer sleep quality than adults in other types of families.

That’s the central finding of a U.S. government report, released Wednesday, on the sleep habits of Americans by gender and family type.

It’s the first time that the U.S. National Center for Health Statistics (NCHS) has assessed adults’ sleep habits by their family situation, meaning whether they live in a single- or two-parent home, or in a household without children.

“Sleep is another domain in which single-parent families are disadvantaged,” the report concluded.

While many studies look at health-related outcomes of children in single-parent families, “generally less attention has been paid to the health of single parents themselves,” said Colleen Nugent, an NCHS health scientist and lead author of the report.

The American Academy of Sleep Medicine recommends that adults get seven hours of sleep on a regular basis for optimal health.

But the new analysis finds that parents with children under age 18, especially women, were more likely to sleep fewer hours a night and have trouble falling asleep, staying asleep and waking up feeling not well-rested.

Among adults in single-parent households, women were more likely than men (43.5 percent versus 37.5 percent) to log fewer than seven hours of sleep a day.

Across every family type, women were more likely than men to have trouble staying asleep and waking up not feeling well rested, the NCHS researchers noted. Among single parents, three in 10 women had problems staying asleep, compared with two in 10 men.

Kathryn Lee, a sleep researcher at the University of California, San Francisco, said the findings aren’t surprising.

“Women tend to make family, and especially their children, a priority in life — day and night, 24/7,” she noted.

The study, based on data from 2013 and 2014, also found that fewer adults in two-parent families (almost 4 percent) frequently took medications to stay or fall asleep than adults living without children (almost 8 percent) and adults in single-parent families (just over 7 percent).

“Even when life seems super-duper busy, you’ve got to make sleep a priority,” said Dr. Shalini Paruthi, an associate professor of internal medicine and pediatrics at Saint Louis University in Missouri.

“This is a big deal, and we already know that sleep deprivation is really common in the United States,” she added.

Poor sleep is associated with chronic illnesses, such as diabetes and heart disease; mental health issues, like depression; and risks for accidents on the road and in the workplace, the NCHS authors added.

Yet, nearly a third of American adults fail to log at least seven hours of sleep each day, according to a national study published last year.

Dr. Shelby Harris, director of Behavioral Sleep Medicine at the Sleep-Wake Disorders Center at Montefiore Health System in New York City, said women’s sleep difficulties may also be partly due to hormonal fluctuations and higher rates of anxiety, stress and depression.

The additional stressor of being a single parent while juggling work and family “can lead to worsened sleep” for women, Harris said.

“And once they’re able to get to bed, they often can’t turn their brains off since they are thinking — or even worrying — about everything that needs to get done the next day,” she added.

More information

Visit the National Sleep Foundation for tips on ” target =”_new”> better sleep hygiene.

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Why Thousands of Women Are Getting Plastic Surgery Down There

Photo: Getty Images

It’s shocking but true: One of the hot trends in plastic surgery right now is labiaplasty, a procedure to trim the vulva’s inner lips, aka the labia minora. (Add this to the list of things you shouldn’t do to your vagina.) According to the latest statistics from the American Society for Aesthetic Plastic Surgery (ASAPS), labiaplasty procedures spiked 49 percent between 2013 and 2014 (from 5,070 to 7,535). And the trend seems to be continuing.

“I am asked about labiaplasty at least once a month,” says ob-gyn Jennifer Gunter, MD, who runs a specialty clinic for vulvar conditions at Kaiser Permanente in San Francisco. “Five years ago, I was probably asked one to two times a year.”

What’s behind this (crazy?) craze? Here’s a look at the facts.

RELATED: Everything You Ever Wanted to Know About Your Vagina

Why the rise?

Michael Edwards, MD, a former president of ASAPS, told Time that some women with more pronounced labia are “devastated.” Another plastic surgeon, Richard Swift, MD, on Manhattan’s Upper East Side, told the New York Post, that women “whose labia are enlarged” feel uncomfortable in yoga pants.

But “normal” labia minora come in all shapes and sizes, ranging from 2 to 10 cm in length and 0.7 to 5 cm in width, per a study published in the journal BJOG (images NSFW). And it’s quite common for the labia minora to stick out past the outer lips of the vagina, according to Dr. Gunter, without any discomfort.

In a blog post about labiaplasty (also NSFW), she noted that smaller labia seem to have become the cultural norm, perhaps because many female performers in the adult film industry have small labia. “Whether this is a self-selecting feature or the result of surgery is hard to know,” Dr. Gunter wrote. But “if you see a lot of images of small labia minora you are more likely to come to view that as … desirable.”

RELATED: Am I Normal ‘Down There’?

How pubic hair trends also play a role

“There is an expression for men, ‘The shorter the bush, the taller the tree,’” and a similar visual effect happens with female genitalia, says Dr. Gunter. “If you remove your pubic hair or trim it significantly, you may start to notice your labia minora.”

In fact, the rise in labiaplasty has been linked to the popularity of the Brazilian wax. As Barbara Levy, MD, the VP of Health Policy at the American Congress of Obstetricians and Gynecologists, put it to NBC News, the hairless trend made women more aware of their genital appearance, and plastic surgeons saw dollar signs.

Do larger labia really cause any symptoms?

The vagina’s smaller, inner folds of skin have an important job: They protect the vaginal opening—called the vestibule—which is made up of delicate mucosa tissue, filled with highly-sensitive nerve endings.

Some women blame painful sex on the size of their labia. Others suspect their labia are the source of their yeast infections, or other irritation. Even doctors attribute some of these vulvar symptoms to the size of the labia minora. But there is almost always another cause, Dr. Gunter says. If you have vulvar symptoms, talk to your ob-gyn first—not a plastic surgeon. You might even want to see a vulvar specialist, Dr. Gunter advises.

RELATED: 20 Weird Facts About Sex and Love

Is labiaplasty safe?

A 2014 study found that more than 91 percent of women who had the surgery felt more satisfied with their genital appearance afterward. But there are no solid figures on complications, and the long-term implications are TBD. “We don’t know how labiaplasty will affect women as they become menopausal, and their tissues start to change,” Dr. Gunter points out.

The bottom line

Dr. Levy summed up the labia-trimming trend like this: “It’s one more body part that we as women are being told to be insecure about.” But that’s not to say that no woman should ever consider the procedure. As with any plastic surgery, the best advice is to make sure you’re interested in the procedure for you, rather than some outside pressure.

For an awe-inspiring reminder that every woman’s body is different, take a gander at the Great Wall of Vagina. The sculpture, by British artiest Jamie McCartney, features plaster casts of 400 vulvas, each beautifully unique.

RELATED: 7 Sneaky Reasons Your Vagina Itches

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Financial Incentives Don’t Spur Employee Weight Loss, Study Finds

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — Financial rewards meant to encourage obese employees to lose weight don’t work, a new study finds.

Many large U.S. companies offer reduced health insurance premiums or other financial incentives to entice workers to adopt healthy lifestyles and shed excess pounds, the University of Pennsylvania researchers said.

But their study of 197 obese employees concluded that more creative incentives might better lead to changes in behavior.

“There is often a presumption that the size of the reward is all that matters,” said Dr. Kevin Volpp, director of the Penn Center for Health Incentives and Behavioral Economics. “In reality, incentive systems vary in effectiveness according to how well they are designed,” he explained in a university news release.

Participants were enrolled in workplace wellness programs and given a 5 percent weight-loss goal. They were randomly assigned to a control group with no financial incentive to lose weight, or to one of three programs each offering a weight-loss incentive valued at $550.

Two of the programs offered health insurance premium reductions, and the third featured participation in a daily lottery.

After 12 months, no significant changes in average weight loss were observed among any of the four groups, according to the study published in the January issue of the journal Health Affairs.

“More than 80 percent of large employers use financial incentives for health promotion,” Dr. Mitesh Patel, an assistant professor of medicine and health care management, said in the news release. “Many use health insurance premium adjustments, but these incentives are often delayed and, even when they aren’t, they are typically hidden in paychecks along with other deductions and payments.”

Patel and his colleagues said the findings suggest that employers should consider testing alternatives to the $550 premium-based incentives used in this study.

Volpp added that “in this case, premium adjustments had little impact on weight, and the lottery incentives we used were constrained by having to do weigh-ins in workplace settings. That made sustained engagement and behavior change more challenging.”

Though study participants didn’t experience significant weight loss, that doesn’t mean that all incentive programs are ineffective, the researchers said.

Under the Affordable Care Act, often called “Obamacare,” companies can use up to 30 percent of health insurance premiums — about $1,800 for the average worker — to encourage employees to adopt healthy lifestyles.

More information

The American Academy of Family Physicians has more about healthy living.

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The health benefits of nuts

It's not all bad news when it comes to debunking the benefits of nuts. Go nuts but remember moderation is key!

Almonds
CASE: 50 g has as much calcium as half a glass of milk
Almonds are the desk snack du jour. Here’s why. A 50 g serve of almonds contains as much calcium as half a glass of milk and supplies about 130 per cent of daily vitamin E requirements (more vit E than any other nut). What’s more, their betasitosterol can block the absorption of cholesterol.

Brazil nuts
CASE: Just two nuts contains your RDI of antioxidant selenium
Forget that they’re 62 per cent fat (but remember most of it is polyunsaturated) – just two of these pearlers will meet your RDI for selenium, an antioxidant depleted in many soils. Magnesium and calcium are also in the mix.

Cashews
CASE: The most iron and zinc you’ll find in a plant source. Cashews, which make a gorgeous vegan cheese, are also a great source of folate.

Chestnuts
CASE: Low kilojoules, high fibre
The low-kilojoule wild card in the nut camp (try 214 kJ for 30 g), these floury morsels are chockers with fibre and gluten free. While they’re staples of mountain roadsides in winter, chestnuts come frozen year round.

Coconuts
CASE: Potassium to replace electrolytes after working out
Sure is (a nut), but not quite as nutritionally virtuous as its miniature cousins. Instead, coconut comes into its own in the sporting arena, with coconut water being added to fitness supplements and electrolyte replacement drinks.

Hazelnuts
CASE: Low fat and packed with B vits
Want to save a few grams of fat (even though they’re goodies)? Hit up a hazelnut, with just 36 per cent fat. The anchors of Nutella also ferry vitamins E and B6, thiamine, niacin, folic acid and calcium.  

Macadamias
CASE: No cholesterol
They may be 70 per cent fat, but 80 per cent of it is monounsaturated (good), and they’ve got zero cholesterol.

Peanuts
CASE: 25 per cent protein  
The game’s up: peanuts aren’t nuts – they’re legumes. They therefore rival beans and peas in the protein stakes, comprising almost a quarter protein. They are 49 per cent fat, which isn’t bad for a nut, and deliver bonus fibre and calcium.

Pecans
CASE: Plant source of alpha linolenic acid for omega-3s
Few plant sources can claim this, so it’s worth taking notice of pecans’ ALA. It might aid blood flow and heart health (and anyway, the ‘can makes a smackin’ pie filling).

Pistachios
CASE: Cholesterol combatant extraordinaires pistachios provide plant sterols that can block cholesterol absorption. They’re also among the best nuts for potassium and protein, and vitamin A precursor beta-carotene.

Walnuts
CASE: Omega-3s
Like pecans, walnuts boast alpha linolenic acid, which can keep blood flowing freely and assist with maintaining heart health as well as facilitating brain function. You know what they say about foods that look like brains…

Head on over and read more about other healthy fats for a balanced diet.

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Study Ties Autism Risk to Prenatal Exposure to Asthma Drugs

By Amy Norton
HealthDay Reporter

WEDNESDAY, Jan. 6, 2016 (HealthDay News) — Children whose mothers took certain asthma drugs during pregnancy may have a slightly increased risk of autism, a new study suggests.

The study, published online Jan. 6 in Pediatrics, found a connection between autism risk and prenatal exposure to drugs called beta-agonists. They are most often used to control asthma, and include inhaled medications such as albuterol, salmeterol (Serevent) and formoterol (Foradil).

Researchers said the findings do not prove cause and effect, and stressed that women with asthma should not simply abandon their medication during pregnancy.

“Uncontrolled asthma in pregnancy has been associated with poor birth outcomes, such as preterm birth, low birth weight and admission to the neonatal intensive care unit,” said lead researcher Nicole Gidaya, of Drexel University, in Philadelphia.

What’s more, preterm delivery and low birth weight have been tied to an increased autism risk.

Geraldine Dawson, director of the Duke Center for Autism and Brain Development at Duke University, in Durham, N.C., made the same point.

Taking beta-agonists during pregnancy has both potential benefits and potential risks for the developing fetus, said Dawson, who wrote an editorial published with the study.

“It’s important for a woman taking these drugs to talk with her physician and make an individual decision based on her unique circumstances,” Dawson said.

Researchers are still trying to understand the precise causes of autism spectrum disorders, which affect an estimated one in 68 children in the United States, according to the U.S. Centers for Disease Control and Prevention.

Beta-agonists come in both short-acting forms — which are used to treat asthma attacks — and long-acting forms, which are taken regularly to help prevent attacks. Gidaya said her study did not differentiate between the two.

Scientists generally agree, though, that autism arises from a combination of genetic vulnerability and certain environmental exposures. Many genes have been linked to autism risk, and the list of environmental suspects is growing.

Birth complications — especially ones that cause oxygen deprivation — are among them, according to the advocacy group Autism Speaks. So are prenatal exposures to certain infections, air pollution and some medications, such as the anti-seizure drug valproic acid, the group said.

According to Gidaya, it’s plausible that beta-agonists could affect fetal brain development in a way that raises the risk of autism. Given to pregnant lab rats, the drugs can affect fetal nerve cell development.

For the new study, Gidaya’s team combed through Denmark’s system of national databases to find information on 5,200 children diagnosed with an autism spectrum disorder. The researchers compared them with 52,000 children of the same age without autism.

Overall, just under 4 percent of children with autism had been exposed to a beta-agonist, versus just under 3 percent of other kids.

When the researchers controlled for other factors — including mothers’ asthma, parents’ age and birth complications — children exposed to beta-agonists in the womb were still 30 percent more likely to develop autism.

But while that number might sound big, it is actually a “modest” increase in autism risk, Dawson said.

Plus, there are other factors the researchers could not account for, such as exposure to pollutants, Gidaya said.

According to Dawson, more research is needed to confirm the link between beta-agonists and autism.

If the drugs are a risk factor, Gidaya said, studying the biology behind it could help researchers gain a better understanding of how autism arises.

More information

Autism Speaks has more on environmental risk factors for autism.

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Ab and core workout by Emily Skye

 

Sculpt rock hard abs with fitness IT girl Emily Skye's exclusive workout for WH&F.

This is a fantastic ab and core workout you really can do anywhere. By doing the workout in a circuit format, you also get the added benefit of a fantastic fat burning session. High-intensity circuits are by far the best way to burn fat as you have the effects of burning fat well after the workout is complete. This particular workout is a basic five-exercise circuit. The beauty of these workouts is that they are easy to construct and require minimal preparation. I do at least two sessions like this a week. I’ll simply choose five exercises, decide how many reps of each exercise I’m going to complete and how long a rest I’ll take at the completion of the five exercises.
It’s a really simple way to create your own effective workouts.

The rules: complete each exercise one after the other with as little rest in between exercises as possible. When all five exercises are complete, rest for 60 seconds. Repeat this process again five times.

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Butterfly kicks

Targets // Abs

1.     Lie on a mat.
2.     Keep your tummy tight throughout the exercise.
3.     Keep your legs straight and slightly above the ground. Kick them up and down in a controlled motion.
4. One up and down kick is one rep.
Reps: 20

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Leg lowers

Targets // Abs

1.     Lie on a mat.
2.     Start with your legs straight up with your feet facing upward.
3.     Slowly lower your legs to the ground while keeping them straight.
4.     When your heels are slightly off the ground. Return your legs upwards and start again.
Reps: 12

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Modified burpees

Targets // Abs, Glutes

 

 

1.     Squat down from standing and set yourself up like you are going to do a push-up.
2.     Keep your back straight and tummy tight so that you don’t sag in the middle.
3.     Bring your feet back up towards your chest so that you can stand back up.
Reps: 12

 

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Plank rope climb

Targets // Abs, glutes

 

 

1.     Start in a push-up position.
2.     Keep your back straight and tummy tight.
3.     Take turns in pulling your knees upwards and out to the side.
4.     One rep is complete when both left and right knees have been raised.
Reps: 10

 

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V-ups

Targets // Abs

 

1.     Lie on a mat.
2.     Place your hand on the ground for balance if required.
3.     Under control, raise your knees to your chest and lower back to ground level.
4.     Keep your tummy engaged throughout.
Reps: 10

Don't forget to complement your workouts with a healthy eating regime to maximise your results!

 

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Conquer the Weight Room: 5 Machines You Should Know How to Use

Photo: Getty Images

Let’s face it: there are few things in this world more terrifying than walking into your gym’s weight room. It’s usually pretty scarce of female allies, it often wreaks of a not-so-appealing bro-stench (some mix of body spray and B.O.), and (worst of all) it’s filled to the brim with mysterious machines you have no idea how to use.

Sure, you could probably figure it out if you tried, but if you’ve never been trained to use the equipment at your gym, it can be incredibly intimidating. What if you accidentally sit backwards on the machine, totally embarrassing yourself? Or worse, what if you use too much weight and hurt yourself? These are genuine (and totally reasonable) fears.

To help move past your gym-fright, Curtis Williams, Under Armour sponsored trainer and owner of Training Camp NYC, gave us a crash course in the top 5 pieces of weight-lifting at the gym. Stick to his tips and you’ll be master of the machines in no time.

RELATED: 4 Reasons Women Shouldn’t Fear the Weight Room 

For all these machines, start with around 15 pounds on each side. Rather than increasing weight too quickly, focus on perfecting your form. When it comes to reps, if you’re trying to build endurance, go for 15-20 and 1-4 sets. If you want to focus on strength, stick with the same number of sets, but 8-12 reps.

 Smith machine

Photo: Courtesy of Precor

First things first: let’s get those legs nice and toned. Williams says the Smith Machine is a great starting point because it forces you to learn how to stabilize through both feet—an important foundation for lifting. Here’s how to conquer this beast:

1. Start with no weight on both sides and focus on getting comfortable under the bar itself, with your hands supporting the bar on either side of your head.
2. Place your feet hip-width apart.
3. Now squat! Bend your knees as close to 90 degrees as you can, driving your tailbone towards the floor. Engage your core to protect lower back. You should feel the burn in your quads and hamstrings
4. While you move through your reps, focus on good posture: keep your spine aligned and perpendicular to the floor.

RELATED: 16 Ways to Lose Weight Fast

Cable Fly Machine

Photo: Courtesy of Precor

This machine should be your new go-to for strengthening your chest muscles. Plus,  since you have to stabilize through your core the entire time—it doubles as a great ab workout, Williams says. Win, win!

1. Stand between the two handles, grabbing one in each hand, arms wide. Your elbows should be slightly bent so there’s no strain on your joints.
2. Engage your core, and bend your knees slightly.
3. Now bring your arms in, like you’re trying to touch your fists to your chest.
4. Hint: if your hips are moving, your core isn’t engaged, you’re using too much weight, or both. Make sure your motion is controlled in both direction—the weight shouldn’t be so heavy that it yanks your arms back.

Plate-loaded seated row machine

Photo: Courtesy of Precor

Williams recommends using this machine to strengthen your back because it’s very versatile. With just a quick grip adjustment on the handles, you can transition between targeting your lower or upper back. Plus, it’s a surefire way to fix your posture after spending long hours slumping over your phone or computer.

1. Get in a comfortable, seated position with your chest against the cushion. (You will be straddling the seat.)
2. Pick either the high-grip (making fists horizontal) or the close grip (with fists in a vertical position). The high-grip targets the upper back, with the close grip targeting the lower back.
3. Pull each side individually, and alternate between left and right. That’s one rep.
4. Make sure you stay balanced on both sides, and your posture is never compromised.

RELATED: 10-Minute Moves for Strength, Speed, and Agility

Seated shoulder press machine

Photo: Courtesy of Precor

This machine is great for weight-room beginners because it’s incredibly simple and manageable—even if you’ve never done a shoulder press in your life. Follow Williams’ steps to look like a total pro:

1. Find a comfortable, seated position on the machine (pictured).
2. Make sure your elbows are level with earlobes.
3. Grip the hand holds comfortably, and press up until your arms are fully extended.
4. Bring your arms back down and make sure the movement is controlled.

RELATED: 5 Killer Push-Up Variations for Seriously Sculpted Arms

Incline ab bench

Last, but certainly not least, let’s get to toning your favorite area: abs. Sure, you could knock out a ton of core work on the ground, but you could also take it to the next level with an incline ab bench. Manipulating the angle of the bench creates an added challenge. You can also use a medicine ball to increase resistance to boost your sculpting potential. But for just the basics, follow these tips:

1. Climb onto the bench insert your legs into the padded areas on either side of the handles, hooking your legs on the padded rests and leaning back.
2. Face your chin forward to protect the back of your neck. And use your core muscles to sit up with your hands across your chest.
3. Start with a slight incline, and re-adjust the bench higher if that’s too easy. For even more of a challenge, keep your elbows wide and hands behind your head.

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