Ask the experts

Natural Health, June, 2007

Q I throw out my back often. Is it safe for me to practice yoga?

A Yoga can be great for people with back injuries. It teaches you how to stabilize your posture and gives you tools to correct your body's alignment. The awareness and strength you develop in yoga can influence your posture and bearing in daily life--whether playing sports, sitting at your desk, or driving in traffic--and help prevent future injury.

If you've recently thrown out your back, try restorative poses to help soothe muscle spasms. While recovering from your injury, use props like blocks, blankets, or straps to help you ease into different postures with less strain on the muscles. Once the pain and swelling decrease, you can introduce more active, targeted movements to work the muscles and tissues surrounding the injury and bring back more elasticity.

Start with standing poses like Triangle Pose (Uttihita Trikonasana, shown at left) and Warrior I (Utthita Parsvateonasana). They use the strength of your legs and the openness of your hips to unlock the lower spine so you can evenly extend your torso and strengthen and stretch your entire back. They also train the strongest muscles in your lower body to bear more weight and stabilize your back's movements. You can use a wall or props in various ways to help maintain balance and alignment, provide leverage, and/or lessen the force of gravity.

--Paul Cabanis, certified Iyengar yoga instructor in Los Angeles

I love chocolate, but I'm sensitive to caffeine. Can I get the health benefits without the jolt?

A Studies show that chocolate--or more specifically, cocoa-rich dark chocolate--is loaded with disease-fighting antioxidants. Unfortunately for caffeine-sensitive people, the source of the antioxidants (cocoa) is also the source of the caffeine in chocolate.

Still, chocolate's caffeine content is relatively low. An 8-ounce cup of brewed coffee contains between 95 and 150 milligrams of caffeine. That's nine times more than a 1.5-ounce Hershey's milk chocolate bar, and about three times more than the same amount of dark chocolate.

That means a half-ounce serving of dark chocolate--a piece that's one-third the size of a Hershey's bar--contains the same minimal dose of caffeine (roughly 10 to 12 mg) and antioxidants as a full-size milk chocolate bar, with substantially less sugar and calories, and arguably more chocolatey richness.

You can nibble on that piece of chocolate, or melt it and use it as a dip for a few perfect strawberries. Or simply make yourself a cup of hot cocoa using one tablespoon of plain unsweetened cocoa powder (12 mg of caffeine). Considering all the pleasure and benefits dark chocolate brings, less can definitely be more. Enjoy.

--Debra Boutin, M.S., R.D., professor and dietetic internship director, School of Nutrition and Exercise Science at Bastyr University in Kenmore, Wash.

Q My friend says flat soles are essential to healthy feet. I hear a kitten heel is better. Who's right?

A Heel height isn't the only factor to consider when choosing foot-friendly shoes: You'll also want to look for good arch support and forefoot cushioning, and a sturdy heel counter (the part of the shoe that cups the back of your foot).

When it comes to heel height, consider the type of foot you have. Most of us have feet that tend to roll either inward (known as pronation) or outward (supination).

If your feet tend to pronate, they'll get better support from a slightly elevated heel which causes the foot to roll toward its outer edge, accentuating the arch. A kitten heel--up to 1 inch and narrow--provides this elevation, but may not be as stable as a wider heel. Also, the higher and narrower the heel, the more stress it places on the forefoot. If you like to wear high heels, choose a pair with a sturdy heel, a roomy toe box, and good forefoot cushioning.

Conversely, if you have high arches and tend to supinate, you're better off in fiat shoes; elevated heels exaggerate supination, creating instability in the outer ankle and increasing the risk of sprains. Be sure to pick a shoe with good arch support.

None of this is to say that pronators shouldn't wear fiats and supinators shouldn't wear heels, but if you wear shoes that exacerbate your foot's natural tendency to roll inward or outward, it's especially important to pick a pair with solid integral structure. And in the end, the best shoe style is the one that feels most comfortable.

--Robert Mohr, D.P.M., chief of podiatric surgery at UCLA Medical Center in Los Angeles

Q just started exercising after a long break, and my psoriasis has flared up. How can I prevent this?

A Like the lungs and kidneys, the skin is an important detoxification organ. When you exercise aerobically with lots of sweating, you start to release toxins like chemicals, metals, and acids through your pores, which can aggravate conditions like psoriasis and eczema. Psoriasis is the result of overactive skin cells rapidly laying down layers, causing raised red patches and silvery scales, especially on rough or stressed surfaces like elbows and knees. While it has many contributing causes, such as genetics, general toxicity and inflammation, stress, and some autoimmune factors, psoriasis can be minimized by reducing stress and inflammation, and following a nutritious diet.