Well: Ask Well: Swimming to Ease Back Pain

Many people find that recreational swimming helps ease back pain, and there is research to back that up. But some strokes may be better than others.

An advantage to exercising in a pool is that the buoyancy of the water takes stress off the joints. At the same time, swimming and other aquatic exercises can strengthen back and core muscles.

That said, it does not mean that everyone with a case of back pain should jump in a pool, said Dr. Scott A. Rodeo, a team physician for U.S.A. Olympic Swimming at the last three Olympic Games. Back pain can have a number of potential causes, some that require more caution than others. So the first thing to do is to get a careful evaluation and diagnosis. A doctor might recommend working with a physical therapist and starting off with standing exercises in the pool that involve bands and balls to strengthen the core and lower back muscles.

If you are cleared to swim, and just starting for the first time, pay close attention to your technique. Work with a coach or trainer if necessary. It may also be a good idea to start with the breaststroke, because the butterfly and freestyle strokes involve more trunk rotation. The backstroke is another good option, said Dr. Rodeo, who is co-chief of the sports medicine and shoulder service at the Hospital for Special Surgery in New York.

“With all the other strokes, you have the potential for some spine hyperextension,” Dr. Rodeo said. “With the backstroke, being on your back, you don’t have as much hyperextension.”

Like any activity, begin gradually, swimming perhaps twice a week at first and then progressing slowly over four to six weeks, he said. In one study, Japanese researchers looked at 35 people with low back pain who were enrolled in an aquatic exercise program, which included swimming and walking in a pool. Almost all of the patients showed improvements after six months, but the researchers found that those who participated at least twice weekly showed more significant improvements than those who went only once a week. “The improvement in physical score was independent of the initial ability in swimming,” they wrote.

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Carl Icahn buys nearly 13% stake in Herbalife as battle heats up

NEW YORK — It's no longer just a war of words.

Corporate raider Carl Icahn has thrown $214 million behind Herbalife Ltd., the Los Angeles-based maker of health foods and nutritional supplements accused of being a pyramid scheme by Icahn's foe, fellow Wall Street tycoon Bill Ackman.

Documents filed with the Securities and Exchange Commission on Thursday reveal that Icahn purchased more than 14 million shares and options in Herbalife, a nearly 13% stake that would make him the company's second-largest investor. Icahn said he would pursue talks with executives about possibly recapitalizing the company or even taking it private.

Icahn and Ackman have been engaged in a rare public battle for the last month, hurling insults at each other about past dealings and their respective positions in Herbalife. The two foes have bad blood stemming from a business dispute.

Ackman launched his assault on the company Dec. 20 by unveiling a $1-billion short position, or bet, against Herbalife. That same day, Icahn began snapping up the company's stock, according to the SEC filing.

"It's pretty obvious Icahn really wants to turn the screws on Ackman," said Chris Stuart, chief executive of Shortzilla, a Boston-area research firm. "He's put his money where his mouth is, for sure."

Investors saw Icahn's disclosure as reassuring that Herbalife was not going to collapse, as Ackman has predicted. Its shares surged more than 24% in after-hours trading after closing up $1.87, or 5.1%, at $38.27 on Thursday.

"I think he is definitely trying to hammer his good buddy Ackman, but he could also make a lot of money in this," said Timothy Ramey, an analyst with D.A. Davidson & Co. "It's an undervalued stock."

Ackman, who heads the hedge fund Pershing Square Capital Management, says that Herbalife defrauds its low-income distributors. His wager against the company pays off if its stock falls.

Herbalife hit back by saying the hedge fund manager was misinformed about the company and made an irresponsible bet with his investors' money. The company pointed to its 32 years in business as evidence that it is not a pyramid scheme.

Icahn sees Herbalife as undervalued and believes that the company has a "legitimate business model, with favorable long-term opportunities for growth," the filing says.

This is just the latest chapter in a long history of Icahn trying to exert influence on companies and their boards of directors in hopes of either motivating a merger or having his stake bought out at a premium.

In the 1980s, he famously took over airline TWA and immediately liquidated most of its assets. Since then, he's taken big stakes or controlling positions in companies including RJR Nabisco, Viacom, Marvel Comics, Blockbuster and Netflix.

Neither Icahn nor Ackman responded to requests for comment. Herbalife also declined to comment.

The battle over Herbalife is becoming a Wall Street spectacle, with money managers supporting either team Ackman or team Icahn.

Robert L. Chapman Jr., managing member of Chapman Capital in Manhattan Beach, who said he has invested in Herbalife, wrote in an email: "Carl Icahn just delivered Bill Ackman a Valentine he'll never forget."

andrew.tangel@latimes.com,

stuart.pfeifer@latimes.com

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Vintage piano given Valentine's Day deadline

HALF MOON BAY, Calif. — The piano was delivered to its bluff-top perch under cover of fog nearly two weeks ago. It is scheduled to leave this coastal enclave in a burst of flames on Sunday.

In between the fog and the fire, musician and sculptor Mauro Ffortissimo has been treating his neighbors to an illicit outdoor concert series grandly dubbed Sunset Piano. Chopin, Debussy, a tango or two. The performances are timed to end the moment the sun sinks below the horizon.

He plays to cyclists and dog walkers, babies in strollers, his landlady in a folding chair, the charmed, the perplexed. Every night the battered baby grand has sounded just a little bit worse as the elements erode the aging, al fresco instrument. Every night, the audience has grown.

Ffortissimo (not his real name, but you probably figured that out already) had hoped to serenade the residents of Half Moon Bay for a month. But it didn't take long for reality to intrude on the 50-year-old artist's well-laid plans.

Two days after Ffortissimo and friends rolled the piano out to a scenic spit of city land, a code enforcement officer sent a warning via email. Someone had complained.

No permit, no piano.

The 90-year-old Estey "appears to be an unauthorized encroachment onto public property," wrote Lamonte Mack. If you can't prove the installation is authorized, he told Ffortissimo, "please remove the piano — and platform — within 10 (ten) days."

That made the deadline Valentine's Day, an occasion to celebrate love, if not misplaced musical instruments.

The artist legally known as Mauro Dinucci has taken the bad news in stride. Asked about the end of the piano during Tuesday night's crowded concert, he crowed: "Woo, hoo! Valentine's Day! Bring chocolate!" and promised that "before we burn this baby, we give it one last boat ride."

Thursday will be the piano's last scheduled bluff-side concert along the Coastside Trail at the end of Kelly Avenue. Friday, Ffortissimo said, he has been invited to play the instrument at the Half Moon Bay Yacht Club.

Saturday he'll give a sunset performance on the water, a nod to the piano's earlier owners who once sent it from California to Panama and back by sea. Sunday he plans to set the piano ablaze in the flower-strewn field behind his studio.

"The idea of the burning," Ffortissimo said, "is a cremation, to liberate the piano from its physical form … I just hope it won't be a 'Spare the Air' day."

Not everyone is as happy as Ffortissimo about the piano's upcoming freedom.

Mayor Rick Kowalczyk, who has yet to hear the Sunset Piano himself, said he was trying to "see if I can't get something done in the short term to allow Mauro to stay." Kicking the Estey off of the bluff, he said, "feels a little bit like a child has a lemonade stand and the city shuts it down."

On Tuesday evening, more than 100 music lovers gathered round as the sun — and the temperature — dropped. Two women danced together on the grass. Wine was sipped and beer chugged. Children ate cold pizza. Shorebirds glided by.

Far away from Half Moon Bay, President Obama was preparing to give his State of the Union address. Christopher Dorner was thought to be shooting it out with police.

But here on a bluff overlooking the Pacific Ocean, Susan Swanson of Redwood City poured white wine from a blue metal flask as Ffortissimo played Albinoni's "Adagio in G Minor." She'd read about the piano performance in the local newspaper, she said, "and it's the kind of news I like to read — good news.

"This to me is everything," said the trying-to-retire office manager. "It's a perfect moment. Once in a lifetime maybe. It's so odd, isn't it?"

maria.laganga@latimes.com

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Epic to pull song with offending Lil Wayne lyric

NASHVILLE, Tenn. (AP) — Epic Records is going to "great efforts" to take down a new Future remix leaked over the weekend with a vulgar Lil Wayne lyric that has offended the family of Emmett Till.

The New Orleans rapper made a sexual reference to the beating death of Till, a 14-year-old Chicago boy tortured and shot in Mississippi in 1955 for whistling at a white woman. Till's family objected and the Rev. Jesse Jackson reached out to his management, The Blueprint Group, on the family's behalf.

The label issued a statement Wednesday night apologizing for the release of the song.

"We regret the unauthorized remix version of Future's 'Karate Chop,' which was leaked online and contained hurtful lyrics," the statement said. "Out of respect for the legacy of Emmett Till and his family and the support of the Reverend Jesse L. Jackson, Sr. ... we are going through great efforts to take down the unauthorized version."

Epic will release an official version of the song that "will not include such references."

Neither Jackson nor members of Till's family could be reached late Wednesday. A publicist says Lil Wayne has had no comment so far.

He appears briefly on the song, alluding to the black teenager's beating in a way too vulgar to print.

Till, a native of Chicago, was in Mississippi visiting family in 1955 when he was killed. He was beaten, had his eyes gouged out and was shot in the head before his assailants tied a cotton gin fan to his body with barbed wire and tossed his body into the Tallahatchie River. Two white men, including the woman's husband, were acquitted of the killing by an all-white jury.

Till's body was recovered and returned to Chicago where his mother, Mamie Till, insisted on having an open casket at his funeral. The pictures of his battered body helped push civil rights into the cultural conversation in the U.S.

Bob Dylan wrote a song about it: "The Death of Emmett Till."

A Facebook posting on the Mamie Till Mobley Memorial Foundation page Wednesday night said Epic Records Chairman and CEO LA Reid had reached out to the family to personally apologize.

___

Follow AP Music Writer Chris Talbott: http://twitter.com/Chris_Talbott

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The New Old Age Blog: A New Commission: Time to Cheer or Yawn?

The fate of the Class Act, which would have established the nation’s first voluntary public long-term care insurance program, was sealed in 2011 when the Obama administration shut it down, essentially calling it unworkable.

As long as the language remained part of the Affordable Care Act, supporters allowed themselves to hope, or perhaps fantasize, that the administration might return to the subject. How to care for an aging population, and who pays for that and how, are questions that won’t go away.

But Congress quietly administered the coup de grâce last month, during the fiscal cliff negotiations. The budget deal stripped the Class Act language from the Affordable Care Act. R.I.P.

In its place — thanks to the intervention of Senator Jay Rockefeller, Democrat of West Virginia — the negotiators created a Commission on Long-Term Care, charged with developing plans for “a comprehensive, coordinated and high-quality system” ensuring long-term care for older adults and people with disabilities.

Its 15 members — three picks each for the president, the Senate majority and minority leaders, and the House speaker and minority leader — face a tight deadline. Within six months, they are supposed to recommend legislative or administrative actions, including actual legislative language. Then bills are to be introduced in both houses of Congress on the very next day they are in session.

Which sounds like urgency, but is it? Even Connie Garner, the longtime Kennedy staff member who directs the advocacy group called Advance Class, was skeptical. “What can you really do in six months?” she said. Actuaries and policy types had been working on the Class plan for 19 months before the plug was pulled. “And so what if you introduce a bill?” she went on. “You can introduce stuff and nothing happens.”

So when Advance Class held its monthly board meeting a few days after the Class Act officially bit the dust, Ms. Garner figured this push for a national long-term care approach was dead, along with her organization. She had prepared a valedictory, praising the group for at least putting the issue on the national agenda.

“But they said, ‘No, we’re going to keep Advance Class going; we’re going to fight the long fight,’ ” she recalled. So on we go.

Discouragingly, the commission has already hit delays: Its members were to be named within 30 days of the budget deal’s enactment, but only the Congressional Democrats have made appointments.

Senator Harry Reid, the majority leader, nominated a veteran health policy scholar, Judy Feder, who is now at the Georgetown University Public Policy Institute; the labor executive Laphonza Butler, who heads California’s United Long-Term Care Workers Union; and Javaid Anwar, a Nevada internist.

Representative Nancy Pelosi, the House minority leader, appointed Bruce Chernof, chief executive of the SCAN Foundation, which promotes quality care for the elderly; Judith Stein, founder of the Center for Medicare Advocacy; and George Vrandenburg, a retired corporate lawyer who has put his philanthropic muscle behind Alzheimer’s causes.

We have heard nothing yet from the White House or the Republican Congressional leadership.

Maybe that barely matters. “I can’t imagine anything coming out of this commission that won’t be totally forgotten a year from now,” said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. “How many commissions have there been?”

Yet one thing that he and the proponents at Advance Class can agree on — maybe the only thing — is that this issue demands attention.

Otherwise, Mr. Slome says, we are stuck with what we have when it comes to older people who might need expensive care for 30 years, and disabled people who might need care for even longer. And what we have, he said, amounts to “a little here, a little there, a little Medicare, a lot of Medicaid, a little long-term care insurance and a lot of unpaid family caregiving.” (I would say very little long-term care insurance, and a vast amount of unpaid family care.)

Discussing the future of Medicare and Medicaid without including long-term care is pointless, Mr. Slome added. Ms. Garner notes that she meets frequently with Republicans and that they never dismiss the issue as unimportant.

Well, there’s a start.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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European Union and U.S. to pursue transatlantic free-trade deal

WASHINGTON — The European Union and the United States announced that they will pursue talks aimed at achieving an overarching transatlantic free-trade deal.

The 27-country EU said Wednesday that such an agreement, first announced in the State of the Union address by President Obama, would be the biggest bilateral trade deal ever negotiated. Any agreement could boost economic output in the EU by 0.5% and in the U.S. by 0.7%, according to some estimates. That would be a highly desirable outcome when the EU and the U.S. are both struggling with slow growth, high unemployment and high levels of debt.

"Both of us need growth," said Jose Manuel Barroso, president of the European Commission, the EU's executive arm. "And both of us have budgetary problems."

In a joint statement issued simultaneously in Washington and Brussels, Obama, European Council President Herman Van Rompuy and Barroso said they were "committed to making this relationship an even stronger driver of our prosperity".

"Through this negotiation, the United States and the European Union will have the opportunity not only to expand trade and investment across the Atlantic, but also to contribute to the development of global rules that can strengthen the multilateral trading system," they said.

Trade between the U.S. and the EU is already huge, reaching $2.69 billion a day, EU Trade Commissioner Karel De Gucht said.

Gary Hufbauer, a senior fellow at the Peterson Institute for International Economics in Washington, estimates that a comprehensive agreement could boost U.S. output by about 0.7 percentage points.

A high-level U.S.-EU working group on jobs and growth said the goals of the agreement would include removing import tariffs, which average 4%, and getting rid of other barriers to trade such as the approval processes that businesses have to go through in order to sell products on both sides of the Atlantic.

Beyond that, De Gucht said, "There seems to be a consensus that the cost of a product contains about 10% of red tape. If you can largely make away with that, you will have the same product for a lower price without anybody paying for it."

One example of where the two economies could benefit from the talks is automaking. If each side recognized the other's car safety standards — or if the standards were harmonized — an auto manufacturer would not have to satisfy two sets of requirements. But there are other areas, such as agriculture, that will prove to be more difficult to negotiate.

U.S. Trade Representative Ron Kirk said Wednesday that the U.S. plans to push the EU to relax its ban on genetically modified crops. That's also a top goal of Sen. Charles E. Grassley (R-Iowa) and Sen. Max Baucus (D-Mont.), two leading members of Congress on trade issues.

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Charred human remains found in burned cabin

Charred human remains
have been found in the burned cabin where police believe fugitive ex-cop
Christopher Dorner was holed up after trading gunfire with law enforcement, authorities
said.

If the body is identified
to be Dorner’s, the standoff would end a weeklong manhunt for the ex-LAPD
officer and Navy reserve lieutenant, who is accused of going on a
revenge-fueled spree following his firing by the Los Angeles Police Department several
years ago. Four people have died allegedly at Dorner’s hands.

The last burst of
gunfire Tuesday came after the suspect, attempting to flee law enforcement
officials, shot to death one San Bernardino County sheriff’s deputy and
seriously injured another. He then barricaded himself in a wooden cabin outside
Big Bear, not far from ski resorts in the snow-capped San Bernardino Mountains
east of Los Angeles, according to police.

PHOTOS: Manhunt for ex-LAPD officer

Just before 5 p.m., authorities smashed the cabin's windows, pumped in tear
gas and called for the suspect to surrender. They got no response. Then, using
a demolition vehicle, they tore down the cabin's walls one by one. When they
reached the last wall, they heard a gunshot. Then the cabin burst into flames.

Los Angeles Police Chief Charlie Beck said he would not consider the manhunt
over until a body was identified as Dorner.

TIMELINE: Manhunt for ex-LAPD officer

"It is a bittersweet night," said Beck as he drove to the hospital
where the injured deputy was located. He is expected to survive, but is expected to need several surgeries. "This could have ended
much better, it could have ended worse. I feel for the family of the deputy who
lost his life."

According to a manifesto Dorner allegedly posted on Facebook, he felt the LAPD
unjustly fired him several years ago, when a disciplinary panel determined that he lied
in accusing his training officer of kicking a mentally ill man during an
arrest. Beck has promised to review the case.

INTERACTIVE MAP: Searching for suspected shooter

Dorner, 33, vowed to wage "unconventional and asymmetrical
warfare" against law enforcement officers and their families, the
manifesto said. "Self-preservation is no longer important to me. do not
fear death as I died long ago."

Last week, authorities had tracked Dorner to a wooded area near Big Bear
Lake. They found his torched gray Nissan Titan with several weapons inside. The
only trace of Dorner was a short trail of footprints in newly fallen snow.

On Tuesday morning two maids entered a cabin in the 1200 block of Club View
Drive and ran into a man who they said resembled the fugitive, a law
enforcement official said. The cabin was not far from where Dorner's singed
truck had been found and where police had been holding press conferences about
the manhunt.

FULL COVERAGE: Sweeping manhunt for ex-cop

The man tied up the maids, and he took off in a purple Nissan parked near
the cabin. About 12:20 p.m., one of the maids broke free and called police.

Nearly half an hour later, officers with the California Department of Fish
and Wildlife spotted the stolen vehicle and called for backup. The suspect
turned down a side road in an attempt to elude the officers but crashed the
vehicle, police said.

A short time later, authorities said the suspect carjacked a light-colored
pickup truck. Allan Laframboise said the truck belonged to his friend Rick
Heltebrake, who works at a nearby Boy Scout camp.

Heltebrake was driving on Glass Road with his Dalmatian, Suni, when a
hulking African American man stepped into the road, Laframboise said.
Heltebrake stopped. The man told him to get out of the truck.

DOCUMENT: Read the manifesto

"Can I take my dog?" Heltebrake asked, according to his friend.

"You can leave and you can take your dog," the man said. He then
sped off in the Dodge extended-cab pickup — and quickly encountered two
Department of Fish and Wildlife trucks.

As the suspect zoomed past the officers, he rolled down his window and fired
about 15 to 20 rounds. One of the officers jumped out and shot a high-powered
rifle at the fleeing pickup. The suspect abandoned the vehicle and took off on
foot.

Police said he ended up at the Seven Oaks Mountain Cabins, a cluster of
wood-frame buildings about halfway between Big Bear Lake and Yucaipa. The
suspect exchanged gunfire with San Bernardino County sheriff's deputies as he
fled into a cabin that locals described as a single-story, multi-room
structure.

The suspect fired from the cabin, striking one deputy, law enforcement
sources said. Then he ducked out the back of the cabin, deployed a smoke bomb
and opened fire again, hitting a second deputy. Neither deputy was identified
by authorities. The suspect retreated back into the cabin.

The gun battle was captured on TV by KCAL-TV Channel 9 reporter Carter Evans, who said
he was about 200 feet from the cabin. As Evans described on air how deputies
were approaching the structure, he was interrupted by 10 seconds of gunfire.

Deputies drew their weapons and sprinted toward Evans. Someone yelled for
him to move — then about 20 more seconds of shooting erupted.

"Hey! Get … out of here, pal," someone shouted. Evans was
unharmed.

The gunfire gave way to a tense standoff. Mountain residents locked their
doors and hunkered down.

Holly Haas, 52, who lives about a mile from where the shootout unfolded,
said she heard helicopters buzzing on and off until about 3:30. One dipped so
close to her home, she said, "I could throw a rock and hit it."

Others watched the standoff unfold on television. At her home, Candy Martin
sat down to watch TV when, to her surprise, she spotted her rental cabin
on-screen — where the suspect was believed to be holed up.

She contacted police and told them that the furnished, 85-year-old cabin had
no cable, telephone or Internet service. No one had booked it for Monday.

"There should have been nobody," she recalled saying. "Nobody
in any way."

Within hours, authorities moved in on the cabin. The fire broke out, setting
off ammunition that had apparently been inside. On TV, viewers saw only the
orange flames and curls of black smoke.

LAPD Chief Beck said his officers have been providing
around-the-clock protection for more than 50 people thought to be Dorner's
targets since the manifesto was discovered.

Police say Dorner's first victims were the daughter of the retired LAPD
official who represented him at his disciplinary hearing and her fiance. Monica Quan and Keith Lawrence were
found shot to death Feb. 3 in their car in their condo complex's parking structure.

Days later, Dorner allegedly attempted to steal a boat in San Diego in a
failed bid to escape to Mexico. By Feb. 7, authorities said, he had fled to the
Inland Empire. In Corona, police said, he fired at an LAPD officer searching
for him at a gas station. About half an later, he allegedly opened fire on two
Riverside officers, killing Michael Crain, 34, and injuring his partner.

Early on in the manhunt, officers mistakenly fired on three people in the
Torrance area — two Latina women and a white man — while searching for Dorner,
who is 6 feet tall and 270 pounds.

After his truck was found in Big Bear, authorities swarmed the area, where
many cabins sit empty during the winter.

At the height of the search, more than 200 officers scoured the mountain,
while others sifted through more than 1,000 tips that poured in after officials
offered a $1-million reward.

Just as some officials began to speculate that the former cop had failed to
survive in the wilderness, Dorner apparently surfaced.

ALSO:

Dorner manhunt: Wounded deputy will need several surgeries

Dorner manhunt: Fish and Wildlife officers make the big break

Dorner manhunt: Maids stumbled on suspect, were tied up, then called 911

--- Andrew Blankstein, Joel Rubin and Ashley
Powers; with Phil Willon, Louis Sahagun, Adolfo
Flores, and Ruben Vives in San Bernardino County and Julie Cart, Matt Stevens, Kate Mather, Wesley Lowery, Samantha Schaefer, Frank Shyong and Rong-Gong Lin II

Photo: San Bernardino County Sheriff's Department public information officer Cindy Bachman updates reporters after a standoff and a shootout with
a man suspected to be former Los Angeles Police Department officer Christopher Dorner. Credit: Kevork Djansezian / Getty Images

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Beyonce hopes her documentary inspires Blue Ivy

NEW YORK (AP) — Beyonce is hoping that her ultra-revealing documentary will someday provide inspiration for Blue Ivy, the year-old daughter she and husband Jay-Z have.

"I hope that she will see all of the beautiful times (and) all the tough times that led up to her being here," the singer said Tuesday night at the New York premiere of her upcoming HBO documentary, "Life is But a Dream."

She added: "I'm hoping that ... it can comfort her and inspire her in her life when she needs it."

The autobiographical film takes a no-holds-barred look at the entertainer. It stems from personal conversations the 31-year old singer made using the video camera on her computer over the past couple of years. It also includes home movies of the Grammy-winning singer and her two sisters.

In the film, Beyonce candidly discusses personal matters like her miscarriage, reports of faking her pregnancy, and firing her father as her manager.

She claims the process of talking into a camera to get all her thoughts out was therapeutic.

"I really grew so much," she says of the process. "This movie has really been my therapy. I've healed from so many wounds and I've been able to understand why some of the things I've been through, why I went through, so feel really proud, and hopefully I can inspire other people."

The singer has been private about her life in the past. But she felt the time was right to let people know how she felt.

"I felt that after 16 years of being a public singer, people didn't know who I was," she admitted. But then she added: "I will always keep certain things to myself because it's only natural."

Oprah Winfrey made a surprise visit to the premiere, and posed with Beyonce on the red carpet. Before going into the Ziegfeld Theatre, Winfrey, known for her tough, results-driven interview style, was asked if this was the kind of story she would have done on Beyonce.

She said Beyonce did a "much better job" of telling her own story. "I wouldn't have been in the bedroom and in the closet and in the car and on vacation," she said.

Beyonce acted as the film's executive producer and co-directed it with Ed Burke. He previously worked on some of her video projects. "Life is But a Dream" airs Saturday on HBO.

_____

Online:

http://www.hbo.com

___

John Carucci covers entertainment for The Associated Press. Follow him at — http://www.twitter.com/jcarucci_ap

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Well: Getting the Right Dose of Exercise

Phys Ed

Gretchen Reynolds on the science of fitness.

A common concern about exercise is that if you don’t do it almost every day, you won’t achieve much health benefit. But a commendable new study suggests otherwise, showing that a fairly leisurely approach to scheduling workouts may actually be more beneficial than working out almost daily.

For the new study, published this month in Exercise & Science in Sports & Medicine, researchers at the University of Alabama at Birmingham gathered 72 older, sedentary women and randomly assigned them to one of three exercise groups.

One group began lifting weights once a week and performing an endurance-style workout, like jogging or bike riding, on another day.

Another group lifted weights twice a week and jogged or rode an exercise bike twice a week.

The final group, as you may have guessed, completed three weight-lifting and three endurance sessions, or six weekly workouts.

The exercise, which was supervised by researchers, was easy at first and meant to elicit changes in both muscles and endurance. Over the course of four months, the intensity and duration gradually increased, until the women were jogging moderately for 40 minutes and lifting weights for about the same amount of time.

The researchers were hoping to find out which number of weekly workouts would be, Goldilocks-like, just right for increasing the women’s fitness and overall weekly energy expenditure.

Some previous studies had suggested that working out only once or twice a week produced few gains in fitness, while exercising vigorously almost every day sometimes led people to become less physically active, over all, than those formally exercising less. Researchers theorized that the more grueling workout schedule caused the central nervous system to respond as if people were overdoing things, sending out physiological signals that, in an unconscious internal reaction, prompted them to feel tired or lethargic and stop moving so much.

To determine if either of these possibilities held true among their volunteers, the researchers in the current study tracked the women’s blood levels of cytokines, a substance related to stress that is thought to be one of the signals the nervous system uses to determine if someone is overdoing things physically. They also measured the women’s changing aerobic capacities, muscle strength, body fat, moods and, using sophisticated calorimetry techniques, energy expenditure over the course of each week.

By the end of the four-month experiment, all of the women had gained endurance and strength and shed body fat, although weight loss was not the point of the study. The scientists had not asked the women to change their eating habits.

There were, remarkably, almost no differences in fitness gains among the groups. The women working out twice a week had become as powerful and aerobically fit as those who had worked out six times a week. There were no discernible differences in cytokine levels among the groups, either.

However, the women exercising four times per week were now expending far more energy, over all, than the women in either of the other two groups. They were burning about 225 additional calories each day, beyond what they expended while exercising, compared to their calorie burning at the start of the experiment.

The twice-a-week exercisers also were using more energy each day than they had been at first, burning almost 100 calories more daily, in addition to the calories used during workouts.

But the women who had been assigned to exercise six times per week were now expending considerably less daily energy than they had been at the experiment’s start, the equivalent of almost 200 fewer calories each day, even though they were exercising so assiduously.

“We think that the women in the twice-a-week and four-times-a-week groups felt more energized and physically capable” after several months of training than they had at the start of the study, says Gary Hunter, a U.A.B. professor who led the experiment. Based on conversations with the women, he says he thinks they began opting for stairs over escalators and walking for pleasure.

The women working out six times a week, though, reacted very differently. “They complained to us that working out six times a week took too much time,” Dr. Hunter says. They did not report feeling fatigued or physically droopy. Their bodies were not producing excessive levels of cytokines, sending invisible messages to the body to slow down.

Rather, they felt pressed for time and reacted, it seems, by making choices like driving instead of walking and impatiently avoiding the stairs.

Despite the cautionary note, those who insist on working out six times per week need not feel discouraged. As long as you consciously monitor your activity level, the findings suggest, you won’t necessarily and unconsciously wind up moving less over all.

But the more fundamental finding of this study, Dr. Hunter says, is that “less may be more,” a message that most likely resonates with far more of us. The women exercising four times a week “had the greatest overall increase in energy expenditure,” he says. But those working out only twice a week “weren’t far behind.”

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Health insurer WellPoint picks Joseph Swedish as its new CEO

INDIANAPOLIS — Health insurance giant WellPoint Inc., parent of Anthem Blue Cross, is picking a veteran hospital executive who has never run a public company to become its next chief executive.

The Indianapolis insurer says Trinity Health CEO Joseph Swedish will take over March 25, replacing interim CEO John Cannon.

WellPoint, the nation's second-largest health insurance company, has been searching for a new leader since Angela Braly resigned in August amid investor frustration over disappointing financial results.

The company runs Blue Cross Blue Shield plans in 14 states, including Anthem — the largest for-profit insurer in California. It also runs CareMore clinics in California and other states.

Swedish, 61, has been CEO at Trinity Health in Livonia, Mich., since December 2004. Under his leadership, revenue at the nonprofit Catholic healthcare system increased from $5.7 billion in 2005 to $8.9 billion in 2012, and total assets increased from $7.5 billion to $11.7 billion. The organization's community benefit ministry, which includes care for the poor and community heath activity, increased from $265 million in 2005 to $615 million in 2012.

Swedish's resume includes work with HCA, the nation's largest hospital chain. He also has served as a director for another insurer, Coventry Health Care.

In his new job, Swedish's tasks will include helping WellPoint prepare for coverage expansions that start next year under the federal healthcare overhaul.

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