8 ways to avoid a urinary tract infection

Urinary tract infections are easy to treat, but that's hardly reassuring when you're rushing to the bathroom every 15 minutes to urinate--and experiencing burning, stinging pain.

One in five women will get a UTI--in the urethra, bladder, or kidneys--at some point in her life. Some women get them over and over again. Men are much less likely to get UTIs because their anatomy makes it harder for bacteria to get inside.

Antibiotics are necessary to knock out urinary tract infections, says Larrian Gillespie, M.D. Once you start taking the drugs, the discomfort will usually disappear within a day or two. In the meantime, here are a few steps to make you more comfortable and help prevent the infection from coming back.

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1) Drink a lot of water. The more you drink, the more you urinate--and frequent urination helps flush harmful bacteria from the bladder, says Mary Jane Minkin, M.D. When you keep filling your bladder and flushing it out, you can reduce the number of bacteria and help improve your condition. 

Water also dilutes the concentrated salts in urine, which can reduce discomfort when you have an infection. Try to drink at least 64 ounces of water each day.

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2) Fight bacteria with baking soda. At the first sign of symptoms, drink a solution made with 1/4 teaspoon of baking soda mixed in 8 ounces of water. Continue this once a day until you can get a culture done at a doctor's office or clinic and can get on antibiotics. Baking soda makes the bladder environment more alkaline, which, thereby, reduces the ability of bacteria to multiply, says Dr. Gillespie. 

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3) Dilute the burn. The concentrated salts in urine can cause stinging pain when you have a UTI. You can reduce discomfort by pouring body-temperature water over yourself while you urinate. 

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4) Relax with a heating pad. Applying heat to the abdomen is a great way to reduce cramps and painful pressure that sometimes accompany UTIs, says Dr. Gillespie. If you don't have a heating pad, a hot-water bottle or washcloth soaked in hot water works just as well. 

5) Avoid orange juice for a few days. Along with strawberries, grapefruit, and pineapple, orange juice has a high acid content. When you have a UTI, it will increase the burn when you urinate, says Dr. Gillespie. 

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6) Don't drink coffee or alcohol. When you have an infection, coffee and alcohol can make it painful to urinate, says Dr. Gillespie. Caffeine and alcohol also stimulate the muscular walls of the bladder, which may increase urinary "urges" and cause additional discomfort. 

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7) Drink cranberry juice. Cranberry juice is a traditional remedy for preventing UTIs, and scientific research suggests it works. Cranberry juice is rich in proanthocyanidins, chemical compounds that appear to help prevent bacteria from sticking to cells in the urinary tract, says Beverly Kloeppel, M.D. If you can't find cranberry juice, look for cranberry juice concentrate that you can mix with water. You should avoid cranberry juice, however, if you have an overactive bladder, because it can irritate the bladder and make it more sensitive. 

If you get frequent UTIs, the key is to drink tart cranberry juice, not sweet cranberry juice cocktail. Drink 8 ounces of unsweetened cranberry juice three times a day or take one 400 milligram capsule of cranberry concentrate twice daily for a few months to see if it makes a difference. "Long-term use of cranberry should be avoided if you have kidney stones," says Dr. Kloeppel.

"If you don't want to drink all the caloric cranberry juice, by all means get cranberry extract pills at the health food store. They do help," says Dr. Minkin.

While you're at it, add some blueberries to your breakfast cereal or morning smoothie--they're related to cranberries and contain the same active compounds, says Dr. Kloeppel.

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8) Eat more yogurt. The research isn't conclusive, but there's some evidence that the organisms in live-culture yogurt, Lactobacillus acidophilus, may help prevent unwanted bacteria from multiplying in the urinary tract and prevent UTIs, says Dr. Minkin. 

Yogurt is especially helpful if you're taking antibiotics. While these drugs are very effective at killing harmful bacteria, antibiotics also kill "good" germs, which can lead to UTIs. Eating a cup of live-culture yogurt daily helps replenish beneficial bacteria while keeping the "bad" bugs away.

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PMS SOS! Can Diet Help?

You know those days -- when you feel more like Eeyore than Tigger, when your abdomen feels like a gargantuan balloon that you wish would just drift away. Premenstrual syndrome is not an illness, but a natural condition characterized by at least one of 150 potential symptoms in most menstruating women, according to "Women's Health" magazine.

For the majority of women who face PMS, symptoms are tolerable but bothersome. Bothersome enough, in fact, that a web search of the phrase "PMS and diet" results in more than 5 billion websites, many touting natural remedies, dos and don'ts, and supposedly sure-fire ways to completely conquer your symptoms. While "completely conquering" your symptoms through dietary changes may not always be possible, certain foods and dietary habits can help minimize your symptoms, which is always a welcome prospect.

 

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If particular foods or supplements could cure PMS, they'd likely become best-sellers, dietary staples among the more than 85 percent of menstruating women who experience at least one bothersome symptom every month. 

"There are no evidence-based guidelines for PMS," said Katherine Isacks, a registered and consulting dietitian and writer of MyNetDiary.com. But improving your overall dietary habits and emphasizing particular foods before your period may provide benefits.

For example, many women fail to meet their daily recommended amount of 1,000 mg of calcium per day. In addition to lowering your risk for osteoporosis and bone fractures later in life, raising your calcium intake could lead to fewer premenstrual symptoms. In a study published in 2008 in the "Taiwanese Journal of Obstetrics and Gynecology," female college students consumed 500 mg of calcium carbonate or a placebo twice daily for three months. Compared to the women who took the placebo, women who consumed the calcium supplements reported significant improvements in fatigue, appetite changes and depression.

Calcium and magnesium are also "fantastic for breast tenderness," according to registered dietitian Robyn L. Goldberg. She recommends eating foods rich in calcium and magnesium, and there are many with an overlap of these nutrients. Valuable sources of calcium and magnesium include collard greens, spinach, low-fat yogurt, artichokes, sweet potatoes, halibut and cashews.

Omega-3 fatty acids, an essential nutrient many Americans lack, may help reduce inflammation and pain. Furthermore, while results of studies are mixed, an omega-3 fatty acid deficiency could contribute to depression. Top sources of the nutrient include flaxseed, walnuts and cold-water fish, such as halibut, herring, salmon and flounder.

It's best to meet your nutrient needs through dietary means instead of supplements. Eating healthy foods can provide the same benefits as supplements but without the potential side effects. Calcium supplements, for example, can sometimes cause bloating, constipation and gas.

 

Beat the Bloat

 

Water retention, or bloating, causes abdominal and emotional discomfort to many women during PMS.

"Women who gain a lot of water weight during their luteal phase -- the two-week period starting right after ovulation and up to the first day of their periods -- might benefit from limiting their sodium intake to recommended guidelines," said Isacks.

If you are 51 or older, or are African-American or have high blood pressure, kidney disease or diabetes, limit your sodium to 1,500 mg per day. Otherwise, aim for a maximum of 2,300 mg per day.

Because half a teaspoon of salt provides 1,200 mg of sodium, and natural foods typically provide sufficient amounts, limit processed foods, particularly during the two weeks preceding menstruation, earns an article on the American Heart Association website. Foods especially high in sodium include potato chips, pretzels, canned soups and vegetables, frozen meals, tomato sauce, and processed meats and cheeses.

Consuming plenty of water and hydrating foods, such as fresh fruits and vegetables, and breaking a sweat through exercise can also help prevent or alleviate bloating. Little evidence supports the effectiveness of herbal diuretics, or water pills, and some herbal pills pose risks.

Herbal teas can provide relief for some women, Isacks says. But speak with your pharmacist or health care provider before drinking an herbal tea to avoid interactions with any medications you may be taking.

 

Cope With Cravings

 

"When we crave more food or specific foods, [it's because] our hormones change, and there is a loss of blood. That's why there's an increase in appetite," Goldberg explained. "Some metabolisms may increase up to 15 percent."

In other words, a woman who requires approximately 1,800 daily calories may need an extra 270 per day before or during her period.

If you resist your cravings, they're likely to intensify, adding to your emotional distress and potentially leading to overeating and weight gain.

When cravings set in, Goldberg suggests not panicking. "One week is not going to be a deal-breaker," she said.

To prevent or reduce the intensity of your cravings, aim for an overall fiber- and nutrient-rich diet. High-fiber foods, such as whole grains, flaxseed, beans, lentils and berries, improve blood sugar and appetite control. And the more nutritious your diet is, the less likely you'll be to experience nutrient deficiencies that may worsen your symptoms.

Boost Your Moods

Many factors can contribute to your emotional state during PMS, including hormonal shifts, emotional stress, whether you're getting adequate sleep and your diet.

Some studies, for instance, suggest deficiencies of vitamin B-6 may contribute to premenstrual dysphoric disorder, according to the University of Maryland Medical Center. Premenstrual dysphoric disorder involves severe depressive symptoms during the week before your period. Although the medical center indicates the research is limited and findings are mixed, ensuring a sufficient B-vitamin intake certainly can't hurt.

Steer clear of megadose dietary supplements, however. Taking more than 500 mg of vitamin B-6 per day can cause nerve damage in your arms and legs, notes the National Institutes of Health Office of Dietary Supplements. Most women require 1.3 mg of vitamin B-6 per day, which is easily reached by eating fortified cereals, bananas, potatoes, garbanzo beans, poultry, oatmeal and fish. Eating plentiful amounts of the nutrient in food-form is not associated with adverse effects.

Although eating a balanced, healthy diet may make you feel good, the specific link between foods and nutrients and emotional PMS symptoms requires further research.

"If women find themselves more moody and irritable," Isacks said, "I would recommend regular physical activity. Exercise helps reduce symptoms of depression and stress. Meditation and yoga are also helpful, especially with stress."

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5 Health Slip-Ups—Remedied

By Denise Schipani

We've all taken one pain reliever too many or not finished a round of antibiotics. But how bad are these mistakes, really? The answers, and what you should know for next time.

Oops! I didn't finish a prescribed course of antibiotics.

It's tempting to stop taking the medication once you start feeling better, but just because you don't feel sick anymore doesn't mean all the bacteria are completely wiped out. And you're more likely to get sick again. Not taking every last pill is also a mistake because you're contributing to the problem of antibiotic resistance. Here's why: In the first few days, the drug gets rid of only the weakest germs. By not finishing the full round, you're leaving behind the strongest strains, which may then become resistant to the most commonly used antibiotics.

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What To Do: If you realize within two days that you didn't finish, start taking the medication again until you're done with the course. But if it's been a week or more, don't bother; by then the bacteria that are left may have mutated and you'll only be encouraging resistance. If you stopped taking the medicine because it gave you bad side effects like nausea or diarrhea, try taking it with food (as long as the directions don't say not to). If that doesn't help, call your doctor, who may be able to prescribe a different medication or alter your dose.

Good To Know: Taking antibiotics can also kill some of the "good" bacteria that are normally in your digestive tract, and this can cause side effects like diarrhea and stomach discomfort. While you're on the medication, counteract this by eating yogurt with active bacterial cultures or taking a probiotic supplement. Antibiotics can also cause yeast infections, since they can upset the pH balance in your vagina. If you're prone to them, ask your doctor for a prescription cream along with the antibiotics prescription. Photo: Jordan McCullough/Woman's Day

Oops! I used a cotton swab to clean my ear and now it hurts.

You've most likely scratched your ear canal—it will probably heal on its own. If it feels like something is stuck, you may have just pushed some earwax farther in. The chance of a permanent problem is rare, but it is possible to puncture your eardrum (which is painful), says Ilaaf Darrat, MD, in the department of otolaryngology–head and neck surgery at Henry Ford Hospital in Detroit.

What To Do: It's a good idea to see your doctor or an ear, nose and throat doctor (ENT) no mattter what. If you scratched any part of your ear and developed an infection, your doctor may prescribe antibiotic ear drops. And if something like wax or a piece of cotton is stuck, the doctor (ideally an ENT) will, of course, carefully remove it. Depending on your symptoms, you may also need to get a hearing test. If you've ruptured your eardrum (meaning there's a hole in it), it will most likely heal on its own, but your doctor may need to check it regularly just to make sure. In the rare case that it doesn't heal or you have a facial nerve injury and/or severe hearing loss, you may need to have surgery.

Good To Know: There's really no need to clean the inside of your ears. Earwax actually helps keep dust and debris from getting into your eardrum. But if your ears are itchy or otherwise bothering you, try using over-the-counter ear drops like Debrox, which can dissolve and dislodge the wax, says Dr. Darrat. Or make your own drops by mixing equal parts hydrogen peroxide and warm tap water. Tilt your head to one side and, using a medicine dropper, put five drops in the ear that faces up. Wait 1 to 2 minutes to let the wax soften, then tilt your head the other way so the fluid comes out into the sink or a washcloth. Repeat on the other side. You can do this as often as once a week, she says. Photo: Getty Images

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Oops! I forgot to take my birth control pill.

Missing one pill usually isn't a big deal, as long as you make up for it the right way, says Jessica Shepherd, MD, assistant professor of obstetrics, gynecology and women's health at the University of Louisville School of Medicine.

What To Do: If you're on a combined progesterone/estrogen pill (such as Ortho Tri-Cyclen or Seasonique), take it as soon as you remember (it's OK to take two in one day). But you can only do this twice in a row before you risk getting pregnant. If you take a progesterone-only mini-pill (like Micronor or Ovrette) and realize within 3 hours of your usual pill-popping time that you forgot, just take the pill immediately. If it's outside the 3-hour mark, take it when you remember, and use backup contraception (condoms or spermicide) for the next week. The mini-pill has lower levels of hormones, so going too long without it could cause you to ovulate. (Birth control pills prevent pregnancy by stopping ovulation.)

Good To Know: If you often forget to take your pill, talk to your doc about a form of birth control that you don't have to remember daily. Good options are the vaginal ring (you change it monthly) and intrauterine devices (IUDs), which can
last up to 12 years.

Oops! I took Tylenol (acetaminophen) for a headache, and realized later that I'd already taken a cold medicine that contains the same thing.

Double dosing is all too easy to do, since hundreds of over-the-counter cough and cold medications and even sleep aids contain acetaminophen. It's better to avoid the combo formulas and instead take individual medications to treat your specific symptoms, says Sandra Fryhofer, MD, an internist in Atlanta and past president of the American College of Physicians. (For example, if you've got a headache and a runny nose, take a pain reliever and an antihistamine separately.) Consistently taking more than the amount recommended on the package could potentially damage your stomach, liver or other organs. 

In the case of acetaminophen, if you take too much just once, you'll probably be OK, but doing it regularly can be toxic to your liver. (If you're popping acetaminophen often for weeks on end, check in with your doctor, who may recommend or prescribe a different drug that may be more effective.) The most an adult should take in a day is 4,000 mg, or four doses of 1,000 mg each.

What To Do: To be safe, don't take any more medications for the rest of the day or night. It's unlikely that you've overdosed from a one-time slip-up, but if you've recently upped your intake overall, pay close attention to how you're feeling. Signs of liver damage can take time to appear, and it's easy to mistake early symptoms (loss of appetite, nausea and vomiting) for something else, like the flu. Call your doctor or poison control center right away if you do feel sick. However, if you think you've taken 4,000 mg of acetaminophen or more in one day, make that call ASAP even if you don't have any symptoms; you may need medication to prevent serious liver damage.

In the future, before you take any OTC cough and/or cold remedy or sleep aid, check the active ingredients list carefully and make sure you don't take anything else that contains the same things.

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Good To Know: If you regularly drink alcohol, taking even the dose that's recommended on the package could be harmful, since alcohol also taxes your liver, says Dr. Fryhofer. A maximum dose of 2,600 mg a day is safer if you do drink alcohol often, but in that case, talk to your doctor about which pain reliever would be best for you to use.

Also, take note that APAP is an abbreviation for acetaminophen sometimes used on OTC drug labels. Be sure to look for it when you're checking for acetaminophen content. Photo: Stephen Smith/Getty Images

Oops! I left my tampon in overnight.

Don't panic—chances are you won't get toxic shock syndrome (TSS), a rare but serious infection that causes fever, muscle aches, vomiting and diarrhea, which results from a buildup of bacteria in the tampon and your vagina. However, you may get bacterial vaginosis or a yeast infection, especially if you have a tendency to get them. The general rule of thumb is to change your tampon every 6 to 8 hours, says Dr. Shepherd. But you'll most likely be fine, even if the tampon has been in for a little longer than 8 hours.

What To Do: Remove the tampon ASAP and use pads for the rest of your period to be sure that any harmful bacteria are flushed out. For the next few days, watch for symptoms of infection, including nausea, vomiting, fever, muscle aches, discharge or diarrhea. Call your doctor right away if you notice any of these—you may need an antibiotic.

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If you're prone to bacterial infections, consider only using regular (not super or overnight) tampons. TSS can happen with any size tampon, but it's more likely with larger ones because they can cause more damage to the vaginal wall, which will make it more vulnerable to a bacterial infection, says Dr. Shepherd.

Good To Know: TSS is less common these days, thanks to changes in the materials used to make tampons. The TSS rate peaked in 1980 with 890 cases in the U.S., but experts now estimate that it's about 1 or 2 cases per 100,000 women between ages 15 and 44.

Not sure if it's an oops or an emergency?

Many drugstore chains like Walgreens, CVS/pharmacy and Walmart have drop-in medical clinics staffed by nurse practitioners, physician's assistants and sometimes doctors. Most health insurance companies also have a 24/7 nurse hotline (check the back of your card or the company's website for the number). Don't have insurance? Go to FindAHealthCenter.HRSA.gov and type in your address to find a federally funded clinic near you.

Denise Schipani is a freelance writer who specializes in health, fitness, relationships and parenting.

Article originally appeared on WomansDay.com.

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25 simple ways to get more steps in your day

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By Su Reid-St. John

So you've heard it a million times: Walk more! Aim for 10,000 steps a day! But taking the stairs instead of the elevator will only get you so far. Steal a few of these fresh tips to help you rack up your mileage. (Looking for a great way to track those steps? Click here.)

1. Pace the room while waiting at the doctor's office.

2. Grocery shopping? Make an extra tour around the perimeter aisles before checking out.

3. Use the restroom one floor down (or up) at work instead of heading for the one just down the hall.

4. Ditto with your coffee.

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5. Hide the remote so you have to actually get up to change the channel. Better yet, turn off the TV.

6. Instead of fighting other drivers for that single open spot near the door, do your blood pressure a favor and park several rows away.

7. Walk around the block while your kid is taking dance class/playing soccer/whatever.

8. Get off the bus or subway one stop early.

9. March in place while brushing your teeth (go ahead and shut the door first if you'd like).

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10. Going to the mailbox? Take a tour around the house first—then take the time to say hello to that chatty neighbor who flags you down.

11. Hoof it to the store when you're only buying a few easy-to-carry items.

12. Walk over to your coworker's desk instead of e-mailing her.

13. Make it a nightly habit to go for an after-dinner stroll with the family.

14. Early for an appointment? Walk around the block instead of adding to your interminable time in the waiting room.

15. Take a daily afternoon "brainstorming" walk.

16. Wander the room while chatting on the phone.

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17. Walk your child to school instead of waiting in the endless carpool line.

18. Instead of cooping yourself and your coworkers up in a stuffy conference room, make your next meeting a walking one.

19. Headed to the mall? Stroll the length of it once before you start buying—and scout the sales while you're at it.

20. Set the alarm on your computer to go off every hour or two, then take a quick tour around the floor (or even just a trip up and down the hall) when it does.

21. Next time you have to run a couple of errands, park midway between your destinations and walk to them both. In between, pause to leave the dry cleaning in the car before strolling over to pick up your best friend's birthday gift.

22. Leave the stilettos in the closet and charm your hubby (or boyfriend) into taking a moonlit walk after dinner at your favorite restaurant.

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23. Tell yourself that you're allergic to escalators and act accordingly.

24. Instead of getting together with the girls for a stay-put meal, plan an evening of window-shopping or an afternoon of new-neighborhood scouting.

25. Whenever possible (and safe), take the scenic route!

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Have you been impacted by suicide?

Coverage of the tenth anniversary of 9/11 has pooled in the center of every media outlet this week with stories of lives and deaths taken control of by terrorist attacks. There is also the slow drip of news about prominent suicide deaths -- totally unrelated to September 11th and still, offering a strange confluence of lingering loss, but this time by one person's choice to end their own existence.

The recent suicide death of reality television cast member Russell Armstrong made many headlines, continuing in the last week with the season premier of "Real Housewives of Beverly Hills" prompting discussion on the show and in the press about his loss, mental well-being, financial downturn, and the wife and children he left behind.

Castmates gathered during the first episode to put their reactions to 47-year-old Armstrong's suicide on record. They were worried for their friend, Russell's estranged wife Taylor Armstrong. They were surprised by his actions. They'd never felt connected to him. They felt compassionate about the financial pressures inherent in their wealthy community. Mauricio Umansky, husband of show star Kyle Richards, said he oscillated daily between sadness and anger at the man who his wife's friend was divorcing.

The honesty didn't stop there. When those same castmates were interviewed by media heavy-hitter Anderson Cooper for his new syndicated daytime talk show, he says the group he expected to cancel devoted nearly half their time to discussing Armstrong's death.

That prompted Cooper to open up about his own brother's suicide, which he said he still ruminates 23 years later. His older sibling leaped out of a penthouse window in New York City in 1988 at the age of 23.

"I had a brother that committed suicide and that was more than twenty years ago and I'm still trying to figure out why he committed suicide. I think anyone who survives suicide, that's one of the horrible things about it, you can't pinpoint one thing necessarily always that did it," Cooper shared.

Cooper also offered advice to the castmates after projection about why Armstrong took his own life.

"You can't put yourself in someone else's mind, a mind that is not acting rationally or not thinking rationally," he said.

The "Real Housewives" cast and Cooper share the commonalities of screen-time and suicide grief. But their openness gives more voices to experience of countless people impacted by the 34,000 suicide deaths in this country every year.

According to the American Foundation for Suicide Prevention, a suicide occurs every fifteen minutes, elevating it to the fourth leading cause of death of adults in the United States. Even more startling, suicide ranks as the fifth leading fatality for children aged 5 - 14, and the third for young adults 15 - 24. The foundation tallies eight to 25 attempts for every suicide death.

This leaves too many of us caught in the grief and pondering Anderson Cooper put words to this week.

Now it is your turn to share your stories: How have you been impacted by suicide? Do you feel emotional when someone famous takes their own life? What are your words of wisdom, experience, or comfort to people who have survived the suicide loss of a loved one?

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Weight Loss Secrets from The Biggest Loser's Olivia Ward and Hannah Curlee

By Jenna Autuori-Dedic

For Biggest Loser: Couples winner Olivia Ward and her sister-teammate, Hannah Curlee, the real secret to shedding a combined 249 pounds -- and keeping the weight off -- wasn't a strict diet or insane workouts. Or even Bob and Jillian. Their success strategies are surprisingly simple and so worth stealing.

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Secret #1: You deserve to be in great shape.

One year ago Olivia Ward (far left), 35, weighed 261 pounds and couldn't walk a block without stopping for a breather. Her sister, Hannah Curlee, 32, tipped the scale at 248 pounds and was too embarrassed to go out with friends at night. "The first step in dropping the weight was realizing that I actually loathed myself and what I'd become," Hannah says. "On the show I gradually came to understand that I deserved so much more of a life than I'd given myself. I deserved to be happy. When I reached my goal of losing 120 pounds, I was proud of myself for the first time in 15 years. I now feel confident, not just about my stronger body but also about who I am inside."

Olivia had a similar aha moment, thanks to long talks with Biggest Loser trainer Bob Harper. "I used to put everyone else's needs ahead of mine," she says. "Now my health is the priority. Exercising is my me-time, and I've learned that that's not selfish at all."

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Secret #2: Stop being so hard on yourself.

"I like to be perfect, and when I can't, I get frustrated," Olivia says. "Past diets never worked for me, because I'd always become overwhelmed thinking how far I still had to go. This time around I realized it's all about the small goals. The very first day on The Biggest Loser we had to push Jillian's truck while she had her foot on the brake, and it really felt impossible. But I kept telling myself, Just five more minutes. I learned from Jillian the power of setting small, manageable goals. When things get tough during a Spinning class, I think, Just get through this song and you'll be okay. Believing that you can do something will make you actually do it."

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Secret #3: You don't have to spend hours in the gym.

"Real life doesn't allow me to exercise six hours a day, like we did on the show," Olivia says. "That's why I took up Spinning at SoulCycle, and I love it! The classes are intense enough to keep me in shape, and they fit into my schedule. I try to work out 90 minutes a day, six days a week. Half my workout is cardio: If I'm not Spinning, I'm running on the treadmill, sprinting on the stairclimber or using the Arc Trainer at home. I strength-train for the rest of the time, doing mini circuits in the gym. I split up my workouts and do 45 minutes in the morning to rev up my metabolism and 45 minutes after work so that food isn't just sitting in my stomach all night."

Don't have 90 minutes to spare? Fit in a good workout before work. "I get up at 5 a.m. and go to a boot camp class," Hannah says. "I enjoy it because it's different every day. We do things like run across a football field holding a weighted bar. I love the social aspect of it, too. The buddy system really works for me -- obviously.

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Secret #4: Eat more, not less.

Start each day with a proper breakfast. "I used to get bacon, egg, and cheese on a bagel and think that it was just a bagel," Olivia admits. "But in reality it was more than an entire day's worth of calories. By lunchtime I'd be starving because I wasn't getting enough nutrients from that kind of food. Now I love an egg white omelet made with vegetables, like asparagus and mushrooms, left over from the previous night's dinner. I pair it with f-- e Total 0% Greek yogurt with some berries and stevia. You can eat healthy and still love what you're putting in your mouth."

And ditch the deprivation diet. Never let yourself get to the point where you're famished with no healthy food around, the sisters say. Hannah carries apples and almonds with her for on-the-go snacks. "When I'm hungry, I get mean," she admits. "So I eat as much fiber as I can to stay full and satisfied. That stops me from grabbing pizza or a candy bar."

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Secret #5: Ask for what you want.

"When I'm eating out I've become that person who asks the chef to hold the cheese, hold the dressing, and please cook my meal without any butter, but I'm totally okay with doing that," Olivia says. "Most restaurants are very accommodating. I'm not going to throw away all the hard work I've done just because I'm afraid to ask the waitress to skip the blue cheese. That doesn't mean I don't enjoy myself when I'm dining out. There has to be flexibility in both your diet and your exercise routine or you'll never be able to sustain them for the rest of your life. If I splurge, I make up for it the next day by pushing myself a little longer during my workout."

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Secret #6: Do the write thing.

"I found that keeping a journal of everything that's going on while you're losing weight is a great way to stay focused," Hannah says. "Even if you just jot down stuff like 'I finally did a pull-up,' you can go back to those accomplishments to push yourself forward and remind yourself of how far you've come. On the ranch another contestant said that Olivia and I would never make it past the first couple of weeks. That lit a fire under me! I'd write those comments down and reread them for motivation. Today when I look back over the entries from when I was in a real funk about life, I can see what a bad place I was in and realize why I don't want to go back there."

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