movement

Water is a powerful energy balancer. Water treatments have been used for centuries to help heal illness and to keep healthy people well. They are so good at balancing energy that most people who begin to experiment with hydrotherapy techniques are astounded by what they can do. During a two-day detox, they can help with the elimination process enormously – after all, this is the prefect time for long, relaxing soaks in the bath to soothe your mind and encourage your body to get on with its job. Dr Douglas Lewis, whilst head of physical medicine at John Bastyr College Natural Health Clinic in the United States explained: ‘Hot water produces a response that stimulates the immune system and causes white cells to migrate out of the blood vessels and into the tissue where they can clean up toxins and assist the blood in eliminating waste’. Hot and cold water applied alternately to the surface of your skin stimulates circulation and spurs good lymphatic drainage, also helping your body to eliminate wastes quickly. Hydrotherapy is also fun. epsom salts bath Epsom salts baths are an old and potent practice for eliminating toxins through the surface of the skin. Epsom salts are magnesium sulfate. Both magnesium and sulfate molecules have an ability to extract excess sodium, phosphorus and nitrogenous toxins from the body. This is why athletes use them to relieve muscular pain. Magnesium sulfate dissolved in water creates a static, unified, electrical field, and immersing your body in it helps to create a magnetic balance. During your apple fast, taking an Epsom salts bath helps speed up the detoxification process and minimizes any aches, pains or fatigue which sometimes come with rapidly eliminating stored toxins from the body. Epsom salts are also wonderful during periods of prolonged stress and when you are feeling overtired. Take two cups of household-grade Epsom salts (available from the chemist), pour them into the bath and fill with blood-temperature water. Immerse yourself for 20 to 30 minutes, topping up with warm water when necessary to maintain a comfortable temperature. Get out of the bath and lie down for 15 minutes – better still, take an Epsom salts bath just before you go to bed. the heat bath Saunas can be a great help during a detoxification regime, as artificially induced perspiration is one of the best means of deep-cleansing the body. However, most of us don’t have a sauna at home. You can get a similar effect – in terms of the elimination of waste through the skin and deep relaxation – by taking a carefully regulated hot bath, provided your tub is large enough for you to immerse all of your body except your head in it. Make sure your bathroom is warm and comfortable – have candles for soft lighting, play some relaxing music, and put your towel somewhere so that it will be ready-warmed for you when you get out. The temperature of the bath is crucial. It needs to be kept at about 105-110 degrees F (40-43 degrees C) – just a few degrees above normal body temperature. Hotter than this can be over-stimulating to the body. You can use a simple thermometer to check the temperature every five minutes and keep topping up with hot water to bring it back when it starts to fall. Lie in the bath for 15 to 20 minutes with just your head sticking out. Then get out, quickly wrap yourself in a big towel (or a cotton sheet if you prefer) and lie down and relax, covering yourself with a blanket, for another 20 minutes. blitzguss A real blitzguss needs to be done by a professional, but you can get many of the same effects in the shower yourself at home – especially if you have a handheld shower which you can direct on different parts of your body. Take a warm shower until your skin is really glowing with warmth. Then turn off the hot water and using only cold, direct it over your face and then down your arms and legs, over your trunk and abdomen and down your back. The process should take no more than 30 seconds. Then get out of the shower, pat off the excess water and dress warmly. This is particularly good done just after skin brushing. Your skin is so fresh and clean after being brushed that it fairly zings in contact with warm water. The quick burst of cold water will make it zing again and get the circulation going a treat. If at any time you feel uncomfortable using any hydrotherapy technique, stop immediately and try again another time. Never force yourself to ‘suffer’ if any of them cause any tension either in your body or your mind. dew bath One of the oldest, and for me one of the most decadent, natural treatments is walking barefoot on dewy grass. The treatment was traditionally used to strengthen immunity, stimulate intestinal functions, act as a counterirritant for the chest and throat and relieve headaches. It is good to use during a two-day detox not only because it is stimulating to the whole system, but also because of the sense of clean freedom it gives you. If you are not in the habit of going barefoot, begin gradually. Start by simply rubbing the feet with a wet cloth for a minute or two then put on socks and shoes and walk about. After a few times try walking on dry grass and then on wet grass – first thing in the morning in the summer is just wonderful. Take the treatment whenever you get a chance – in the garden, in the park or in the country. Bare your feet to the elements and you’ll reap the benefits. By the way, bathing your feet can help with a headache, too. Half fill a bath with cold water. Then, making sure you are well covered so your body doesn’t get cold, walk about in it with bare feet for three minutes. Immediately afterwards, put on warm socks and lie down for ten minutes. You might feel silly doing it, but it really can help, and it gives you the same lift as paddling in the sea. air bath Water is not the only thing you can bathe in. Of all the nature cure treatments, the air bath is the simplest. It involves removing all your clothing and allowing fresh air to circulate around your body for a few minutes. It is believed that exposing the body in this way even for only ten minutes can increase metabolism temporarily by as much as 50 percent, no bad thing when you are trying to eliminate wastes. Certainly it makes sense to regularly give your entire skin surface a chance to breathe unrestricted by clothing. The easiest way to take a regular air bath is to strip down while you do your morning or evening toilet. Make sure you open a window in the bathroom so that there is fresh air. If you need to turn on a heater in the room do, although cool air on your body for a few minutes can have a positive, stimulating and strengthening effect. This is yet another technique you can use after your two-day apple fast to tone your skin and help keep that feeling of being fresh and alive that comes after a detox.

“I’ve got no energy.” It’s the complaint I hear most often from men and women...an experience which carries endless consequences: feeling sluggish, unmotivated, and devoid of the sparkle that makes life enjoyable. In truth, energy potential is still there within you. It just needs to be rediscovered and set free. Begin by listening to the whispers of your soul, and the rest will come naturally. I’d like to share with you my Ten Steps to Energy. They work. For some they have even been life-changing. So let’s get started… STEP ONE—GET INTO BODY Did you know that how you think and feel are inextricably linked to how well your body functions? Mind and body are integrated through our nerve pathways, hormones and chemical messengers. The first step, therefore, requires a real change of perspective. Start to see your body as not external to yourself: but as the physical expression of who you are. Decide you matter. Decide that you have a right to energy. You do. STEP TWO—RECORD IT As when embarking on any new journey, it helps to know where you’re starting from. So as you’re starting the energy journey, take note of where you are now. Start an energy diary. Try writing down a few sentences about how you think and feel, where you want to be, and record anything you think may be holding you back. Form a crystal clear vision of what you are seeking to achieve. The clearer your visualization, the easier it becomes to make high energy a reality. STEP THREE—FIND THE DRAINERS Unfortunately, our world is filled with external energy parasites. Environmental poisons—like pesticides, solvents, estrogens, heavy metals, junk foods. Then there are the inner energy thieves: Negative emotions. Addictions. Low self-esteem. With all these energy enemies pitted against us, it may seem like an uphill battle. But don’t be disheartened. Once you have identified the drainers at work in your life, you can take action to fight them. STEP FOUR—DO A HEALTH CHECK Not only are there environmental and emotional energy drainers to watch out for. Biochemical factors may also come into play. These include things like low blood sugar; allergies; anemia; yeast infections; leaky gut syndrome. How do we start addressing these drainers? Identify and eliminate foods from your diet which are causing or worsening these conditions. You might also want to supplement with the nutrients or digestive enzymes you’re low on. STEP FIVE—CLEAR THE JUNK So far you’ve started your energy journey and dealt with the baddies sapping your vitality. Now is the time for bold action. It’s time for a detox—spring cleaning your body from the inside out. Over the years, a less-than-optimum diet results in wastes building up in the tissues. The energy expended on dealing with these toxins is less energy for you to utilize. So it’s time to clear out the junk. Quite literally, throw away all your junk food. Drink plenty of water. Try a fruit-fast for a day or two. Then you’re ready for the next step—making alterations to the kind of foods you were eating before. STEP SIX—EAT REAL FOODS Too few people know that grains and grain-based products are terrible for energy levels—especially in the amounts that many of us eat them in. This is cutting edge science—still ignored by the media and much of the medical profession as a result of pressures from Big Pharma and the multinational convenience food industry, as well as the FDA. Grains, cereals, convenience foods—which most of the western world lives on—turn rapidly into glucose when we eat them. This creates serious health issues: Weight gain in those with a genetic propensity to it, rapid aging, and degenerative diseases such as heart disease, arthritis, and even cancer. This is hot stuff, yet still largely unrecognized by most. A high-energy way of eating shuns them. It emphasizes lots of fresh vegetables and fruits, pulses, sprouted seeds and lean, high-quality proteins. STEP SEVEN—EAT MORE SUPERFOODS Next, it’s time to acquaint yourself with some of Nature’s superfoods. To name just a few: Spirulina—seaweeds— chlorella, white tea, immune-enhancing mushrooms like shiitaki and maitake. Tap into their amazing power. You won’t look back. STEP EIGHT—GET MOVING Pick a physical activity that you absolutely love, and get into it. It can be anything you like, so long as it’s regular (done maybe three times a week), consistent (lasting 20 to 30 minutes each time), rhythmic, and uses plenty of large muscle groups. If you’re stuck for ideas, here are a few suggestions: Walking. Easily incorporated into daily life, and a great option if you’re unfit. Yoga. Incredibly adaptable and practical, especially for frequent travelers. Rebounding (bouncing up and down on a mini-trampoline). So much fun, and perfect to do at home, regardless of your fitness level. It may be a little hard to get started, but once you do, you’ll look forward to it. Exercise becomes a reward in itself. STEP NINE—LAUGH IT OFF You’ve learnt the serious stuff. Now it’s time to start living with energy and joy. Laughter is a great way to start. It’s good for your immune system and your entire body. Seek out and spend time with the people whose sense of humor you love. Watch wonderful comedy movies like Dirty Rotten Scoundrels, Bowfinger, Roxanne. They will cheer you up endlessly and help you energize your life. STEP TEN—LOOK AHEAD We’ve now come full circle. Go back to your energy diary and the questions you asked yourself in step two. Have your answers changed? Set some more goals, and be specific. Ask yourself positive questions, and record answers when they come. Make a long-term energy plan featuring aspects of the other steps you found most helpful. Remember, the energy process is an ongoing journey. And it’s an amazing one. Enjoy it!

Epsom salts baths are one of the world’s most potent yet underrated natural treatments. Don’t take them lightly. They can improve your health and they cost almost nothing. They can be useful if you have been having a stressful day because they deep cleanse the body, both physiologically and energetically. They are great for encouraging deep, restful sleep and relaxation. Epsom salts also carry a magic that goes way beyond this. Lying in an Epsom salts bath is a superb way to enter your inner world and make you aware of dreams and longings you may not even have discovered yet. Use them to help forge deep connections with your essential being. Use them often and just allow yourself to BE instead of having to DO all the time. Named after a compound of minerals discovered in 17th century England, Epsom salts were first discovered by Nehemiah Grew in Epsom, a small town not far from London. He discovered that Epsom salts could relieve pain in muscles, calm headaches, and quell inflammation. Early on, drinking Epsom water was used as a purgative. The salts themselves were produced by boiling Epsom water until it turned into hydrated magnesium sulfate—which is where the name Epsom salts comes from. This hydrated magnesium sulfate brings important minerals your body, and they are absorbed through the skin when you take an Epsom salts bath. Both the magnesium and the sulfate molecules have the ability to leach excess sodium, phosphorous, and nitrogenous wastes from the body. As they reduce toxicity, more of your body’s energetic potential gets freed up for use. Magnesium and sulfur also happen to be among the most alkalinizing of earth minerals. In practical terms, what this means is that they have the ability to create more physical space between the atoms and molecules of your body. This is important since the greater the acidity in the body and the more compressed this molecular space becomes, the greater the physical and emotional pressure you feel. There’s more good news. When you step into an Epsom salts bath, magnesium sulfate immerses your body in a unified electrical field. This takes excess electrical discharge from one area of the body and sends it to areas that are undercharged, which creates energetic balance and flow. There is nothing quite as good as an Epsom salts bath; for instance, taking an Epsom salts bath after you have been on a long flight or if you are suffering from jet lag, emotional tension, or fatigue. Magnesium deficiencies are rampant in the Western world as industrial agriculture has removed massive quantities of magnesium from our soils and also because most people choose to feed themselves on packaged convenience foods. More than 80 percent of people in the United States are deficient in magnesium. Very few have any idea just how important magnesium is to their health. Magnesium is the second-most abundant element in your cells. It is also the fourth most positively charged ion in your body and essential to more than 300 specific enzymes in the body. Magnesium helps activate your muscles and nerves. It’s a catalyst for vital neurotransmitters like serotonin. It helps create ATP, which are energy molecules for your body. And it must be present for optimization of the mitochondria in cells, which are crucial for vitality, health, and athletic performance. What about sulfur—the other half of the Epsom salts equation? Sulfur is a natural detoxifier. It is a powerful antioxidant, pain reliever, and anti-inflammatory. Inviting sulfur into your body through the surface of your skin while lying in an Epsom salts bath is a superb way to strengthen your system as a whole. The electrical charge between magnesium with its positive charge and sulfur with its negative charge helps these two minerals blend together in a superb way. There is a very specific way of taking an Epsom salts bath. Let me share it with you: Pour two large cups of industrial grade Epsom salts into the bathtub. You can find them in small amounts at the chemist and in supermarkets. Far better is this: order in bulk a 25 kg bag over the Internet. This way Epsom salts are inexpensive. One more tip: I like to add a pound of sodium bicarbonate (baking soda) to every Epsom salts bath because it blends well with magnesium sulfate and is wonderful for skin. But you must make sure that any baking soda you use contains no aluminum since this is the last thing you should ever put into your bath water or anywhere else. Fill the bath with blood-heat tepid water, just above body temperature. Immerse yourself in it for at least 20 to 30 minutes. If your body gets too cool, add some more hot water. If your body becomes too warm, add some cold water. You need to be able to sustain being in this bath in a very relaxed state for 20 to 30 minutes. Then get out of the bath and wrap yourself in a towel. If you are doing this just before bed, now climb into bed, cover yourself up, keep warm, and you can easily drift into blissful sleep. If it’s during the day or if you are trying to restore yourself to be able to go out in the evening, then when you get out of the Epsom salts bath wrap yourself up in a towel and lie down for 10 minutes. Then get up, get dressed, and go about doing whatever you are intending to do. In our home we are completely addicted to the joys and the benefits of daily Epsom salts baths. I predict that you too may become the addicts we have become. Try it and see.

One factor which has a powerful influence on how much energy you have is not your physical strength, or what you had for lunch, nor even how much sleep you got last night, but rather whether or not you are totally involved at any particular moment in what you are doing - physically, mentally, and emotionally. To be able to live this way, what you are doing has to have value to you. It has, in some way, to feed your soul or satisfy some longing or value or goal for you. Biologists, sports experts, and psychologists have recently studied the phenomenon of energy or vitality, and tried to distinguish between the traits of those people with high energy levels and the rest of us. They have discovered that, whether looking at sportsmen, executives, artists, or craftsmen, those with high energy all have one thing in common: total involvement. A few lucky people - often they are those who are vitally interested in their work or hobbies - find total involvement comes naturally. For the rest of us it has to be learned. We have to train ourselves in much the same way as students of Aikido, Japanese sword training, or Tai Chi do - slowly and systematically. Rarely in Western society do we function as a whole. Most of us tend to do whatever we are doing with half our thoughts on what we are going to do when we have finished, or thinking about what we should have done yesterday but didn't. Such distractions not only make the task in hand seem long and tedious, they also divide our concentration, with the result that energy is dissipated. For more energy, make a commitment to becoming deeply involved in the process of energy creation in your life. The opposite is true too. Where living the ‘right’ way for you breeds more energy, living in a way that ignores your basic values will have you fighting yourself and the world around you and continually drain your vitality.

How do you feel about your body? Is it a source of pleasure and pride? A burden to be borne? A matter of indifference? Does it feel like a ‘good runner' which always seems to do what you ask of it? Or is your body something on which you don’t think you can depend? I find that most men and women in the Western world feel uneasy about their bodies. The cultural models which our culture has inherited from the ancient Greeks separates ‘body’—our physical presence—from ‘soul', the so-called ‘real' person, creating a schizoid attitude towards ourselves. Often we treat the body as an object. Then we alternate between narcissistically indulging it and continually neglecting it. Sometimes, we seem to dissociate from it altogether. QUANTUM RADIANCE NOW The body is the medium through which we experience reality. This is a truth most people forget. Your sense of aliveness and vitality, peace and relaxation, joy, sexuality, power—even intellectual enjoyment—are all experienced through your physical body. The more vital it is, the more intense are your sensibilities, and the richer your experience of being alive. The right treatments carried out on the surface of the body using simple substances such as water, oils, clays—even doing dry skin brushing—profoundly influence your state of wellbeing, both mentally and physically. Some techniques improve lymphatic drainage, clearing away wastes stored in the system. Others pep you up when you're tired, or relax you when you're stressed. They contribute to an experience of quantum wellbeing. The body is a finely-tuned instrument. It becomes more sensitive and stronger as you use it. The radiant body feels comfortably in tune with the earth on which it stands, yet free to move, to dance, to feel, and to experience joy and pain fully. This is what being fully alive is all about, no matter what your age. Ideally, the body should always have been this way. A child born naturally, without trauma or drugs, who enters a safe and welcoming world and has a good bond with its mother already has such a body. It moves fluidly, experiences emotions and physical sensations deeply. This makes it fully expressive both in shape and movements of the innate essence of the unique being. Sadly, for most of us, our natural aliveness and bodily freedom have become distorted or truncated. Traumas which we experience tighten muscles, damping down our sensory input. Some people find themselves oppressed and overwhelmed by living in a world which is anything but life-nurturing. This is a not-uncommon feeling for children and young adults. All of these experiences which are felt through the body leave their ‘scars' since they are held in the tissues. Then, instead of maintaining the sensitivity and responsiveness which is our birthright, the body gradually becomes ‘deadened’. This deadness can express itself in many ways—from rigidity or strange postural attitudes and gaits to flaccidity, muscles which seem lifeless and lackluster skin, even low self-esteem, depression, and a sense of impossibility about one’s life. BODY MAGIC The most remarkable gift of the human body is its natural plasticity. It is more than capable of transforming itself. Unlike a machine, your body is continually in flux. It changes its shape and ways of functioning from day to day and moment to moment. It can collect poisons in the tissues which decrease vitality and promote illness, and it can easily be encouraged to eliminate these poisons, becoming more alive, strong and beautiful. This in turn improves your whole way of experiencing life. You can work with a twisted, strained body, or one without a great capacity for feeling physical pleasure. Gradually, over a period of months, you can help it reclaim its ‘aliveness' and its natural good looks. There are a number of simple but powerful techniques for bringing this about. Regular exercise is one. So is the Alexander Technique. Yoga too can be useful—if it is practised well. And there are other professional disciplines which can help, like the bio-energetic therapies, touch for health, and Rolfing or structural integration. There are also many wonderfully effective practices which you can do for yourself day-to-day to help reawaken vitality, improving the way you look and feel. They can alter the way you move, as well as the way you feel about yourself and your life. For, when your body feels more alive, more responsive and stronger, so do you. DO IT YOURSELF The healing of our culturally inherited mind-body split is a slow but totally necessary process, in order to achieve the kind of integration which makes quantum wellness possible. Many of the techniques useful for bringing it about—such as the clay and sea-plant treatments, massage, water therapy, breathing exercises—can be a lot of fun and leave you feeling great when you use them, as well as the long lasting benefits each promises. Also, making time in your life to practice them can be an excellent method of de-stressing, allowing you to get away from any leaning towards becoming an `automaton'—a tendency we all have to some degree— and become more conscious of who in essence you really are, and where you are going. This is an important part of a quantum way of life. TAKE THE PLUNGE A simple thing like water, which you come in contact with every day, is ideal for beginning transformation and heightening vitality. Applications of hot and cold water used to be a standard therapy for aches and pains and for revitalizing. We know this thanks to the pioneering work of Father Sebastian Kneipp, the Bavarian parish priest who strengthened his own less-than-hearty health with the healing powers of water, and then went on to develop a whole system of treatment using it to dissolve toxic wastes while strengthening the entire organism. Many of Kneipp's techniques—which I wrote at length about a few weeks ago—are great for bringing you more vitality and a growing experience of aliveness. He insisted that the easiest way of ‘hardening and bracing the system' is to walk barefoot—on wet grass or stones, on freshly fallen snow, or in cold water up to your knees. This may sound strange to someone who has never tried it, but it can be enormously invigorating—even on winter mornings. I do it at some time every day, come rain or shine. I learned of its power from doctor friends who use it to increase a patient's resistance to illness with excellent results. The secret is to spend only a few minutes (from 3-5) walking barefoot in this way, making sure that you keep shoes and socks dry, so you can put them on immediately afterwards. If they too are allowed to get damp you miss out on the stimulating effect of the contact with the cold dampness. This can deplete your body of energy instead of revitalizing and strengthening it. This, by the way, is the secret for using any cold water applications on the body. You must be warm to begin with and you must keep warm and dry afterwards. Contact with cold water under these circumstances first causes constriction of the blood vessels, momentarily driving the blood inwards. Then, the moment it is stopped, the blood rushes to the surface of the skin, warming it. BRUSH FOR BLISS The same principles apply to hot and cold showers or cold sitz baths. One of the best possible ways of waking up each morning and getting yourself going for the day ahead is to brush your dry skin down well with a dry hemp glove or a natural vegetable bristle bath brush. Then step into a warm shower. As soon as the warmth of the water has suffused your body so you are warm and comfortable, switch from `warm' to `cold'. Remain under cold water for only half a minute (no more), making sure that your body all over gets covered with the cold spray. Emerge from the shower, dry yourself briskly and dress warmly. It is important that the bathroom is always warm and that you begin very slowly with only, say, 10 seconds of cold water at first, gradually increasing it to half a minute as you become used to it. I think you will be surprised at how quickly this adaptation takes place. It will make your body feel alive and tingling, increase your stamina and, according to the European doctors who still use it regularly with their patients, heighten your resistance to colds and flu. SITZ BATHS FOR SLEEP Here’s a variation on the cold water theme that will surprise you. A cold sitz bath is one of the best ways of relaxing quickly and preparing your body and mind for sleep. It is another technique the effectiveness of which you won't believe until you have tried it several times yourself. It is a great blessing for people who suffer from insomnia because their minds race and they can't turn off mental energy when they go to bed. Here's how: Fill a bath with 3"-4" of cold water from the tap. Make sure the bathroom is warm and that you have done all of the things you need to do before retiring. Wrap the top half of your body in a sweater or dressing gown which you can tuck up so that when you sit in the water it won't get wet but it will keep the upper part of your body warm. Now immerse your hips and bottom in the tub for 30 seconds. You can do this either by letting your legs hang over the side of the tub or by sitting in the bath and allowing your heels to go into the water to steady your body. Get out, dry yourself well, then climb into bed. The technique draws the body energy away from the head and brings a marvellous sense of peace and relaxation. Next week we’ll look at more simple do-it-yourself techniques for quantum radiance, such as the health-enbhancing magnesium chloride flakes and gifts from the sea. See you then...

The next time you have a chance, watch an animal move. The rhythmic lope of a wolf whose body almost becomes the motion. The horse in a field, tossing its mane, pounding its hooves and charging about for sheer pleasure. The dolphin who leaps high in the air twisting its powerful body before disappearing into the waves to emerge a minute later with yet another joyous leap. For many years I wondered why most of us after childhood no longer experience this kind of explosive, rhythmical freedom and energy, grounded in the physical body. Why do we often feel only half alive? And why do those of us who are women tend to look upon our body as something separate from ourselves, something to be criticized, judged, or pushed and shoved into shape, instead of celebrating its power and the joy of movement the way animals do? For too many human beings the primary experience of life is one of deadness. And since none of us is able to live with deadness for long we are forced to seek artificial stimulus through drugs or alcohol, compulsive work or sex - just to make us feel alive again. The trouble is, none of the artificial things that we turn to in an attempt to recover our aliveness ever seems to work for very long. Where does the real key lie? MUSCLE MIRACLE The answer to this question may surprise you. It stunned me when I first came upon it because it is so simple. The key to aliveness is found in the body itself. It lies in the same place as the key to burning excess fat is - in muscle. Your muscle is the engine that turns food calories into energy, burns fat and creates an experience of ongoing simple joy whatever you may be doing. Muscle creates the life-energy for you to think, to move and to feel. The power of the horse, the rhythmical gait of the wolf able to run on and on with ease, the wild playfulness of the dolphin - all depend on good strong muscle. To create a firm, beautiful, lean body for yourself, begin to listen to, nurture and develop your muscle. Your body is a potential powerhouse of vitality. If you want to access it, you need to move. People sometimes talk about the body as if it were a machine. In reality your body is nothing like a machine. A machine, when you use it, wears out. Your body was designed to be active. The more you use it wisely the stronger and more beautiful it will become - regardless of your age. I learned all this the hard way—the best way too I guess—but it wasn’t fun. ENDLESS PAIN Several years ago I injured my left leg badly from a nasty fall while walking down a steep incline to board a plane in Munich. The thing was running with water. Amidst a lot of blood and mess I had no idea just how bad the injury was until I found I was in constant pain and could hardly walk for weeks. This injury was followed by another nasty one to my right ankle, then another a few months later when I cracked my sacrum at 5am in the middle of winter getting out of a spa when I tumbled back onto a hardwood deck. Anyway all of this meant that I stopped using my body. In fact my body became for me a source of pain and fear, not pleasure and joy. Where I had once done exercise regularly for the sheer joy of it, I stopped completely—not just for months at a time—for years. I forgot what it was like to experience the joy and feel the sense of radiance I had long been used to from movement I had for thirty years adored doing. I lost a lot of muscle tone and ease of movement and I no longer felt the kind of vitality I had been used to for many many years. LIFE REBORN Then one day, for no apparent reason, I woke from my ignorant stupor and began to move a little just to find out if my body was still alive: to dance to music, to stretch, to cycle on a wind trainer in the garden, allowing my body to feel the sensuous pleasure of swimming gently in our pool or spending 10 or 15 minutes in passive relaxation on our PowerPlate. Slowly, steadily I began to come alive again. I kept asking myself, “How could I have forgotten how simple and joyous moving my body could be, and all of the rewards it brings when one begins to exercise, not because it’s supposed to be good for you - out of some kind of duty - but because you owe it to your body to let it live?” Anyway, I wanted to share my own experience with you and here is the bottom line: No matter what your age or how much you have neglected moving your body, no matter how much tone your muscles may have lost, your body has the most amazing capacity to regenerate and restore its muscles, its vitality and its capacity to provide you with the joyous experience of freedom which is everyone’s birthright. You need only to remember what is possible and begin with kindness and love to let yourself move again.

What a woman can accomplish through exercise is impressive not only in terms of protecting her body from the ravages of female troubles, and even from time itself, but also in preventing illness and rejuvenating her body in medically measurable ways. But exactly what kind of exercise is the right kind? It is an important question to answer because so much of what has become fashionable - fancy clothing and tossing weights around in a gym - is mostly the wrong kind. Walking or running along roads filled with air pollution and subjecting your body to the stress this brings can also do more harm than good. Aware of the benefits of exercise, most people who exercise regularly do aerobic movement - swimming, cycling, running or walking. There is a great deal that is wonderful about this kind of exercise. It improves the functioning of the heart, lowers cholesterol, and shifts brain chemistry so that you produce natural opiates which make you feel good. It also increases noradrenaline - a brain chemical which improves your self image and confidence so you feel even better about yourself and your life all round. Aerobic exercise can also enhance your body's ability to burn fat not only while you are working out but for many hours afterwards as well. This makes aerobic exercise an important part of any good exercise program. So get out and walk briskly as often as you can. But aerobic exercise doesn't go far enough. It does not offer the body enough weight resistance to maintain muscle mass. One interesting study compared the Lean Body Mass to fat ratio in three groups of women - non-exercisers, aerobic exercisers, and weight trainers. Researchers found significant differences. In sedentary women, 21.8 percent of their body weight was fat. Among the aerobic exercisers 16.2 percent was fat while among resistance trainers only 14.7 percent of their body weight was fat. This is revolutionizing fitness advice as exercise physiologists have come to realize that, although aerobic exercise has a place as part of an exercise program, it does not maintain bones and muscle the way resistance exercise does. The bottom line is we need both, although resistance exercise is the more important of the two. In an official statement of advice issued by a member of the advisory board of The American College For Sports Medicine - who in the past promoted aerobic exercise as the best form for over all health and fitness - the word is in: "Done correctly, weight training is the most efficient, effective, and safest form of exercise there is, and it won't be long before people realize it." let's get started What does a confirmed lounge-lizard do once she decides she wants to explore how exercise can change her life? First you get an OK from your doctor to make sure that there is no reason you should not start on a simple graded program. Then go easy. If you start small and work up you will win. If you start big you can not only wear out your body but also lose your taste for movement, then the whole effort will have become counter productive since you will end up hating exercise and getting nowhere. For exercise to work it has to become an ordinary part of your daily life. It needs to done regularly at least three times a week. Begin with only 15 minutes in the morning when you get up or at any other time of the day that is convenient. The great news is that right from that very first session your body will begin to rejuvenate itself. Exercise routines progress well when you work out at the same time each day. Try to do this if you can. Your body will get used to the routine and love it. When it comes to resistance training you don't need to own a lot of fancy equipment either. Nor do you need to join a gym. A couple of dumbbells will do. Later on if you catch the exercise bug big you might like to have a barbell as well. Dumb bells and barbells are what are known as free weights as opposed to the kind of gym equipment you find in a multitude of sizes and shapes and glitzy finishes these days. Beginners are often dazzled by the high tech stuff in gyms, but as any serious weight trainer will tell you, for most exercises free weights are far better. They are also far simpler since you can tuck them under the bed out of sight when they are not in use and you can make use of them any time you want without having to dress in special clothes and go to the gym. Choose the kind of dumbbells - each of which fits into one hand - that have six removable weights on each so you can add and then take off weights as needed for each exercise. When you are not using the dumbbells stash them away out of sight. Your body and their weight against gravity offer all the resistance you need to work muscles deeply. The machines you find in gyms are designed to mimic the effects of free weight exercises but - with a couple of minor exceptions - no matter how flash they look, they are not as good as simple free weights because the range of movement which you go through in each exercise is restricted by the machine. Once you get into weight training and gain a bit of confidence with it then you might find it fun to work out in the gym using these machines occasionally. But free weights should form the basis of any good weight training routine, whether you are a complete beginner, as I was, or a professional weightlifter. There are three things you want to accomplish on your exercise program. First you want to maintain and to improve your heart and lung fitness. For this you will use weights plus some form of aerobic activity for warming up and cooling down. Second you want to maintain and increase your muscle mass. Finally you want to improve and maintain your flexibility, and for this you need some kind of slow stretching afterwards. warm up It is important at the beginning of any exercise session that you spend a few minutes doing an aerobic activity. (You must never pick up a weight when your muscles are cold). This can be running in place, slow steady jumping jacks, using a rowing machine (my favorite) or bouncing on a rebounder. In the beginning, your total exercise session may only last 15 to 20 minutes, in which case you will want to devote five minutes at the beginning to the aerobic warm up. Later on it can be longer. I generally row on a Concept II rowing machine for about 10 minutes at a slow steady pace to get my heart and lungs moving and warm up before beginning my weights. As the length of your exercise session grows week by week, until it is ideally 45 minutes to an hour at a time, so will the time you spend on your aerobic activities at the beginning and end of the session, and perhaps in the middle too. stretch out After this initial warm-up period which should last long enough that you feel fully warmed up, you should then spend 5 to 10 minutes stretching. Stretch slowly and smoothly towards the ceiling, towards your toes, to the side. Never jerk when stretching and breathe deeply. Stretching before a workout but after a warm up is done to allow major muscle groups along with associated tendons and ligaments to be gently stretched, ensuring possible injuries are greatly reduced. Now you are ready for your muscle work. weights workout To work with weights properly, you need to split your sessions into different body parts and work one or two body parts per session, leaving at least 48 hours between that session and the next time you work that body part. The muscle and bone strengthening that comes with resistance training does not take place while you are using the weights. In fact, working out stresses the muscles and bones, causing tiny breakdowns in the cells to occur. It is during the rest that comes after a workout that new muscle and bone is built in direct response to the piezoelectric stimulation at a molecular level. If you come to the point of using quite heavy weights and training five times a week then it is important to work out each body part only once a week for it can take about 48 hours for the breakdown process to take place and between 48 and 72 hours to build new strong tissue to replace it. Ignorant of these facts, many gung ho body builders and weight trainers over-train their muscles and end up undermining their immune system as a result ,while getting nowhere near the benefits in terms of strengthening LBM (Lean Body Mass) that they should. Exercising a particular muscle group every 5 to 8 days is ideal for optimum progress. Stand in any gym and watch weight trainers do their stuff. It can be highly instructive, at least so far as showing you how not to work with weights. 90 percent of the men and women who use weights let their bodies swing all over the place and when they are doing an exercise such as a dumbbell curl they let the weight just fall back after each movement instead of being in control. When you do your movements be sure to keep your body absolutely centered with each movement, only using the particular muscle group that is supposed to be working, and emphasize the eccentric contraction or return movement where you are returning the weight to its original position. Resist the movement all of the way back. It is the stress placed on your muscles of lengthening again when they are under resistance load that brings about most of the gains in strength and LBM you are after. Be sure while you are working out that you drink lots of water - between each set - and eat plenty of alkaline forming foods since any kind of exercise tends to make your system more acid. the cool down It is also important to spend a few minutes at the end of a weights session again doing some kind of aerobic activity to cool down. How long depends on the length of your weights session. You can go through the same kind of activity you have used in the beginning of your session, or even take a brisk walk, but make sure you stay warm by adding an extra sweater, for after a session your body cools down fast and you don't want to become chilled. the stretch out Then do some more stretching for a couple of minutes. You will find that your body stretches more easily now since your muscles are full of blood and energized. Go slow and enjoy the feeling. It can be wonderful. beginners program All of the exercises here are classic weight training movements. They are simple and straightforward. They require nothing more than a couple of dumbbells - the kind that have six weights on each which can be unscrewed and changed will give you the particular weight you need for an exercise. Start with the lightest weights. You will be able to tell for yourself if something feels right. Never strain. As your body becomes accustomed to the lighter weight you can add a bit more. The object of the exercise is not to use heavy weights but simply to provide your body with enough weight to create resistance against which your muscles do their work. You will find pictures of the movements below in any standard book of weight training, or you can find pictures and videos showing you how to do them on the internet.  Or ask a fitness instructor to show them to you. Each exercise is done smoothly and with complete control, both on the contraction of the muscle group and on the relaxation. While one muscle group is working, the rest of the body remains still and centered. Start off by doing only three training sessions a week with one set (a set is the same exercise repeated a certain number of times: so 2x10 would mean ten repetitions of the movement, rest for two to three minutes, then ten more repetitions of the movement: 3x10 means the ten repetitions is done three times with two minutes rest between each set) per exercise, then work up to longer by adding more exercises for each muscle group you are working with, and doing one warm up set of easy repetitions (10-15) followed by a heavier set using a little more weight (5-10 repetitions). Begin with very light weights - just enough for you to feel that your muscles are being worked as you near the end of your repetitions. Then by the time you are ready to add your second set, put on a little more weight until at the end of your repetitions your muscles feel tired. Session One: Shoulders and Arms Dumbbell press 2x10 Side lateral raise 2x10 Single arm tricep extension 2x10 Tricep kickback 2x10 Dumbbell curl 2x10 Concentration curl 2x10 Session Two: Chest and Back Dumbbell bench press 2x10 Dumbbell flies 2x10 Single arm rowing 2x10 Dumbbell shrug 2x10 Floor hyperextensions 2x10 Session Three: Legs and Abdominal Muscles Dumbbell squat 2x10 Dumbbell lunge 2x10 Calf raise 2x10 Abdominal crunch 2x10-15 Reverse crunch 2x10-15 advanced workout Once you have got a taste for weights and have trained three times a week you can begin doing longer sessions - up to 45 minutes to 1 hour. You might also like to do more sessions per week moving up from three to five. Then you would divide your body part work in this way: Session One: Shoulders Dumbbell press 1x12, 2x8 Side lateral raise 1x12, 2x8 Bent lateral raise 1x12, 2x8 Front lateral raise 2x10 Session Two: Back Dumbbell dead lift 1x12, 3x8-10 Single arm rowing 3x10 Floor hypers 3x10-12 Dumbbell shrugs 3x10 Session Three: Chest Dumbbell bench press 1x12, 3x8-10 Dumbbell pullover 1x12, 2x8-10 Dumbbell flies 3x10 Session Four: Arms Single arm tricep extension 1x12, 3x8 Tricep extension 3x8-10 Dumbbell curl 1x12, 3x8 Concentration curl 3x8-10 Session Five: Legs and Abdominals Dumbbell squat 1x12, 3x8 Dumbbell lunge 3x10 Dumbbell step up 3x12 Stiff leg dead lift 3x10 Calf raise 3x12 Abdominal crunch 3x15-20 Side crunch 3x15-20 Reverse crunch 3x15-20 the result Each woman is in reality two women, an outer woman which can come in many forms - conventionally attractive, plain, sexy, dynamic, withdrawn, aggressive, apparently assured or terribly uncertain about herself - and an inner counterpart, that is an individual self that is utterly unique. Each woman has a stable center of strength and growth. Each inner woman sees the world in her own way, has her own brand of creativity, her own needs and desires, and is a law unto herself. The inner self holds the power to create, change, build, nurture and transform. The outer woman is the vehicle for what the self creates. When her self is allowed free expression, then a woman is truly beautiful for she is fully alive. Her body is strong, her skin is clear and healthy, and her movements, speech and actions radiate a kind of vitality that is unmistakably charismatic because it is real, an outward expression of who she truly is. Many of the secrets to calling forth this kind of aliveness are to be found within the body itself - secrets which are best learned by working with muscle. Once you get the hang of it, working with weights is like meditation - one of the most mind-stilling activities in the world. Meanwhile, as your LBM begins to develop, you will find your muscles and whole body have come alive. Then, as you work out, your muscles will begin to glow, until after a few months your body begins often to feel the way it did when you were a child - radiant with life and spirit.

By now I’ve worked with thousands on Cura Romana. I have tried to help them come to terms with the fact that the program has little in common with conventional slimming diets. These demand that you grit your teeth, summon up every ounce of willpower, and exercise like a fanatic not only while you are losing weight but ever afterward. Such an attitude breeds fear. We have been taught by the media and all those slimming gurus that, just like denying yourself the pleasure of eating delicious food during weight loss, if you don’t force yourself to exercise vigorously you will never reach your weightloss goals. After all, we are told, the body needs discipline. Like a resistant child, the body must be forced to do what is good for it whether it likes it or not. DESTRUCTIVE NONSENSE Nothing could be further from the truth. You do not need to exercise on the CURA ROMANA JOURNEY. Because of the dynamic nature of this unique protocol—unless you are someone who is in the habit of exercising regularly just because you love it—while you are on the rapid weightloss part of the program, exercise can actually be counter-productive. Why? Because the biological, physiological and spiritual transformation that takes place in your body on the program need space and time to be able to take place in their own unique way. So do the “miracles” of enhanced self-awareness and capacity for joy which participants report . Extra pressure exerted from outside by trying to push your body hard or altering the exacting dietary protocol because you think this will make you lose more weight faster will not work on Cura Romana. Don’t even think about it. Now, after more than three years of doing my best to get this through to participants on the program, I think I am beginning to succeed. It is time for exercise to be reborn. Facing a run, swim or cycle as a chore is missing the point. Movement—whether dancing, yoga, weights, Pilates, swimming or what-have-you is never something you ‘should’ do because you are ‘supposed to’. Exercise has enormous value. It is an important key for reconnecting with your essential being: physically, mentally, emotionally and spiritually. So let’s throw out all the ‘shoulds’ we’ve had forced down our throat, and explore the real power of movement and discover how, when it is done for pleasure, excecise can literally transform your life. MOVE FOR JOY Joy is a powerful motivator. Once you discover this your whole experience of exercise changes forever. Far from being something you do quickly to get it over with—a chore you ‘virtuously’ suffer through—it becomes one of the most enjoyable parts of your life. American enthusiast the late George Sheehan, whose legacy still continues to inform people of the true nature of exercise, describes this experience well: “Exercise that is not play accentuates rather than closes the split between body and spirit. Exercise that is drudgery, labor, something done only for the final result is a waste of time.” Running easily down a country road at dawn, gliding through water, speeding down a mountain covered with fine snow, are meant to be done for their own sake—for the sheer pleasure of it. The fact that these activities are good for you becomes incidental to the sensuous, delicious, unexpected pleasure you can come to experience. As you discover this for yourself, you begin to know what moving your body is all about. In the next few weeks I want to explore exercise—movement—and its relationship to joy, authentic freedom, and wellbeing on every level of our lives in a whole new way. I’m excited about doing this and I hope you will enjoy what comes of it and that in the simplest ways it can help enhance your connections with your own body and your life as a whole.

Let’s talk exercise. It’s time we did. For there is no area of health more misunderstood than exercise—its benefits, its drawbacks—what it will and won’t do. The medical profession continues to feed us the party line: It begins with “every calorie is unique…it doesn’t matter where it comes from…if you want to lose weight, all you have to do is burn calories through exercise.” This is absolutely untrue—in fact, exercise can sometimes be seriously detrimental to those who are considerably overweight. Nevertheless doctors, and the media, keep telling us that it works. And, like sheep, we just keep trusting them. MEDICAL IGNORANCE What happens? Well, when people find that it doesn’t work, they get depressed. They feel like failures. They stop exercising and start eating more because they’re disheartened. They figure that exercising is no use. This makes metabolic syndrome—Syndrome X—worse than ever. For metabolic syndrome and chronic high blood sugar levels are what makes us fat, and keep us that way. That’s the bad news. The good news about exercise is this: Whether you’re overweight or not, exercise done regularly, for as little as 15 minutes a day, is absolutely the single most important thing that you can do to improve your overall health. TRUTH ABOUT CALORIES Because of the media, the medical profession, and purveyors of diet supplements, just about everybody still believes that energy expenditure—and therefore calorie burning—comes with exercise. However the truth is that during physical activity, only the smallest amount of energy expenditure takes place. Exercise accounts for no more than 5% of the calories you burn, unless you happen to be a top athlete. I think this will surprise you too: The greatest percent of calorie burning takes place, not while you’re moving, but while you are sleeping. This phenomenon is called “resting energy expenditure”. Depending on how heavy or light you are, resting energy can account for as much as 60% of your total daily energy expenditure. Another way your body expends energy by burning calories is thanks to the “thermic effect of food”. This refers to the energy it takes your body to digest, absorb and metabolize the foods you have eaten This thermic effect accounts for about 10% of the energy that you burn during the day. So you can see by contrast just how low, in fact virtually insignificant, is the amount of calories burnt during most physical activities. TOTALLY MISUNDERSTOOD The idea most people have—that if they exercise they can lose weight—is also nothing more than a pipe dream. So what does exercise actually do for you? The answer is: some pretty wonderful things. Exercise enhances sensitivity to insulin. This helps your body make use of the fat that has accumulated in the liver and around other organs improving insulin sensitivity and lower ing insulin levels. It also improves both leptin signaling and leptin sensitivity in the cells., calming food cravings, improving muscle tone, and making you feel more vital. Exercise builds muscle. Most people, including most medical doctors, still wrongly equate BMI (Body Mass Index) with body fat. The truth is BMI does not measure the difference between muscle and fat, or between subcutaneous fat (the inessential fat) and visceral fat. Many studies looking at body composition before and after periods of exercise show that the percentage of fat goes down. But this is only because muscle has increased. As this takes place, a person’s metabolic facilities are also improved. PREVENTING ILLNESS We are often told that we need to change our diet in order to prevent heart disease. Indeed this is quite true: However, the metabolic transformations that take place during regular moderate exercise are an even more powerful force than dieting for preventing disease—including heart disease. To take things further, exercise is actually a more effective force in preventing heart disease than losing weight! A study of almost 40,000 American men demonstrated quite clearly that physical activity was more important in preventing heart disease than being normal weight. These major gifts of exercise are more important than people realize, but they have nothing to do with controlling weight. Let’s look now at how exercise works, biochemically and physiologically. NEW ENERGY FACTORIES Regular exercise activates your sympathetic nervous system. This , in turn, tells your muscles to make new mitochondria. Mitochondria are the amazing little energy factories inside muscle cells that burn glucose or fatty acids, to produce vitality for your whole body. Regular exercise plays a big role not only in building new mitochondria, but in getting rid of the old, inefficient mitochondria. Old mitochondria do not function properly. As a result they produce free radicals to undermine your health and encourage rapid aging. Regular exercise clears away the old and helps your muscles make clean and efficient use of the energy stored within the new. This too improves insulin sensitivity, and enhances metabolic health all round. STRESS BUSTER Regular exercise lowers your stress levels. It’s true that blood cortisol levels go up temporarily when you start to exercise. This is a good thing, It keeps your blood sugar and blood pressure up while you are moving. They come back down quickly afterwards. In fact, one of the long term benefits of regular exercise is that it reduces blood pressure. This is thanks to exercise’s ability to lower stress levels all round. Regular exercise also encourages your body to release feel-good chemicals in the brain known as endorphins. This makes regularly moving the body one of the most effective treatments for depression, far better than drugs or psychotherapy. The way exercise increases endorphins always fascinated me. This was what made me become a regular runner. I was determined to experience what is known as the “runner’s high”. And I found it wonderful. WHAT EXERCISE IS BEST For a long time we’ve been told that the best kind of exercise is low-intensity, long interval, aerobic practices, now known as “cardio exercise”. We learned that cardio worked the heart in a beneficial way, and provided all sorts of cardiovascular benefits by pumping more blood to the heart, slowing heart rate, and increasing peripheral muscles. The one thing it was never able to do—although we were misled to believe that it did—was bring about weight loss. Recently, however, a number of studies have shown that high-intensity interval training, where you use an extreme activity for a very short period of time interspersed with a short recovery—as well as plain old weight training—brings equal improvements both in waist circumference and blood vessel flow. So the bottom line is this: It doesn’t matter what kind of exercise you choose. Just do it. BE CAUTIOUS Whatever kind you decide to try, you need to do it regularly—at least five days a week. Why? Because the wonderful metabolic effects of exercise—which tell your mitochondria to divide and make new mitochondrial factories for vitality—slow and decline when you miss even a day of exercising. Miss two weeks, and your insulin sensitivity is likely to decline as well until it reaches the level it was before you started exercising. So whatever you decide to do, do it regularly. You need only do it for short periods, but do it every day. A FINAL WORD It is not only the overweight by the way who suffer from insulin resistance—metabolic syndrome. So do 40% of normal weight men and women, especially those who have fatty livers. Recent research shows that fitness not only helps mitigate the effects of overweight on visceral fat. In fact, it mitigates many other health complaints also provided you are consistent with doing it. This is also likely to increase your longevity. And...great news...if you are overweight, but not obese, exercising regularly can help you live significantly longer than that emaciated model on the cover of Harper’s Bazaar. Recent research shows that overweight people with BMIs between 25 and 30 tend to live longer than skinny people with BMIs of less than 19. DO WHAT YOU LOVE The most important thing for you to decide is what kind of exercise you want to do. It can be as simple as going for a walk each day for half an hour—not a power walk, just one where you feel the movements of, and a connection with, your body. It can be dance. It doesn’t have to be vigorous. It can be rebounding on a mini-trampoline. It can be moderate weight training, for 15-20 minutes a day. I personally like cycling on a wind-trainer. This is a device that your bicycle fits into. It allows you to regulate how hard you choose to pump while the wheels spin but the bicycle remains static. I use a wind trainer because I don’t like cycling on roads. The other exercise I do is on a Concept 2 rowing machine which I was given many years ago. I use it five days a week for 20 minutes at a time. I love doing it: It enables me to move my whole body, and brings me a rhythmic feeling of being completely connected to it. What exercise you do depends entirely on what you love. So begin to experiment. Let go of the idea that exercise is going to make you thin. It will not. What it will do for your health, your emotional and spiritual wellbeing, and to slow the aging process, is fantastic. It can also be a lot of fun. Discover the joys and great gifts that come with moving your body. The time is now. REFERENCES P. Wen et al., "Minimum Amount of Physical Activity for Reduced Mortality and Extended Life Expectancy: A Prospective Cohort Study," Lancet 378 (2011) S. Ludwig, "The Glycemic Index: Physiological Mechanisms Relating to Obesity, Diabetes, and Cardiovascular Disease," JAMA 287 (2002) Stensvold et al., "Strength Training versus Aerobic Interval Training to Modify Risk Factors of Metabolic Syndrome," /. Appl. Physiol. 108 (2010) P. Little et al, "Skeletal Muscle and Beyond: The Role of Exercise as a Mediator of Systemic Mitochondrial Biogenesis," Appl. Physiol. Nutr. Metab. 36 (2011) K. J. Acheson et al., "Protein Choices Targeting Thermogenesis and Metabolism," Am. J. Clin. Nutr. 93 (2011) Shaw et al., "Exercise for Overweight or Obesity," Cochrane Database Syst. Rev. CD003817 (2006) M. J, Gibala et al, "Physiological Adaptations to Low-Volume, High-Intensity Interval Training in Health and Disease," /. Physiol. 590, no. 5 (2012) A. McAuley et al., "Obesity Paradox and Cardiorespiratory Fitness in 12,417 M a l e Veterans Aged 40 to 70 Years," Mayo Clin. 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