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A Documentary Look at Health Care in America

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If you want to understand the state of American health care, this carefully reported documentary from Pulitzer Prize-winning journalist Hedrick Smith does an admirable job of addressing the major issues of quality and affordability.

Although the documentary is aired in a three-hour block, it is divided into four segments that explore regional differences in quality of care, the woes of people with chronic illness, the health maintenance organization model, and the uninsured. Californians will be particularly interested in the third segment, which examines Oakland-based Kaiser Permanente, the nation’s second-largest HMO. Kaiser’s virtues are on display along with its problems. And the fourth segment provides a very compelling look at California’s Healthy Families program for the uninsured, showing the program’s early mistakes and how it has righted itself in order to reach the people who need it.

“Critical Condition” is too long and complicated to easily absorb in one sitting and might have had more impact if shown in two or more segments. Nevertheless, it’s an outstanding work that relies on candid interviews and has an air of honesty. It convinces us that we are seeing some of the very best and worst about our health care system.

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THE ATHLETIC WOMAN’S SURVIVAL GUIDE

By Dr. Carol L. Otis and Roger Goldingay

Human Kinetics News, $17.95, 272 pages.

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Dr. Carol Otis of UCLA is one of the world’s leading authorities on the health of female athletes, and here she explores the pressures on them to conform to particular body types while excelling in their sports.

Otis questions the practice of pushing female athletes to meet unrealistic standards for shape, weight, training and performance, which can eventually backfire and lead to illness. The illness typically occurs in the form of the “female athlete triad,” a syndrome consisting of disordered eating, menstrual cycle disruptions and osteoporosis. According to Otis, all or parts of the triad occur in many active women and are a particular threat to female athletes.

The book explains the triad and how to avoid it but, perhaps more important, also urges women to adopt a definition of fitness that encourages whole-body health--and a positive body image based on an individual’s physical characteristics.

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As American women continue to gain fame in sports--as was seen during the Summer Games in Sydney--it’s more important than ever to make sure that those achievements are based on the tenets of good, comprehensive, long-term health.

EATING FOR IBS

By Heather Van Vorous

Marlowe & Co., $16.95, 304 pages.

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Irritable bowel syndrome affects an estimated 39 million to 52 million Americans. It’s a miserable condition that must be controlled primarily through diet. For many people with IBS, that usually means trial-and-error approaches to eating. “Eating for IBS” is designed to help people avoid mistakes while enjoying tasty, relatively normal foods.

The author is an IBS sufferer who learned as a child to avoid foods that triggered attacks. The recipes are from her 20-year collection and represent a range of home-style and ethnic foods, desserts and snacks. The message to readers is that eating to control the illness does not mean deprivation. However, the recipes are mostly devoid of such trigger foods as red meat, dairy, most fats, caffeine, alcohol and insoluble fiber.

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Although this is primarily a recipe book, the first part explains irritable bowel syndrome, its symptoms, possible causes and treatments. The strategy behind the eating plan is explained. There is also a wonderful section on other tips that help control the illness.

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