Well: The Benefits of Exercising Outdoors

While the allure of the gym — climate-controlled, convenient and predictable — is obvious, especially in winter, emerging science suggests there are benefits to exercising outdoors that can’t be replicated on a treadmill, a recumbent bicycle or a track.

You stride differently when running outdoors, for one thing. Generally, studies find, people flex their ankles more when they run outside. They also, at least occasionally, run downhill, a movement that isn’t easily done on a treadmill and that stresses muscles differently than running on flat or uphill terrain. Outdoor exercise tends, too, to be more strenuous than the indoor version. In studies comparing the exertion of running on a treadmill and the exertion of running outside, treadmill runners expended less energy to cover the same distance as those striding across the ground outside, primarily because indoor exercisers face no wind resistance or changes in terrain, no matter how subtle.

The same dynamic has been shown to apply to cycling, where wind drag can result in much greater energy demands during 25 miles of outdoor cycling than the same distance on a stationary bike. That means if you have limited time and want to burn as many calories as possible, you should hit the road instead of the gym.

But there seem to be other, more ineffable advantages to getting outside to work out. In a number of recent studies, volunteers have been asked to go for two walks for the same time or distance — one inside, usually on a treadmill or around a track, the other outdoors. In virtually all of the studies, the volunteers reported enjoying the outside activity more and, on subsequent psychological tests, scored significantly higher on measures of vitality, enthusiasm, pleasure and self-esteem and lower on tension, depression and fatigue after they walked outside.

Of course, those studies were small-scale, short-term — only two walks — and squishy in their scientific parameters, relying heavily on subjective responses. But a study last year of older adults found, objectively, that those who exercised outside exercised longer and more often than those working out indoors. Specifically, the researchers asked men and women 66 or older about their exercise habits and then fitted them all with electronic gadgets that measured their activity levels for a week. The gadgets and the survey showed that the volunteers who exercised outside, usually by walking, were significantly more physically active than those who exercised indoors, completing, on average, about 30 minutes more exercise each week than those who walked or otherwise exercised indoors.

Studies haven’t yet established why, physiologically, exercising outside might improve dispositions or inspire greater commitment to an exercise program. A few small studies have found that people have lower blood levels of cortisol, a hormone related to stress, after exerting themselves outside as compared with inside. There’s speculation, too, that exposure to direct sunlight, known to affect mood, plays a role.

But the take-away seems to be that moving their routines outside could help reluctant or inconsistent exercisers. “If outdoor activity encourages more activity, then it is a good thing,” says Jacqueline Kerr, a professor at the University of California, San Diego, who led the study of older adults. After all, “despite the fitness industry boom,” she continues, “we are not seeing changes in national physical activity levels, so gyms are not the answer.”

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Inflation remains tame, but so do gains in earnings









WASHINGTON -- Despite worry in some corners about the Federal Reserve's stimulus efforts stoking inflation, there continues to be little indication that consumer prices are heading higher.


The consumer price index was flat in January for the second month in a row, the Bureau of Labor Statistics reported Thursday. A drop in gas prices and a halt to recent gains in food prices held down the overall index. Compared with a year ago, the consumer price measure for January was up a mild 1.6%.


But that moderate inflation rate will provide little comfort to most consumers. Not only have gas prices jumped in recent weeks, the end of the payroll tax holiday at the start of this year has clipped about $40 from the biweekly paycheck for the average worker.








With that, inflation-adjusted average hourly earnings in January were up just 0.6% from a year ago, the Bureau of Labor Statistics said.


Excluding energy and food, the so-called core measure of consumer prices, which is more closely tracked by the Fed, rose 0.3% in January from December, the highest in 20 months. Higher prices for clothes and shelter accounted for much of that increase, although consumers also paid more for airline fares, medical services and school tuitions in January.


Still, the annual core inflation rate in January held at 1.9% for the third straight month. That is just a notch below the 2% inflation target set by the Fed, which has been pumping money into the financial system to stimulate economic growth and help bring down the high jobless rate.


The Fed's stimulus efforts include the purchase of $85 billion worth of government and mortgage bonds a month, aimed at holding down long-term interest rates to spur investment, spending and hiring. Many economists and policymakers, including some Fed members, are concerned that the central bank's easy-money policies will lead to spiraling inflation down the road.


So far, there’s little sign of that.


"Consumer inflation remains relatively tame, mostly because of persistently subdued economic growth," said Diane Swonk, chief economist at Mesirow Financial in Chicago. "Ongoing constraints on consumer budgets, however, will force a reallocation away from discretionary purchases toward necessities. This will hold overall inflation in check, but remain extremely uncomfortable."


ALSO:


Consumer sentiment bounces back in February


Retail sales growth slows as higher payroll tax resumes


More Fed officials worry about negative effects of stimulus





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Grapevine on Interstate 5 closed due to ice















































The California Highway Patrol shut down a stretch of Interstate 5 through the Grapevine early Wednesday because of ice.


The freeway was closed about 6:35 a.m. between Castaic and Grapevine Road, said CHP Officer Ed Jacobs. No motorists were stranded, he said.


“Until further notice, it’s Mother Nature’s call” on when to reopen the highway, Jacobs said.








Lingering rain, snow showers and gusty winds were expected to affect mountain regions until midday, according to the National Weather Service. Up to three inches of snow could fall Wednesday at elevations as low as 2,000 feet.


The additional precipitation could create hazardous icy roadways, the National Weather Service said. Snowfall, coupled with heavy winds, could reduce visibility to zero.


A stretch of California 58 in Kern County, which was shut down Tuesday night because of snow, remained closed, according to the California Highway Patrol.






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Robin Roberts returns to 'Good Morning America'


NEW YORK (AP) — Five months after undergoing a bone marrow transplant, Robin Roberts is back on television in the morning.


Roberts said Wednesday she'd been waiting 174 days "to say this, good morning America."


The morning-show host is recovering from MDS, a blood and bone marrow disease. She looked thin with close-cropped hair but was smiling broadly, back at work on "Good Morning America" at ABC's studio in New York.


Roberts was welcomed back in a taped message from President Barack Obama and his wife, Michelle, former ESPN colleagues and Magic Johnson.


ABC announced Roberts will interview the first lady later this week, to be shown next Tuesday.


ABC News President Ben Sherwood came into the studio to give fist bumps to the anchors at the 7:25 a.m. EST break. He said Roberts' health will be closely monitored to make sure she doesn't overdo it at the beginning.


"This was up to Robin, her doctors and God," Sherwood said. "It's a day that we all rejoice."


ABC didn't miss a beat with her absence, continuing in first place in the ratings after first overcoming NBC's "Today" show last spring. Sherwood said the success with Roberts' absence surprised him.


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Ask an Expert: Questions About Hearing Loss? A Help Desk





This week’s Ask the Expert features Neil J. DiSarno, who will answer questions about hearing loss. Dr. DiSarno is the chief staff officer for audiology at the American Speech-Language-Hearing Association. From 1998 to 2012 he was chairman of the department of communication sciences and disorders at Missouri State University. Following are the types of questions that Dr. DiSarno is prepared to answer.







Neil J. DiSarno of the American Speech-Language-Hearing Association.







¶My wife has told me she believes I’m not hearing as well as I used to. What sort of specialist should I see and what can I expect?


¶I’ve been told that I should consider using hearing aids. If I decide to, how much better am I likely to hear?


¶I’ve noticed that my 2-year-old granddaughter’s speech is not developing properly. Neither her mother or the pediatrician seem to be concerned, but I suspect there is a problem. What do you suggest?


¶I use hearing aids, but still have great difficulty hearing conversation in restaurants and in large group settings. Is this common and is there something more that I can do to improve my ability to function in those settings?


Please leave your questions in the comments section. Answers will be posted on Wednesday, Feb. 27. (Unfortunately, not all questions may be answered.)


Booming: Living Through the Middle Ages offers news and commentary about baby boomers, anchored by Michael Winerip. You can connect with Michael Winerip on Facebook here. You can follow Booming via RSS here or visit nytimes.com/booming and reach us by e-mail at booming@nytimes.com.


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2 fugitives accused of Medicare fraud may be in Glendale, U.S. says

























































































Medicare fugitives sought


Federal investigators say Anush Sahakyan, above, and Karo Gotti Blkhoyan fraudulently billed Medicare for $1.3 million.
(U.S. Department of Health and Human Services)













































Federal authorities say two of Medicare's most-wanted fugitives may be hiding out in Glendale.


Healthcare investigators say Karo Gotti Blkhoyan, 32, and Anush Sahakyan, 29, set up a phony medical clinic in South Carolina from 2009 to 2010 and billed for $1.3 million in false claims. Medicare paid out more than $300,000.


The pair, indicted last year on charges including healthcare fraud and money laundering, used the stolen identities of Medicare patients in California and New York, officials said.





"We have information through witnesses that they are in the Glendale area," said Su Kim, a special agent in South Carolina with the U.S. Department of Health and Human Services' inspector general.


The inspector general's office launched its most-wanted list in 2011, and 41 fugitives have been captured thus far. There are more than 170 fugitives on the list, officials said.


The giant healthcare program has been a tempting target for criminals for years. Medicare processes about 2.9 million claims daily and 10,000 seniors join the rolls every day.


ALSO:


Small surgeries, huge markups


Tax help comes with health insurance advice


Former L.A. clinic owner makes Medicare's most-wanted list


Follow Chad Terhune on Twitter






















































































































































































































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At least one dead in shootings near Tustin; SigAlert on 55 Freeway



























































































































At least one person was dead Tuesday morning after shootings in multiple locations in Tustin, KTLA-TV reported.


The shootings occurred near the 55 Freeway, according to officials with the Tustin Police Department.


A SigAlert was issued at 6 a.m. for the southbound 55 Freeway at McFadden Avenue and the McFadden exit ramp was closed.





































































































































































































Comments are filtered for language and registration is required. The Times makes no guarantee of comments' factual accuracy. Readers may report inappropriate comments by clicking the Report Abuse link next to a comment. Here are the full legal terms you agree to by using this comment form.












































';
shareDiv.innerHTML = templateHTML;

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document.body.appendChild(shareDiv);

/* Store the div in both a regular JavaScript variable and as a jQuery object so we can reference them faster later */
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/* This extends our settings object with any user-defined settings passed to the function and returns the jQuery object shareTip
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NBC hires former Obama strategist


NEW YORK (AP) — David Axelrod, former strategist and aide to President Obama, has landed a new job at NBC News.


The network said Tuesday that Axelrod is joining as a senior political analyst. He'll contribute to broadcasts on both NBC News and the cable network MSNBC.


Axelrod helped run Obama's successful campaigns in 2008 and 2012 and worked as an adviser to the president during his first term. The former political writer and columnist for the Chicago Tribune started his own political and media consulting firm in 1984.


NBC already employs Steve Schmidt, a top adviser to Obama's 2008 opponent John McCain, as an analyst.


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Well: Susan Love's Illness Gives New Focus to Her Cause

During a talk last spring in San Francisco, Dr. Susan Love, the well-known breast cancer book author and patient advocate, chided the research establishment for ignoring the needs of people with cancer. “The only difference between a researcher and a patient is a diagnosis,” she told the crowd. “We’re all patients.”

It was an eerily prescient lecture. Less than two months later, Dr. Love was given a diagnosis of acute myelogenous leukemia. She had no obvious symptoms and learned of her disease only after a checkup and routine blood work.

“Little did I know I was talking about myself,” she said in an interview. “It was really out of the blue. I was feeling fine. I ran five miles the day before.”

Dr. Love, a surgeon, is best known as the author of the top-selling “Dr. Susan Love’s Breast Book” (Da Capo Press, 2010) now in its fifth edition. She is also president of the Dr. Susan Love Research Foundation, which focuses on breast cancer prevention and research into eradicating the disease. But after decades of tireless advocacy on behalf of women with breast cancer, Dr. Love found herself in an unfamiliar role with an unfamiliar disease.

“There is a sense of shock when it happens to you,” she said. “In some ways I would have been less shocked if I got breast cancer because it’s so common, but getting leukemia was a world I didn’t know. Even when you’re a physician, when you get shocking news like this you sort of forget everything you know and are scared the same as everybody else.”

Because Dr. Love’s disease was caught early, she had a little time to seek second opinions and choose her medical team. She chose City of Hope in Duarte, Calif., because of its extensive experience in bone marrow transplants. At 65, Dr. Love was startled to learn she was considered among the “elderly” patients for this type of leukemia.

She was admitted to the hospital and underwent chemotherapy. Because her blood counts did not rebound after the treatment, her stay lasted a grueling seven weeks.

She went home for just two weeks, and then returned to the hospital for a bone-marrow transplant, with marrow donated by her younger sister, Elizabeth Love De Garcia, 53, who lives in Mexico City.

Although the transplant itself was uneventful, the next four weeks were an ordeal. Dr. Love developed pain and neuropathy from the chemotherapy drugs. Dr. Love’s wife, Dr. Helen Cooksey; daughter, Katie Love-Cooksey, 24; and siblings offered round-the-clock support. Ms. Love-Cooksey slept in the hospital every night. “I wasn’t very articulate during that time, but I always had my family there,” Dr. Love said. “They were great advocates for me.”

The transplant “is quite an amazing thing,” Dr. Love said. Her blood type changed from O positive to B positive, the same type as her sister. She also has inherited her sister’s immune system, and a lifelong allergy to nickel has disappeared. “I can wear cheap jewelry now,” she said. She returned to work last month.

Dr. Love has been told her disease is in remission, though her immune system remains compromised and she is more susceptible to infection. So she avoids crowds, air travel and other potential sources of cold and flu viruses.

While Dr. Love has always been a strong advocate for women undergoing cancer treatment, she says her disease and treatment has strengthened her understanding of what women with breast cancer and other types of cancer go through during treatments.

“There are little things like having numb toes or having less stamina to building muscles back up after a month of bed rest,” she said. “There is significant collateral damage from the treatment that is underestimated by the medical profession. There’s a sense of ‘You’re lucky to be alive, so why are you complaining?’ ”

Dr. Love says her experience has emboldened her in her quest to focus on the causes of disease rather than new drugs to treat it.

“I think I’m more impatient now and in more of a hurry,” she said. “I’ve been reminded that you don’t know how long you have. There are women being diagnosed every day. We don’t have the luxury to sit around and come up with a new marketing scheme. We have to get rid of this disease, and there is no reason we can’t do it.”

People who remain skeptical about the ability to eradicate breast cancer should look to the history of cervical cancer, she said. Decades ago, a woman with an abnormal Pap smear would be advised to undergo hysterectomy. Now a vaccine exists that can protect women from the infection that causes most cervical cancers.

“We need to focus more on the cause of breast cancer,” she said. “I’m still very impressed with the fact that cancer of the cervix went from being a disease that robbed women of their fertility, if not their lives, to having a vaccine to prevent it.”

Dr. Love, who wrote a book called “Live a Little!,” said illness has also made her grateful that she didn’t put off her “bucket list” and that she has traveled the world and focused on work she finds challenging and satisfying.

“It just reminds you that none of us are going to get out of here alive, and we don’t know how much time we have,” she said. “I say this to my daughter, whether it’s changing the world or having a good time, that we should do what we want to do. I drink the expensive wine now.”

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Talk of more corporate deals sends stocks higher









Talk of more mergers and acquisitions is sending stock prices higher in early trading, setting the market up to continue a seven-week rally.

Reports that retailers Office Depot and OfficeMax are discussing a combination come after several big corporate deals were announced in recent weeks. Investors are becoming optimistic that more deals could be on the way as buyers pay premium prices for publicly traded companies.

The Dow Jones industrial average was up 44 points at 14,025 after the first hour of trading Tuesday. U.S. markets were closed Monday for the Presidents' Day holiday.

The gains were broad. All 10 of the industry groups tracked by the Standard & Poor's 500 index rose, led by consumer staples. Two stocks rose for every one that fell on the New York Stock Exchange.

The S&P 500 was up five points at 1,525. The technology-heavy Nasdaq composite index was up nine points at 3,201. Google traded above $800 a share for the first time.

Markets were also higher in Europe following news that the German economy is picking up steam. Indexes rose about 1 percent in Germany, France and Britain.

Stocks of office supplies stores jumped in early trading following a report in The Wall Street Journal that OfficeMax and Office Depot were considering a deal to combine, which would result in big cost savings. The paper said an announcement could come as early as this week.

OfficeMax soared $2.73 to $13.48, a gain of 25 percent, and Office Depot shot up 821 cents to $5.41, a gain of 18 percent. Staples also rose as investors anticipated that more mergers could be on the way for companies that sell office supplies.

Analysts cautioned that corporate deals in the highly competitive office supply business may not win the approval of antitrust regulators. Staples tried to buy Office Depot in 1997, but was blocked by the Federal Trade Commission.

The news follows shortly after a wave of big corporate deals that involved household names like Heinz and Dell.

Health insurers fell following the release of preliminary government data that suggests rate cuts to Medicare Advantage plans for next year that were steeper than many had anticipated.

Humana had the biggest loss in the S&P 500, dropping $6.27 to $71.72, a drop of 8 percent. UnitedHealth fell $1.35 to $56. Humana and UnitedHealth are the two largest Medicare Advantage providers.

The government says it expects costs per person for Medicare Advantage plans to fall more than 2 percent in 2014. The government uses this figure as a benchmark to determine payments for these privately run versions of the government's Medicare program, which covers the elderly and disabled. Medicare Advantage plans are offered by health insurers and subsidized by the government.

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