I suffered from chondromalacia for years. Arthroscopic surgery a few years ago helped, but what did the trick was developing the muscles that hold my knee in place and allow...
Nutrition & Physical Activity
It's hard to say if weight or fitness has a greater impact on overall health, so there's really no clear-cut answer to your question. However, recent research indicates that we should reconsider our beliefs about the relationship between weight and fitness. Weighing a lot or “being fat” is not always a sign of poor health and weighing a smaller amount or “being thin” is not always a mark of physical fitness or good health. And no matter what your size, being physically active on the regular has its benefits.
Many health professionals emphasize the importance of determining a person’s body max index (BMI), which is an estimate of body fat based on your height and weight. BMI is often thought to be a good indicator of the health conditions a person might be at greater risk for. However, the labels of “underweight,” “normal,” and “overweight” can be misleading. For example, some professional athletes are classified at either extreme simply because of how their muscle and fat are distributed. So BMI alone is not necessarily an accurate reflection of a person’s overall fitness.
Clearly, being fit is much more complex than maintaining a particular weight or having a specific BMI. According to the Centers for Disease Control and Prevention (CDC), physical fitness is measured by heart and lung performance, muscular strength and endurance, flexibility, and body composition (ratio of "lean mass" to fat). You’ll notice that weight and BMI are not included. While your weight does not necessarily indicate your fitness level, the CDC emphasizes that being “overweight” may factor into an increased risk for conditions like high blood pressure, heart disease, and diabetes.
It’s important to remember that not all body fat is unhealthy. In fact, different types of fat serve various functions in the body. White fat stores energy and produces hormones that regulate insulin in the body. Brown fat can burn white fat for calories and provide warmth. Studies have shown that lean individuals typically have more brown fat than those who are overweight. Location of fat on the body makes a difference, too. Subcutaneous fat is the type that can be found right under the skin. This differs from visceral fat, which is fat that surrounds your internal organs. When these types of fats are found in excess around the stomach and waist (particularly visceral fat), it can increase the risk for diabetes, heart disease and stroke. If you have excess fat found primarily in the lower parts of the body, like the thighs, you may not have the same type of health risks.
Don’t forget that lifestyle choices are also a sizeable component of overall fitness. For example, someone who does not fall within the "overweight" BMI weight range but is a regular smoker might have less heart and lung capacity than someone who is within the "overweight" BMI weight range. Smoking could also put them at a greater risk for serious conditions like lung disease. By the same token, a person within the "overweight" BMI weight range who gets more physical activity than someone in the "normal" BMI weight range might have a healthier heart and stronger muscles.
No matter how much you weigh, it is recommended that adults get 150 minutes of moderate intensity or 75 minutes of vigorous intensity physical activity, in addition to muscle strengthening activities on two or more days in a week. Need some more information (and maybe a little motivation) to get and stay active? Click on over to the CDC Physical Activity website for tips on activities, videos, and more. If you’re a Columbia student, check out CU Move, where you can learn how to get involved in physical activity on campus and find helpful information about how to stay fit.
Every body get moving now, ya hear!
Dear Student & Parent,
Bravo to eating breakfast! It's fairly well known as this point that a healthy breakfast is a great way to start each day — especially when it's made from scratch. Taking into consideration that, just sometimes, younger people are a little picky about what they'll eat, not to mention the energy it can take a groggy chef to whip up something in the A.M., here are a few easy, interesting, and nutritious breakfast recipes:
Creamy Apple-Cinnamon Oatmeal (makes two servings):
2 c. skim milk
1 c. rolled oats
1 T. Brown sugar
1 T. Maple syrup
1 apple — peeled, cored, and chopped into cubes
Berry Parfaits (makes two servings):
2 containers of yogurt (vanilla, lemon, or peach)
2 c. mixed berries: strawberries, raspberries, blueberries, and/or blackberries
1 c. low fat granola
Egg Scramblers (one serving):
1 or 2 eggs
1 toasted whole wheat pita or toasted English muffin
Optional item(s): mushrooms, peppers, grated cheese, chopped tomatoes, onions, salsa, or whatever else you like!
Banana Smoothie (makes one serving):
1 banana cut into 1-inch chunks (works great if already frozen)
½ c. yogurt
½ c. milk or soy milk
2 T. honey or jam
¼ t. vanilla extract
You can freeze this beverage overnight, then toss it into a blender, and pour it back in the plastic cup you froze it in. If you run out of time in the morning, you can bring your smoothie with you on the way to school.
Regardless of what you make, consider involving your breakfast companion in both the decision process and making the breakfast. This way you can both enjoy some time together and a nutrient-filled morning. Eat up!
Dear Nuts for nuts,
What did one squirrel say to the other squirrel? "I'm nuts about you!" One variety of nut isn't necessarily healthier or better than another. All nuts are healthy, unless you have an allergy or sensitivity to one or more kinds. While individual types vary in nutrients, most nuts contain an array of vitamins and minerals, such as iron, magnesium, zinc, vitamin E, and small amounts of folate, copper, phosphorous, and calcium. Nuts may also contribute to one's daily protein and fiber needs.
The following chart provides nutritional information for some popular nuts. All numbers are for dry roasted, unsalted nuts. Some nuts are roasted in oil, which adds fat and calories without adding additional vitamins or minerals. In addition, some nuts are salted, which may greatly contribute to one's daily sodium intake. Based on that information alone, it seems that dry roasted, unsalted nuts are the way to get the best bang for your buck.
|Nut type||Calories(per oz.)||Fat (g)||Sat. Fat (g)||Unsat. Fat (g)||Protein (g)||Fiber (g)||
|Zinc (% DRI)||Vit. E (% DRI)||Magnesium (% DRI)|
Nuts are calorie dense foods, meaning they pack a lot of calories into a small amount of food. This can be helpful for people trying to gain weight, but also need not make them off limits to those watching their waistlines. For example, one ounce of most nuts equals about 18 to 24 nuts (a small handful for many, and a tiny handful for larger-handed folks), and contains between 165 and 200 calories. The majority of the calories in nuts is derived from their unsaturated fats — specifically, monounsaturated fat — which is more healthful than saturated fat.
Nuts offer so many valuable nutrients, and can be enjoyed in small servings as well. Why not try to:
In conclusion, it's great that you're nuts about nuts. No ifs, ands, or nuts about it!
Dear Ab man,
Forget pretzel-like positions and expensive gadgets — the best exercise for strengthening your abdominal muscles (fondly known as "abs") is the basic crunch. Proper form is essential to strengthening the abs. Beginners may start with 10 - 15 repetitions. As you become stronger, you may perform more repetitions, or hold each contraction for five seconds, or longer. This can get really tough! Since your stomach muscles are comprised of different sections, you can work each separately.
For the upper portion of the abs, you can do a basic crunch:
For the obliques (the muscles on either side of the center of your belly):
For the lower abs (the section below your navel):
If you're properly working your abs, but are disappointed with the results, remember that strength training a specific muscle group doesn't reduce the amount of fat over that area. Cardiovascular exercise and proper diet can help reduce body fat. Unfortunately, it is difficult to control where fat loss (or fat storage) occurs. Some people are predisposed to carry a little extra padding in their midsection. Others, because of the way their internal organs are situated, appear to have a bit of a "tummy." Instead of focusing too hard on one area, why not engage in a variety of exercises and strive for overall fitness? You can check out the related questions for some ideas for getting fit. In addition, Columbia students can get active with CU Move.
Dear Haulin' Oats,
According to the 1990 Nutrition Labeling and Education Act, the U.S. Food and Drug Administration (FDA) may authorize a health claim only if there is significant scientific agreement that it is true — meaning that the claim must be accurate and not misleading to consumers. In 1997, the FDA allowed whole oat food manufacturers to make the health claim that their products reduce the risk of heart disease. Scientifically, the basis for this assertion is that the dietary fiber found in oats has been shown to help lower cholesterol, one of the risk factors for cardiovascular disease.
Oats contain beta-glucan, a water-soluble fiber thought to decrease LDL (low density lipoprotein, the harmful cholesterol) and total cholesterol. Since soluble fiber has a high water-holding capacity, it becomes gooey when dissolved in water. This feature allows soluble fiber to travel slowly through the digestive tract and attach to bile acids in the intestine, and then carry the acids out of the body as waste. Since bile acids are made from cholesterol, soluble fiber helps with the absorption of less dietary cholesterol.
In order to put the health claim on the food label, the oat item must be whole oat and provide at least 0.75 grams of soluble fiber per serving. In addition, the health claim must also include the words, "Diets low in saturated fat and cholesterol" rather than “Diets high in oats;” otherwise, consumers may think that eating oats is all they need to do to lower their risk of heart disease.
So, how much oats does a person really need to get the health benefits? Research has shown that two servings of oats daily can reduce cholesterol two to three percent beyond what is achieved with a low-fat diet alone. Other sources of soluble fiber may help instead of, or in addition to, the oats. Some examples of dietary soluble fiber include:
|Food||Serving Size||Soluble fiber (grams)|
|Kidney beans (cooked)||½ cup||2.0|
|Pinto beans (cooked)||½ cup||2.0|
|Brussels sprouts (cooked)||½ cup||2.0|
|Oat bran (dry)||1/3 cup||2.0|
|Oatmeal (dry)||1/3 cup||1.3|
|Broccoli (cooked)||½ cup||1.1|
|Spinach (cooked)||½ cup||0.5|
|Brown rice (cooked)||½ cup||0.4|
|Whole wheat bread||1 slice||0.4|
To reduce the risk for heart disease further, it is necessary to keep weight, cholesterol, and blood pressure at healthy levels, don't smoke, and exercise regularly. Also it is beneficial to munch on plenty of fruits, veggies, and whole grains. For more information on healthy eating, you can check out the United States Department of Agriculture (USDA) MyPlate website.
Lastly, while oat cereals are part of a healthy eating plan, if you can't stand them, don't force feed yourself. You can incorporate many other strategies and dietary sources of soluble fiber into your lifestyle to achieve better heart health. To life!
Under the knee cap and covering the ends of the femur (thigh bone) and tibia (shin bone) is a sort of natural shock absorber made of cartilage. This shock absorber does not come with a lifetime guarantee; wear and tear over the years can result in a loss of mass of the shock absorbing cartilage. Once some of this cartilage has degenerated, the knee obviously cannot absorb or handle shock from running, for example, as well as it could before. This condition is referred to as "chondromalacia patella."
Technically, chondromalacia is an overuse injury that causes a dull, aching pain under and around the knee cap. Climbing stairs, walking up hills, and doing anything that involves a fair amount of running can all become painful activities for someone with chondromalacia patella. This knee condition is fairly common among runners — by some estimates, almost 30 percent of runners develop this condition. Skiers, cyclists, and soccer players also have a higher risk for chondromalacia patella. The tendency to develop chondromalacia patella also seems to run in families.
Everyday that you get up is a day of stress as far as your knees are concerned. Walking around, climbing stairs, running, dancing, waiting in lines — all of these activities put some amount of stress on the knees. As far as joints go, the knee is the largest one in the body; it's also multi-talented, acting as a hinge, a lever, and/or shock absorber at any given time. For support, the knees rely almost entirely on soft tissue (ligaments, tendons, and muscles), which isn't always the most reliable. It's no wonder that knee pain and injury are so common!
You can do some things to prevent (further) knee injury and pain. Always wear good, supportive shoes that aren't worn out, especially when you exercise. Have a health care provider check your feet to make sure that they aren't contributing to a misalignment of your body that puts undue stress on one knee over the other. Or, if you get a chance to see a physical therapist, ask her/him to check the way you walk. If you ride a bike regularly, make sure that your seat is up high enough so that your knee is only slightly bent at the bottom of a pedal stroke. If you're a runner, avoid running on uneven surfaces as much as possible to lower your risk of falling and/or twisting your knee.
If, after every time you engage in a certain sport, say racquetball or running, you experience a great deal of knee pain, you might want to take a break from that particular activity and try different options that won't aggravate your knees (hopefully). A few "easy on the knees" sports are swimming, slow jogging, walking, and cross-country skiing. If you choose swimming, be aware that strokes involving the frog kick will put more stress on your knees than those that use a straight-leg, flutter kick (such as freestyle and backstroke). Any sport that requires deep knee bends and/or twisting at the knee causes knee pain most often.
It's extremely important to strengthen your leg muscles, especially those that support your knee, primarily the quadriceps; but, it's best to work on the leg as a whole so as not to favor one muscle group over another (this, too, can lead to injury). Remember, the knee doesn't have much of a support system, so you need to do all you can to build up what it does have. Ask your health care provider to show you some strength building exercises you can do. Perhaps you can get a referral to see a physical therapist or orthopedist to learn how to build up strength and reduce any pain. Keep those joints happy!
I suffered from chondromalacia for years. Arthroscopic surgery a few years ago helped, but what did the trick was developing the muscles that hold my knee in place and allow...
I suffered from chondromalacia for years. Arthroscopic surgery a few years ago helped, but what did the trick was developing the muscles that hold my knee in place and allow them to track properly. Spinning classes 2 - 3x/week for the last two years *really* helped with this. I am also sure to stretch it well, including the ITB. Anyone with chondromalacia should see a good sports- and fitness-focused physical therapist, and with their blessing, try spinning!
I JUST WANTED TO SAY THANK YOU FOR YOUR PAGE. I HAVE HAD KNEEE PAIN FOR OVER TWO YEARS AND FINALLY GAVE IN AND WENT TO THE DOCTOR. I HAVE CHONDROMALACIA AND DID NOT KNOW WHAT IT...
I JUST WANTED TO SAY THANK YOU FOR YOUR PAGE. I HAVE HAD KNEEE PAIN FOR OVER TWO YEARS AND FINALLY GAVE IN AND WENT TO THE DOCTOR. I HAVE CHONDROMALACIA AND DID NOT KNOW WHAT IT MEANT. SO THANKS FOR THE INFO. I WAS A RUNNER AND I AM NOT READY TO GIVE THAT UP, SO I AM DOING MUCH RESEARCH NOW. AGAIN, THANKS FOR YOUR PAGE AND INFO.
Hypertension is known as the "silent killer" and is one of the most common diseases of the cardiovascular system. It is defined as a condition of sustained elevated pressure in the arteries of 140/90 or higher. In this case, 140 is the systolic pressure. Simply put, systolic pressure represents the blood pressure against the arteries while the heart is contracting or beating. The number 90 is the diastolic pressure, meaning the blood pressure while the heart is relaxing or between beats. People who are genetically sensitive to sodium experience high blood pressure from excesses in salt intake. People who are most likely to be salt sensitive include children of parents with hypertension, African Americans, and people over 50 years of age. It is important to keep in mind that not everyone is salt sensitive. As hypertension in the body becomes prolonged, the risk for heart failure, vascular disease, kidney (renal) failure, and stroke increases.
Although there has been no cause identified for hypertension in 90 percent of people, dietary factors have been shown to influence blood pressure. People with hypertension can use the following food guidelines:
Hypertension can also be treated with drugs, including diuretics, beta blockers, calcium channel blockers, and ACE inhibitors. Talk with your health care provider to see what treatment is best for you, if you need it.
According to a Harvard research study, the DASH! Diet could be another possible way to decrease blood pressure. DASH! stands for Dietary Approaches to Stop Hypertension. The Dash trials began with 459 adults with systolic pressure of less than 160 and diastolic pressure between 80 and 95. The Dash study randomly assigned people to one of three diets for eight weeks. The first diet was the Control Diet. This diet had levels of fat and cholesterol that matched the average American's diet. It had lower than average levels of potassium, magnesium, and calcium. The other two groups were divided into a "Fruit and Vegetable Diet" and a "Combination Diet." The Fruit and Vegetable group matched the control group in fat, saturated fat, cholesterol, and protein. However, the difference was that this diet had more potassium and magnesium. The fruit and vegetable diet reduced systolic blood pressure 2.8 mm Hg more than the control diet. It also reduced diastolic blood pressure 1.1 mm Hg more than the control. The Combination Diet had less total fat, saturated fat, and cholesterol than the fruit and vegetable and control diets. The combination diet, rich in fruits, vegetables, and low-fat dairy products, also had more potassium, magnesium, calcium, fiber, and protein. This combination diet reduced systolic blood pressure 5.5 mm Hg more than the control diet. It also reduced diastolic blood pressure 3.0 mm Hg more than the control diet.
To adapt the Dash Diet into your lifestyle, follow these guidelines:
For example, total number of servings in a 2,000 calorie per day menu would look like this:
|Meats, Poultry, & Fish||2|
|Nuts, Legumes, & Seeds||1|
|Fats & Oils||2.5|
For more info on the Dash Diet, you can go to the Harvard Medical School Family Health Guide website.
Finally, weight loss is recommended if you are overweight. Obesity can worsen hypertension. Extra adipose tissue means miles of extra capillaries through which the blood must be pumped. Weight loss can be accomplished through aerobic activity. Aerobic exercise will utilize fat stored in the body. This, along with weight training, will increase your muscle mass, which, in turn, will raise your metabolic rate. Therefore, you will expend more calories throughout the day.
Marieb, Elaine N. Human Anatomy and Physiology. CA: The Benjamin/Cummings Publishing Co., 1997: p. 710.
Whitney, Eleanor and Sharon Rolfes, eds. Understanding Nutrition. Minneapolis/St. Paul: West Publishing Co., 1996.]
The lower back is an area that's commonly ignored in strength training, despite the fact that it can be a painful area for many people. Strengthening exercises, as well as stretching, can help prevent injury and pain in the lower back. It is important to focus on the lower back muscles as well as those in areas that support the lower back. These include the stomach, hip flexors, and hamstrings (back of the thigh).
It is always recommended to seek the advice of a health care provider before beginning any physical activity program, including back-strengthening and stretching exercises. If you have a condition that could be affected by physical activity, it is especially important to speak with your health care provider in advance.
Here are a few lower-back exercises to start with:
Front lying chest lift:
Double knee to chest stretch:
Abdominal muscle-strengthening stretch:
Hip flexor stretch (a.k.a. Runner's stretch):
Hamstring stretch (straight leg raise):
If you have access to a gym, the lower back machine allows you to increase resistance as you become stronger. Try the following resistance exercises two or three times per week on non-consecutive days:
You may stretch every day once you've warmed up your muscles. Stretch smoothly, as opposed to bouncing, which can cause injury. For maximum effectiveness, each stretch needs to be held for at least fifteen to thirty seconds. Some examples of lower back stretching exercises include:
You can also choose structured exercises for strengthening your back. Yoga, for instance, is an excellent form of back strengthening physical activity. Many of the suggested stretches listed above are a part of poses and movements performed during a yoga session. Swimming is another excellent exercise for your back, because the buoyancy of the water offers some support.
Also, take notice of your posture. What position do you spend most of your time in when you are sitting, standing, and walking? For example, are you sitting at a desk throughout the day? If so, be aware of your posture. Make sure the ergonomics of your work set up are optimal for your body. If you have freedom to play with your workspace, consider using a balance ball as a desk chair even for part of the day. Sitting on a ball demands your posture to be proper and many of your torso muscles to stay active.
Again, it is important that you speak with a health care provider before you begin a new physical activity regimen. If you are a Columbia student, you can make an appointment with Medical Services (Morningside) or the Student Health Service (CUMC).
Hope these exercises and stretches allow you to attain your physical activity goals!
In terms of locating naturally occurring sources of alpha-galactosidase, unfortunately you won't have much luck. Aspergillus niger is found in rotting cassava vegetables (also known as yucca). The enzyme alpha-galactosidase is, in turn, isolated from the aspergillus mold and incorporated into Beano tablets along with invertase, a sugar-hydrolyzing enzyme. Alpha-galactosidase and invertase help to relieve gas symptoms due to their ability to break down complex sugars before they become gaseous. If you really like the effects of Beano, stick to it – however, there are cheaper ways to manage your gas that don’t necessitate the use of expensive dietary supplements.
Being knowledgeable about the following causes of gas can provide you with some additional comfort to help reduce gas production:
1. Gas can be caused by swallowed air. Try to eat slowly and chew your food thoroughly. If you tend to gulp beverages, make an attempt to sip instead. Carbonated beverages can also cause belching.
2. Sugar-free foods containing sorbitol or xylitol are poorly digested and can cause gas. Read labels to look for and avoid these ingredients.
3. Lactose intolerance, or the inability to digest lactose, the naturally occurring sugar found in dairy products, causes gas. Try eliminating milk products from your diet for a few days to see if your symptoms improve. If this is effective, you may be somewhat lactose intolerant. Look for supplements and food products that contain lactase, the enzyme needed to break down lactose during digestion, which may help you feel better.
4. High-fiber diets can result in flatulence (gas). If you have suddenly added a great deal of fruits, vegetables, cereals, and whole grains to your diet, the result may well be gastrointestinal discomfort. Try to add these foods to your diet slowly. While 20 - 35 grams of fiber is recommended as part of your average daily intake, you don't want to shock your system by jumping from low or medium fiber intake to a high fiber intake at the drop of a hat. However, you can eat lots of high-fiber brown rice without worrying about passing gas because rice is the only whole grain known not to cause gas.
5. Yes, beans do live up to their reputation, both for being a healthy addition to your diet and for causing gas. Here are methods for "de-gassing" your beans: soak dry beans for at least eight hours and rinse thoroughly before cooking them; if you buy canned beans, drain off the liquid and rinse the beans thoroughly before cooking. This will also help to reduce your sodium intake.
Keep in mind that gas is perfectly normal. Many people assume they produce excessive amounts of gas; however, it’s quite typical to pass gas around 20 times a day!
If none of these suggestions are helpful, talk to your primary care provider, gastroenterologist, or nutritionist about a "complex carbohydrate elimination diet." This is a strict diet that excludes all forms of complex carbohydrates and high-fiber foods (i.e., fresh fruits and veggies, and whole grains). Over time and as tolerated, these food sources are gradually added back to the diet. Columbia students can also reach out to Medical Services (Morningside Campus) or Student Health Services (Medical Center Campus) to make an appointment with a health care provider or nutritionist. You can also take a peek at Columbia’s Get Balanced Guide for Healthier Eating for more ideas.
Dear Early bird exerciser,
The best time to exercise is the time that's right for you. Morning workouts really get some people going, release endorphins, and enhance mood. If you enjoy starting your day with a workout, or find that it's the only time you can fit it into your schedule, stick with it. Others find afternoon or evening workouts productive and stress-relieving. When we wake up, our body temperature and blood sugar levels are low, so our muscles aren't as "loose" as later in the day. In a perfect world, our muscles are warmer and fueled by a few meals (hopefully) later, well after we awake.
There isn't really a "simple" answer to your second query. It will be helpful, though, to ask yourself the following questions: How hard do you work out (intensity)? How long are your sessions (duration)? What are your exercise activities? How soon after you awake do you begin exercising? Your answers are important in determining what may enhance your performance.
For some people, exercising with no fuel (food) beforehand may cause lightheadedness, dizziness, and early fatigue. Research shows that eating before exercise, as opposed to exercising on an empty stomach, improves athletic performance. If you have three hours until your workout, have a normal breakfast. However, if you're going straight to a workout after waking up, here are a few suggestions:
If you eat before exercising, make sure you allow your body some time to digest and absorb the food. During digestion, our bodies send blood to the stomach to help out with this process. When we exercise, our muscles need the blood flow, so our stomach becomes a second class citizen and digestion is slowed. If too much food is in the stomach while we're exercising, we may be uncomfortable.
Also take into account the type of food you eat and the activities you do. Some people tolerate liquids more easily because they leave the stomach more quickly than solid food. Some exercisers, such as runners, for example, would prefer not to have the internal "sloshing" around that liquids may cause.
General guidelines for eating before exercising are:
In addition, people tolerate foods differently, and the composition of the food matters. Fats stay in the stomach longest, followed by protein and high fiber carbohydrate, then low fiber complex carbohydrates, and finally simple sugars, which are absorbed fastest.
Sugary foods, such as sodas and candy, are absorbed quickly by the body and produce a sugar high within an hour of a workout. Along with a quick "sugar high" comes a quick "sugar low." People who eat sugar 15 - 30 minutes before exercising may experience a "low," with lightheadedness and fatigue, during their workout. If you feel that you absolutely must have juice or some sugary snack before exercising, have it only five or ten minutes before you begin. This way, there isn't enough time for your body to secrete insulin, a hormone which lowers blood sugar, causing fatiguing symptoms. Since everyone reacts differently, try various strategies to determine what helps you the most. No matter what, drink water before, during, and after exercise. And, have breakfast afterwards, especially if you haven't had anything to eat earlier, since this will replace glycogen stores and will keep you going all morning long.
For more information about staying active while at Columbia, check out CU Move, a physical activity initiative open to all Columbia students, faculty, alumni, and staff. CUMove posts updates regularly and also sends out monthly CU Move emails. For more frequent updates, “Like” CUMove on Facebook. Keep moving!
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