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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Ex-Bell officials defend themselves as honorable public servants

Less than three years ago, they were handcuffed and taken away in a case alleged to be so extensive that the district attorney called it "corruption on steroids."

But on Monday, two of the six former Bell council members accused of misappropriating money from the small, mostly immigrant town took to the witness stand and defended themselves as honorable public servants who earned their near-$100,000 salaries by working long hours behind the scenes.

During her three days on the stand, Teresa Jacobo said she responded to constituents who called her cell and home phone at all hours. She put in time at the city's food bank, organized breast cancer awareness marches, sometimes paid for hotel rooms for the homeless and was a staunch advocate for education.

"I was working very hard to improve the lives of the citizens of Bell," she said. "I was bringing in programs and working with them to build leadership and good families, strong families."

Jacobo, 60, said she didn't question the appropriateness of her salary, which made her one of the highest-paid part-time council members in the state.

Former Councilman George Mirabal said he too worked a long, irregular schedule when it came to city affairs.

"I keep hearing time frames over and over again, but there's no clock when you're working on the council," he said Monday. "You're working on the circumstances that are facing you. If a family calls … you don't say, '4 o'clock, work's over.' "

Mirabal, 65, said he often reached out to low-income residents who didn't make it to council meetings, attended workshops to learn how to improve civic affairs and once even made a trip to a San Diego high school to research opening a similar tech charter school in Bell.

"Do you believe you gave everything you could to the citizens of Bell?" asked his attorney, Alex Kessel.

"I'd give more," Mirabal replied.

Both Mirabal and Jacobo testified that not only did they perceive their salaries to be reasonable, but they believed them to be lawful because they were drawn up by the city manager and voted on in open session with the city attorney present.

Mirabal, who once served as Bell's city clerk, even went so far as to say that he was still a firm supporter of the city charter that passed in 2005, viewing it as Bell's "constitution." In a taped interview with authorities, one of Mirabal's council colleagues — Victor Bello — said the city manager told him the charter cleared the way for higher council salaries.

Prosecutors have depicted the defendants as salary gluttons who put their city on a path toward bankruptcy. Mirabal and Jacobo, along with Bello, Luis Artiga, George Cole and Oscar Hernandez, are accused of drawing those paychecks from boards that seldom met and did little work. All face potential prison terms if convicted.

Prosecutors have cited the city's Solid Waste and Recycling Authority as a phantom committee, created only as a device for increasing the council's pay. But defense attorneys said the authority had a very real function, even in a city that contracted with an outside trash company.

Jacobo testified that she understood the introduction of that authority to be merely a legal process and that its purpose was to discuss how Bell might start its own city-run trash service.

A former contract manager for Consolidated Disposal Service testified that Bell officials had been unhappy with the response time to bulky item pickups, terminating their contract about 2005, but that it took about six years to finalize because of an agreement that automatically renewed every year.

Deputy Dist. Atty. Edward Miller questioned Mirabal about the day shortly after his 2010 arrest that he voluntarily told prosecutors that no work was done on authorities outside of meetings.

Mirabal said that if he had made such a statement, it was incorrect. He said he couldn't remember what was said back then and "might have heed and hawed."

"So it's easy to remember now?" Miller asked.

"Yes, actually."

"More than two years after charges have been filed, it's easier for you to remember now that you did work outside of the meetings for the Public Finance Authority?"

"Yes, sir."

Miller later asked Mirabal to explain a paragraph included on City Council agendas that began with the phrase, "City Council members are like you."

After some clarification of the question, Mirabal answered: "That everybody is equal and that if they look into themselves, they would see us."

corina.knoll@latimes.com

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Young Afghan musicians in NY for date at Carnegie

SCARSDALE, N.Y. (AP) — For these young people from Afghanistan, it's the perfect trip to America. They get to scarf down New York pizza, go ice skating — and take the stage at Carnegie Hall.

The Afghan Youth Orchestra, many of whose members are not far removed from eking out a living on the streets of Kabul, is on the New York leg of a U.S. tour that melds Western classics with traditional Afghan music.

About 50 players held a joint rehearsal Monday with 25 members of the Scarsdale High School orchestra, which meant that young musicians from a war-torn country where music was banned for several years by the Taliban were playing alongside those from one of New York's toniest suburbs.

"This is all providing a model for the future of Afghanistan," said William Harvey, the Afghan orchestra's American conductor and arranger. "The recomposed music, taking the best from both worlds, and the cooperation between the Afghan kids and the Scarsdale kids, shows what has to happen for Afghanistan."

Among the pieces rehearsed in advance of Tuesday night's Carnegie program were adaptations of Vivaldi's "Four Seasons" and Ravel's "Bolero," both incorporating Afghan instruments and rhythms.

A handful of people in the Scarsdale auditorium got to hear familiar melodies perked up with such instruments as the sitar, dilruba and ghichak. Some of the Afghan musicians were barefoot.

"I love the 'Bolero,'" said Milad Yousofi, 18, a pianist from Kabul who, like the rest of the orchestra, attends the Afghanistan National Institute of Music, which was founded just three years ago.

Yousofi is hoping the orchestra's U.S. visit — it played in Washington last week and is headed for Boston — will help him find a way to continue his musical education in America.

"I'm very excited and amazed that we are going to Carnegie Hall," he said. "New York is my dream city. I want to come here as soon as possible. But then I want to go back to Afghanistan and teach."

Hojat Hameed, 21, a violinist who also plays electric guitar in a rock band, said he became interested in music when he heard a Celine Dion recording.

"That made me want to become a musician," he said. "I could feel I wanted to come home to music."

Some of the Afghans may have been saved from desperate lives by the music school.

"One of my violinists used to sell chewing gum on the street," said Harvey, who spoke to the musicians in English and Dari, one of Afghanistan's two main languages. "She had to. The Taliban had beaten her father paralyzed and he couldn't work."

"The return of music to Afghanistan is a victory of the human spirit," Harvey said.

Ahmad Sarmast, who founded the school, said hearing the orchestra play was "a touching experience."

"The Taliban deprived children of their music," he said. "It was like a genocide of music. Now this is an incredible way of showing pride in our people, our youth, our school, our country."

He said the school, which is funded by the World Bank and others, is free and provides enough of a stipend to keep the musicians off the streets. And it accepts boys and girls, another reversal of Taliban orders.

Amedee Williams, who heads the Scarsdale music program, said he heard last year that the Afghan school was trying to raise funds for a tour. He contacted the school and suggested their orchestra members could save on New York hotels by staying with Scarsdale families. That turned out not to be necessary, but it forged a partnership that resulted in the Scarsdale orchestra joining the Afghans at Carnegie Hall.

Before the joint orchestra rehearsed on Sunday, he said, all the youngsters had pizza. Afterward, they went ice skating, which was a new activity for the Afghans "and some of the Scarsdale kids," Williams said.

"There was a lot of hand-holding, supporting each other," he said. "It was good to see."

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Domino's hopes customers flock to 'pizza theater'

A pair of mustachioed pizza makers in blue aprons — visible from behind a glass display at a new Domino's store in Seattle — tossed dough into the air as a handful of corporate executives looked on.

Domino's calls the concept "pizza theater" because customers now can come in and watch their orders being made.

The new look is part of a four-year effort to freshen the pizza chain's image and boost its growing ranks of carryout customers.

The open-kitchen format includes seating for a dozen or so people, a chalkboard where customers can leave comments, and a refrigerated section for grab-and-go items such as salads and milk.

"This is the way we always made our pizzas. A lot of people just had no idea," said Domino's Chief Executive Patrick Doyle, who was in Seattle last week to see the new store. "It was sort of one of those lightning-bolt moments where we said, 'Gee, maybe we should show them.' "

Founded in 1960, Domino's long has been known for inexpensive pizza delivered to your doorstep. Its 30-minute guarantee helped make it the world's largest pizza-delivery company in the 1980s (though it later had to drop the pledge amid charges that it led to reckless driving).

Today, the Ann Arbor, Mich., company holds a 22% share of the U.S. pizza-delivery market and ranks No. 2 overall among U.S. pizza chains.

More than two-thirds of U.S. consumers buy carryout pizza at least once a month, making carryout the most popular pizza format, according to research firm Technomic Inc. Nearly half of all pizza orders are for carryout, while a third are for delivery and a fifth are for eat-in.

Experts say that if a Domino's store is nearby, many consumers prefer to pick up their orders and save a few dollars that otherwise would go to a delivery fee and tip.

Domino's jumped on the trend last year when it began offering a weekday pickup promotion of a large three-topping pizza for $7.99. It also redesigned its logo, dropping the word "pizza" to reflect a larger menu, including sandwiches, pasta and chocolate "lava" cakes.

Doyle said the plan is to redo the greater Seattle area's 74 franchised locations by midyear, which would make Seattle the first market to be completely overhauled.

Doyle said Domino's also is setting out to hire 800 new full-time and part-time employees in that area — something he attributed to new store openings, as well as solid sales growth.

Domino's has about 4,500 U.S. franchised stores, as well as 390 company-owned stores. Its U.S. sales at stores open at least a year rose 3.3% in the third quarter, and its stock has been trading at the upper end of a 52-week range of $28.17 to $47.91. Its shares rose 8 cents Monday to $46.81.

Pizza Hut is the largest U.S. pizza chain, with an 18% market share, followed by Domino's, at 11%, and Papa John's, at 7%, according to Technomic.

In late 2009, Domino's rolled out a new recipe promising a garlic-seasoned crust, bolder tomato sauce and tastier cheese. The new store format builds on that push to be more transparent, Doyle said.

"Consumers want to see what they're eating," he said. "We've always been known as delivery experts, but a third or more of our orders now are for carryout. We're proud of these pizzas, and we want people to see it."

Seattle resident James Johnson, 28, a longtime Domino's customer, said he welcomes the changes. Johnson stopped by the revamped Domino's on his way home from work last week to pick up dinner.

"You can watch the pizza being made from beginning to end," he said. "It's kind of cool to see, depending on whether you're engaged and not on your cellphone."

Martinez writes for the Seattle Times.

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Grammys 2013: Fun., Mumford, Gotye lead a newer generation

Grammy Awards voters gave their top honor to British roots music band Mumford & Sons for their album "Babel" on Sunday at the 55th awards ceremony. Other top honors were distributed to a broad array of younger acts, including indie trio Fun., electronic pop artist Gotye, rapper-R&B singer Frank Ocean and rock group the Black Keys.

"We figured we weren't going to win because the Black Keys have been sweeping up all day — and deservedly so," Mumford & Sons front man Marcus Mumford said after he and his band members strode to the stage at Staples Center in Los Angeles to collect the award from last year's winner, R&B-soul singer Adele.

Pop culture historians may look back at 2013, however, as the year the Grammy Awards gave up its long fight against new forms of music dissemination, embracing songs and videos that consumers soaked up by way of YouTube and other Internet outlets as opposed to purchasing them.

PHOTOS: 2013 Grammy Award winners

"Somebody That I Used to Know," the wildly popular collaboration between Gotye and New Zealand pop singer Kimbra, took the top award presented for a single recording upon being named record of the year, which recognizes performance and record production.

"Somebody…" not only was one of the biggest-selling singles of 2012 but also has notched nearly 400 million views on YouTube, powerfully demonstrating the increasingly vital role of the "broadcast yourself" video Internet phenomenon. Different YouTube posts of Ocean's "Thinking About You" single have totaled nearly 60 million views.

New York indie rock trio Fun. was named best new artist, an acknowledgment of the good-time music the group brought to listeners and viewers last summer largely through its runaway hit single "We Are Young," which has racked up nearly 200 million YouTube views. It also was named song of the year, bringing awards for the group's songwriters, Jack Antonoff, Andrew Dost and Nate Ruess, and collaborator Jeff Bhasker.

GRAMMYS 2013: Full coverage | Pre-show winners | Winners | Ballot

"Everyone can see our faces, and we are not very young — we've been doing this for 12 years," Ruess said as they collected the award.

The song's title could also serve as a theme for the evening, which was dominated by other relatively young acts in the most prestigious Grammy categories.

Singer, rapper and songwriter Ocean emerged the victor in the one category that pitted him directly against real-life rival Chris Brown, as his critically acclaimed solo debut album, "Channel Orange," won the urban contemporary album award. A few minutes later Ocean got a second Grammy with Kanye West, Jay-Z and the Dream in the rap-sung collaboration category for their single "No Church in the Wild."

GRAMMYS 2013: Winners list | Best & Worst |  Red carpet | Timeline | Fashion | Highlights

Ocean's tuxedo covered all but his hands, but it appeared as he picked up the urban album award that his left arm remained in a wrist brace he'd exhibited Thursday at rehearsals for this year's broadcast, a remnant of his scuffle last month with Brown over a parking space at a recording studio. Los Angeles Police Department investigators said Ocean informed them that he would not press charges against Brown.

It was the Black Keys' Dan Auerbach who quickly built up steam as the front-runner to dominate this year's awards, taking several statuettes barely an hour into the show, including producer of the year for himself and three with his group including rock performance, rock song and rock album for "El Camino."

The Black Keys homed in on the fundamentals of rock 'n' roll — big guitar riffs, lustful lyrics and a bevy of musical hooks on "El Camino," one of the best reviewed albums of the group's career.

FULL COVERAGE: Grammy Awards 2013

Auerbach picked up another award as producer of the blues album winner, Dr. John's "Locked Down."

Carrie Underwood grabbed the country solo performance Grammy for the title track from her album "Blown Away," which also won the country song award for writers Josh Kear and Chris Tompkins earlier during the pre-telecast ceremony at Nokia Theatre, across the street from Staples Center.

The Zac Brown Band added to its growing place as a new-generation country powerhouse with a win of the country album trophy for its "Uncaged," built on muscular Southern rock guitar riffs, elaborate multipart vocal harmonies and jam-band instrumental excursions.

Last year's big winner, Adele, collected the first statuette of the night for her single "Set Fire to the Rain" in the pop solo performance category.

The show got off to an eye-popping start with a Cirque du Soleil-inspired performance by Taylor Swift of her nominated single "We Are Never Ever Getting Back Together."

The preponderance of youthful acts not broadly known to mainstream TV audiences heightened the use of cross-generational pairings. Rising songwriter and singer Ed Sheeran shared the stage early with veteran Grammy darling Elton John, while Bruno Mars teamed with Sting and Rihanna in a Bob Marley tribute later in the show. Several members of Americana acts, including Alabama Shakes and Mumford & Sons, sang alongside veterans John, Mavis Staples and T Bone Burnett in a salute to drummer Levon Helm of the Band.

But it was the young guns to whom the evening — and perhaps the future — of the Grammy Awards belonged.

The Grammys are determined by about 13,000 voting members of the Recording Academy. The eligibility period for nominated recordings was Oct. 1, 2011, to Sept. 30, 2012. The show aired on CBS live except on the West Coast, which gets a tape delay.

randy.lewis@latimes.com

Twitter: @RandyLewis2

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Producers: 'Chicago' cast to join Oscar performers

LOS ANGELES (AP) — Academy Awards producers Craig Zadan and Neil Meron have run out of rehearsal space. Dressing rooms, too.

The award-winning production duo is planning the most performance-filled Oscar show ever. They promise a "wow moment" in each of its 13 acts, so the show demands a more dynamic stage and more dressing rooms and rehearsal time than previous Oscar productions.

"I don't think any Oscars have been as performance-based," Meron said.

It's no surprise, given the pair's hit-filled history: They produced 2003's best picture, "Chicago," and count TV's "Smash" and the recent Broadway revival of "How to Succeed in Business Without Really Trying" among their credits.

Running out of space for their Oscar production's A-list roster of performers — including Barbra Streisand, Adele and Norah Jones — is what Zadan calls a "great problem."

"When you do an Oscar show, you don't have a dressing room problem. The presenters don't get dressing rooms. And how many people perform on the Oscars, like one or two?" he said. "We have a staggering amount of performers, and each of them needs a dressing room... We're measuring the magnitude of how big the show is by the fact that we don't have (enough) dressing rooms."

Just added to the list of stars who may need spots? The cast of "Chicago."

The producers announced Monday that Renee Zellweger, Catherine Zeta-Jones, Queen Latifah and Richard Gere will reunite on the stage where "Chicago" won its Oscar 10 years ago.

"In a night of celebration of the music of the movies, we find it very appropriate," Meron said.

So will the musical cast sing?

"We can't talk about what they're going to do!" Zadan said.

Here's what they will talk about:

— Expect a dynamic, screen-filled set to accommodate the movie-focused numbers: "We're using a lot of cutting-edge technology with new LED screens of different sizes, shapes and configurations... It's kind of thrilling what we're doing with screens," Zadan said. "There will be, too, the regular screen that you have to use each year... but then we have all kinds of other screens that we're using in the show that are completely unique and different and allow us to do stuff with cinema, so it's not a concert thing where somebody comes out and sings a song. It's all integrated into movies."

— Look for a lot of host Seth MacFarlane: "He's going to be very present as a host, as a host should," Meron said.

— And expect to hear him show off his chops: "Seth will sing. He's got a great voice," Zadan said.

"Seth really does understand and have great reverence for the music of the movies," Meron added. "He loves it."

— And about those "wow moments?" Among them will be a celebration of the James Bond film franchise, a tribute to movie musicals, Streisand, Adele, a "special appearance" by Daniel Radcliffe, Charlize Theron, Channing Tatum and Joseph Gordon-Levitt, and maybe something from the cast of "Chicago."

"We think seeing the cast of 'The Avengers' is pretty wow," Meron said.

Better book them a dressing room.

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Contact Sandy Cohen at www.twitter.com/APSandy.

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Well: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.

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This is the second of two articles on addiction treatment. The first can be found here.

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Dozens of airline fees rose or changed in 2012, study finds

Airline travel fees — including charges to check a bag and to board early — have become so prevalent that travelers almost need an advanced degree in mathematics to calculate overall trip costs.

Last year at least 36 airline fees increased, and 16 others were redefined, bundled or unbundled with other services, according to a recent study by the consumer travel website Travelnerd.

One bright spot in the Travelnerd study of 14 U.S. airlines is that most fee increases were only $5 to $10 each.

In one case an airline had a big fee reduction. The study found that United Airlines reduced its fee for checking an overweight bag to $100 from $200 for bags 50 to 70 pounds and to $200 from $400 for bags 71 to 100 pounds.

"Travelers really have to be extra cautious when booking a flight," said Alicia Jao, vice president of travel media at Travelnerd, who predicts travelers will see even more fees in 2013. "U.S. carriers are becoming creative at charging consumers extra fees."

But some airlines seem to charge fees arbitrarily, said Perach Mazol, a Los Angeles resident who recently flew to Florida with friends from Romania to take a cruise.

On her flight from L.A. to Fort Lauderdale, Fla., on Spirit Airlines, she said the Florida airline did not charge for the carry-on bags she and her friends were carrying, but the carrier asked for $50 each to carry the same bags on the flight back. (Spirit is one of only two airlines in the U.S. that charge passengers for carry-on luggage.)

"I don't understand why they charged us on one flight and they don't on the other," Mazol said. "It's confusing."

A spokeswoman for Spirit said the airline tries to enforce its policies consistently.

"Maybe she got lucky one way and didn't have to pay," Spirit spokeswoman Misty Pinson said.

United offering satellite-based Wi-Fi

United Airlines was one of the last major airlines to offer onboard wireless Internet. But the Chicago carrier is trying to make up for its tardiness.

United offers Wi-Fi in about 3% of its fleet of about 700 planes, one of the lowest rates of any major carrier in the nation, according to a recent study.

But United recently became the first U.S.-based international carrier to offer satellite-based Wi-Fi Internet for passengers traveling on long-haul overseas flights.

The carrier has installed satellite-based Wi-Fi on nearly a dozen planes, with plans to expand the service to more than 300 planes, or about 43% of the fleet, by the end of the year.

"With this new service, we continue to build the airline that customers want to fly," said Jim Compton, vice chairman and chief revenue officer at United.

Satellite-based Wi-Fi is typically as fast as ground-based Wi-Fi, experts say, but the advantage is that it can give passengers Internet access when flying over areas where cellular towers don't exist — such as the Pacific or Atlantic oceans.

But, of course, there is a price to pay for the service.

United is charging $3.99 to $14.99 for standard speed, depending on the duration of the flight, and $5.99 to $19.99 for faster speeds.

United is not the only airline to offer satellite-based Wi-Fi. Southwest Airlines, the nation's largest domestic carrier, offers it through Westlake Village-based Row 44.

Delta to raise fee to access lounges

Airline fees are rising not only for onboard services but for amenities at the airport too.

Delta Air Lines, which has invested more than $20 million in its airport lounges over the last two years, announced that it would raise the cost for annual membership to access its lounges across the country by $50, starting March 1.

The increase means that an annual membership will range from $350 to $450, depending on membership level. (The more miles passengers fly on Delta the less they pay for membership.)

Among the investments Delta has made is the addition of a new luxury bar that opened recently at Delta's lounge at Los Angeles International Airport. Instead of helping themselves at a self-serve bar, members can now belly up to a fully stocked bar and order a drink from a bartender.

hugo.martin@latimes.com

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Cardinal Mahony used cemetery money to pay sex abuse settlement

Pressed to come up with hundreds of millions of dollars to settle clergy sex abuse lawsuits, Cardinal Roger M. Mahony turned to one group of Catholics whose faith could not be shaken: the dead.

Under his leadership in 2007, the Archdiocese of Los Angeles quietly appropriated $115 million from a cemetery maintenance fund and used it to help pay a landmark settlement with molestation victims.

The church did not inform relatives of the deceased that it had taken the money, which amounted to 88% of the fund. Families of those buried in church-owned cemeteries and interred in its mausoleums have contributed to a dedicated account for the perpetual care of graves, crypts and grounds since the 1890s.

Mahony and other church officials also did not mention the cemetery fund in numerous public statements about how the archdiocese planned to cover the $660-million abuse settlement. In detailed presentations to parish groups, the cardinal and his aides said they had cashed in substantial investments to pay the settlement, but they did not disclose that the main asset liquidated was cemetery money.

In response to questions from The Times, the archdiocese acknowledged using the maintenance account to help settle abuse claims. It said in a statement that the appropriation had "no effect" on cemetery upkeep and enabled the archdiocese "to protect the assets of our parishes, schools and essential ministries."

Under cemetery contracts, 15% of burial bills are paid into an account the archdiocese is required to maintain for what church financial records describe as "the general care and maintenance of cemetery properties in perpetuity."

Day-to-day upkeep at the archdiocese's 11 cemeteries and its cathedral mausoleum is financed by cemetery sales revenue separate from the 15% deposited into the fund, spokeswoman Carolina Guevara said. Based on actuarial predictions, it would be at least 187 years before cemeteries are fully occupied and the church started to draw on the maintenance account, she said.

"We estimate that Perpetual Care funds will not be needed until after the year 2200," Guevara wrote in an email.

The church's use of fund money appears to be legal. State law prohibits private cemeteries from touching the principal of their perpetual care funds and bars them from using the interest on those funds for anything other than maintenance. Those laws, however, do not apply to cemeteries run by religious organizations.

Mary Dispenza, who received a 2006 settlement from the archdiocese over claims of molestation by her parish priest in the 1940s, said her great-uncle and great-aunt are buried in Calvary Cemetery in East L.A.

"I think it's very deceptive," she said of the way the appropriation was handled. "And I think in a way they took it from people who had no voice: the dead. They can't react, they can't respond."

The fund dates to the tenure of Bishop Francis Mora, who opened Calvary in 1896. An official archdiocese history published in 2006 recounts how the faithful of Mora's era were assured their money was "in the custody of an organization of unquestionable integrity and endurance" — the Catholic Church.

Over the next century, the archdiocese built more cemeteries, and each person laid to rest meant a new deposit into the maintenance account. By the time of the sex abuse settlement, there were cemeteries from Pomona to Santa Barbara and $130 million in the fund. Church officials removed $114.9 million in October 2007.

"Management plans to repay these appropriated funds from future cemetery sales ... after all liabilities associated with the lawsuits ... are paid off," a December 2012 church financial report stated.

It's unclear when that will happen. The archdiocese is still repaying a $175-million loan it took to help cover the settlement. Archbishop Jose Gomez, who took over from Mahony two years ago, is mulling over a $200-million fundraising campaign. Cemeteries have been a reliable source of income for the church, and the use of the upkeep-fund money is one of several ways the archdiocese is depending on them to erase its abuse debts.

When Mahony agreed to the settlement six years ago, he did so knowing his archdiocese couldn't afford it. But he had little choice. If cases brought by more than 500 victims went to trial, the archdiocese feared it could be facing jury awards and legal bills in excess of $1 billion.

The deal reached after lengthy negotiations paid an average of $1.3 million per victim. Even with contributions from its insurance companies, religious orders and others, the archdiocese was on the hook for more than $300 million, vastly more cash than it had on hand.

Bishops in other cities had closed parishes and schools or filed for bankruptcy, moves that angered the faithful and that Mahony wanted to avoid. He went to Rome at least twice to consult with Vatican officials, who must approve the transfer of archdiocese property worth more than $10 million. He later told the National Catholic Reporter he got permission to "alienate" — the Vatican's term for sale or transfer — $200 million in church assets. Asked whether the Vatican had signed off on the use of cemetery funds, archdiocese Chief Financial Officer Randolph E. Steiner said in a statement, "All approvals under the Church's Code of Canon Law were obtained."

After the settlement, Mahony and others from the archdiocese said publicly that the money would come from administrative cuts, liquidation of investments, a bank loan and sales of real estate not directly related to their religious mission. Such real estate included the archdiocese's Wilshire Boulevard headquarters, which eventually sold for $31 million.

Three months later, with no announcement, the archdiocese reached into the cemetery account. Steiner said that during an internal review of church assets, the money "was determined to be excess funding and was made available to the 2007 settlement."

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