In this issue
- Exercise now
- Nutrition and arthritis: food for better health
- NAAP Year Two: Defining new channels for conversations about arthritis
JointHealth™ insight June 2011
Exercise and good nutrition:
essentials for a complete arthritis treatment plan
The last thing someone living with the extreme pain of arthritis may want to think about is . . . exercise. As it happens, exercise is one of the most important components — along with healthy eating — of your arthritis treatment plan. In this issue of JointHealth™ monthly, we tell you about the benefits of exercise and a nutritious diet. To help you get started with improving how you feel physically and emotionally, we have some suggestions for appropriate exercises and diet changes.
Exercise now
Our bodies are made for moving, so we must move. Exercise is especially important if you live with the joint pain and stiffness of arthritis. It may seem daunting at first, but in the long run exercise will help manage your symptoms and you will feel better. The Arthritis Research Centre of Canada (ARC) says that regular, moderate physical activity strengthens bones and muscles, decreases fatigue, and increases stamina and muscle flexibility. The kinds of exercises you can perform may vary depending on the severity and types of conditions you have.
The most common form of arthritis, osteoarthritis, results from wear and tear on joints that accumulate over a lifetime. With osteoarthritis, injuries to the joints—whether through trauma or repetitive strain—lead to pain, stiffness, and eventually to inflammation. Any kind of movement that puts your joints through their full range of motion eases stiffness and helps reduce arthritis symptoms. Exercise is important for all joints and controlling your weight particularly benefits weight-bearing joints like knees, hips, and the back.
High impact, joint punishing exercises such as contact sports, long distance running, or heavy weight lifting should be avoided, especially during flare-ups. It is important not to over stress and over work joints while they are inflamed. Before starting an exercise program, we encourage you to discuss your workout options and ideas with someone on your arthritis healthcare team.
The current guidelines for getting enough physical activity are to do at least two types of exercise each week for at least 150 minutes (2 hours and 30 minutes). This goal can be achieved by exercising 4 to 7 days a week, up to 3 times a day for at least 10 minutes. Here, we provide some suggestions for types of exercise that are helpful for weight control and optimal health. If you would like more information or ideas for combinations of exercise to get the most benefit, we recommend visiting the Centers for Disease Control and Prevention web page on physical activity.
Low-impact exercise / high-impact benefit
Walking, bicycling, yoga, tai chi, Pilates, low-impact aerobics, swimming, and water aerobics are types of low-impact exercises. Regardless of their age, those living with long-term arthritis and its associated pain can participate in low-impact exercises. A bonus, is that low-impact exercise decreases stress levels and helps to improve the way you feel.
Don’t wait to work with weights
Except during acute joint inflammation, working out with weights is an important part of your exercise program. This type of exercise lubricates joints and helps control joint swelling and pain. Weight work helps strengthen muscles, thus improving your endurance and mobility. Strong muscles are better able to support bones and help to put less stress on joints affected by inflammatory arthritis. Also, weight training increases bone density, which is especially useful for those with osteoporosis. It is best to avoid lifting heavy weights, but they are not necessary to get the benefits of strength training. To get the best effect, we recommend working with a physiotherapist or fitness trainer with arthritis training.
There are two types of strengthening exercises: isometric and isotonic. Isometric exercise is the contraction of a specific muscle, without moving the joints. Isotonic exercise involves using your own body weight, added weight, or exercise equipment to create resistance on the muscles.
Staying in motion
Range of motion (ROM) exercises move your joints through their full normal range. These exercises should be done at least once a day to keep, or increase, joint flexibility, reduce stiffness and pain, and to help with performing everyday activities.
Stretching is done to gradually increase muscle flexibility. To avoid injury during an exercise routine, stretch beforehand as a warm-up. However, it should be noted that overstretching an actively inflamed joint could cause damage. Therefore, we recommend consulting with a health professional if you are uncertain about how to do stretching exercise or to find out if stretching is suitable for your joint condition.
Yoga U
For many, yoga is joining the treadmill and stationary bike as a way to safely and effectively increase physical activity. Having arthritis should not prevent people from trying yoga as an alternative to traditional exercise. However, for many, yoga in particular, may bring to mind pretzel-like poses requiring considerable strength and balance.
More than 75 scientific trials have been published on yoga in major medical journals that show that yoga is a safe and effective way to increase physical activity. Yoga can increase muscle strength, improve flexibility, enhance respiratory endurance, and promote balance—all elements that may be especially helpful for people with arthritis. And, because of its meditative nature, yoga has many psychological benefits, such as relieving depression, anxiety, and stress.
Healing waters
ARC reports that water provides an excellent medium for exercising. The buoyancy of your body in water means less weight on the main weight-bearing joints, (feet, ankles, knees, and hips) to allow for freer, less painful movement while still providing resistance to muscles. Simply walking through the water in a swimming pool protects joints and lessens possible pain, while providing a workout with 12 times the resistance of walking on land.
Participants in a warm water exercise program in Toronto, Ontario reported that exercising in a pool heated to 34°C, soothed the pain of arthritis inflammation and allowed them to perform stretching and strengthening exercises they otherwise could not, according to the website of Baycrest, an academic health science centre that focuses on aging.
Rounding out your exercise plan:
Warm me up
Warming up before exercising is a good idea for everyone, but is particularly important if you have arthritis. Vigorous exercise without a proper warm up can make joint pain worse. Start your exercise routine with stretching and range of motion exercises before moving on to strengthening or aerobic activities. Applying a heating pad or hot pack to your joints or taking a warm shower or bath before exercising can help loosen your muscles and joints. When you begin exercising, use gentle movements to avoid stressing stiff joints, and gradually increase the intensity of your movements as your joints relax.
Nutrition and arthritis:
food for better health
Although there are no dietary miracles for arthritis, a diet based on nutrient balance, variety, and moderation may help you lose weight and feel better. Certain types of arthritis, such as osteoarthritis and gout may see more improvement than other forms due to diet and lifestyle changes, especially when the changes result in reaching a healthy body weight. Regardless of the arthritis type you live with, you cannot go wrong by eating a healthy diet and in almost every case, exercising regularly.
Try to eat a wide variety of foods. A well balanced diet is the best way to get most of your vitamins and minerals. The Eating Well with Canada’s Food Guide is a good resource for getting information on the right foods in the proper amounts. Educating yourself and making permanent changes to your lifestyle can optimize your health, and long-term weight control is often the result.
Some people may need supplements, but it is important to speak with your doctor or pharmacist to ensure you are not taking anything that may interfere with your medications. You may want to consider the fact that most supplements are expensive and may not be worth the cost for everyone.
Finding the right balance in your diet and lifestyle is not complicated, but it can take a while to break bad habits. Do the best you can and be patient with yourself. Here are some diet basics to get you started:
Vegetables and fruit
Only 40% of Canadians eat the recommended number of servings, which is seven to ten each day. Try to eat at least one green vegetable and one orange one each day, plus get a good variety of other colours with each meal.
Grain products
Six to eight servings per day is recommended, but most people over consume from this group. Try to choose grains that are high in fibre and low in fat. If possible, limit white breads, white rice, and sugar cereals.
Milk and alternatives
This group is a key source of calcium, protein and riboflavin, which are important for maintaining bone health. The recommendation is two to three servings a day. Try to stick to lower fat options, such as skimmed or 1% milk or yoghurt and cheeses with less than 18% milk fat.
Meat and alternatives
Consume fish at least twice a week because they are a good source of omega-3 fatty acids, and choose leaner meats. Note that people with gout should avoid foods rich in purine, a chemical that is converted into uric acid in the body. These foods may include red meats and seafood generally, and especially organ meats, like liver, kidney, and brain, as well as shellfish.
Choose meat alternatives more often because they are a good source of protein and fibre.
NAAP Year Two:
Defining new channels for conversations about arthritis
Zoomer Magazine signs on as media partner
A key media partner we have confirmed for NAAP Year Two is Zoomer Magazine—one of Canada’s leading lifestyle magazines for men & women age 45 and up. Zoomer covers a wide range of groundbreaking lifestyle trends with a particular focus on health and wellness. The media partnership with Zoomer includes prominent advertising and advertorials in the magazine and its online editions as well as Zoomer Magazine’s participation at the NAAP’s booths at two leading national Canadian healthcare conferences.
Zoomer provides the NAAP an incredible opportunity to reach its target market. Zoomer Magazine has been identified by PMB (Fall 2010) as the most efficient media vehicle in Canada to reach the demographic of affluent and influential Canadians 45-plus (82% of its 481,000 total readers are over 45).
As part of our partnership, Zoomer is offering all of our constituents a special on subscriptions for their home or office—www.zoomermag.com/naap.
Other channels of communication for NAAP Year Two
Social media is a powerful tool to help people engage with your cause and ACE has experienced that first hand with the Arthritis is cured! (if you want it) National Arthritis Awareness Program (NAAP). To help expand the national conversation about arthritis, the NAAP uses numerous social media activities. The feedback has been tremendous and many consumers have found the social media tools valuable and motivating.
For NAAP Year Two, we elected to enhance our already effective social media strategy by building a stronger online following and raising awareness of the release of the ArthritisID apps for iPhone, resulting in a closer relationship with consumers and healthcare professionals.
NAAP website
In Year One, ACE launched a NAAP website, arthritisiscured.org, featuring specially developed videos, evidence-based treatment and prevention information and a Facebook page for Canadians and international visitors to swap treatment ideas and access educationally driven tools. This year the website has been updated and enhanced to include:
NAAP has enlisted the support of program volunteers across Canada to serve as community managers for the NAAP Facebook page and we plan to incorporate photos from events, media coverage, press releases, announcements, and arthritis treatment and prevention tips.
Each community manager will be equipped to initiate interactive elements: poll, quiz, recommendations from followers/friends/watchers, etc.
We opened a NAAP Twitter account to expand engagement with current and new followers by sharing treatment and prevention tips, interacting with followers, and addressing their arthritis health issues.
We started a group for the NAAP on Linkedin to connect with healthcare professionals.
The NAAP created a great YouTube channel showcasing ‘favourites’, media coverage, and topical videos.
Listening to you
We hope you find this information of use. Please tell us what you think by writing to us or emailing us at info@jointhealth.org. Through your ongoing and active participation, ACE can make its work more relevant to all Canadians living with arthritis.
Update your email or postal address
Please let us know of any changes by contacting ACE at info@jointhealth.org. This will ensure that you continue to receive your free email or print copy of JointHealth™ monthly.
Arthritis Consumer Experts (ACE)
Who We Are
Arthritis Consumer Experts (ACE) provides research-based education, advocacy training, advocacy leadership and information to Canadians with arthritis. We help empower people living with all forms of arthritis to take control of their disease and to take action in healthcare and research decision making. ACE activities are guided by its members and led by people with arthritis, leading medical professionals and the ACE Advisory Board. To learn more about ACE, visit: www.jointhealth.org
Acknowledgements
Over the past 12 months, ACE received unrestricted grants-in-aid from: Abbott Laboratories Ltd., Amgen Canada, Arthritis Research Centre of Canada, Bristol-Myers Squibb Canada, Canadian Institutes of Health Research, GlaxoSmithKline, Hoffman-La Roche Canada Ltd., Merck & Co. Canada, Novartis Canada, Pfizer Canada, Sanofi-aventis Canada Inc., Takeda Canada, Inc., and UCB Canada Inc. ACE also receives unsolicited donations from its community members (people with arthritis) across Canada.
ACE thanks these private and public organizations and individuals.
Disclaimer
The material contained on this website is provided for general information only. This website should not be relied on to suggest a course of treatment for a particular individual or as a substitute for consultation with qualified health professionals who are familiar with your individual medical needs. Should you have any healthcare related questions, you should contact your physician. You should never disregard medical advice or delay in seeking it because of something you have read on this or any website.
This site may provide links to other Internet sites only for the convenience of World Wide Web users. ACE is not responsible for the availability or content of these external sites, nor does ACE endorse, warrant or guarantee the products, services or information described or offered at these other Internet sites.
Although the information presented on this website is believed to be accurate at the time it is posted, this website could include inaccuracies, typographical errors or out-of-date information. This website may be changed at any time without prior notice.
Exercise and good nutrition:
essentials for a complete arthritis treatment plan
The last thing someone living with the extreme pain of arthritis may want to think about is . . . exercise. As it happens, exercise is one of the most important components — along with healthy eating — of your arthritis treatment plan. In this issue of JointHealth™ monthly, we tell you about the benefits of exercise and a nutritious diet. To help you get started with improving how you feel physically and emotionally, we have some suggestions for appropriate exercises and diet changes.
Exercise now
Our bodies are made for moving, so we must move. Exercise is especially important if you live with the joint pain and stiffness of arthritis. It may seem daunting at first, but in the long run exercise will help manage your symptoms and you will feel better. The Arthritis Research Centre of Canada (ARC) says that regular, moderate physical activity strengthens bones and muscles, decreases fatigue, and increases stamina and muscle flexibility. The kinds of exercises you can perform may vary depending on the severity and types of conditions you have.
The most common form of arthritis, osteoarthritis, results from wear and tear on joints that accumulate over a lifetime. With osteoarthritis, injuries to the joints—whether through trauma or repetitive strain—lead to pain, stiffness, and eventually to inflammation. Any kind of movement that puts your joints through their full range of motion eases stiffness and helps reduce arthritis symptoms. Exercise is important for all joints and controlling your weight particularly benefits weight-bearing joints like knees, hips, and the back.
| For every pound of extra weight you have, you are putting four pounds of pressure on your knees, so weight loss is crucial for treating arthritis, particularly osteoarthritis. |
High impact, joint punishing exercises such as contact sports, long distance running, or heavy weight lifting should be avoided, especially during flare-ups. It is important not to over stress and over work joints while they are inflamed. Before starting an exercise program, we encourage you to discuss your workout options and ideas with someone on your arthritis healthcare team.
| If you find it difficult to get motivated to exercise, find a buddy to exercise with or join a class or maybe a walking group. For you social butterflies, you are more likely to stick with an exercise routine if you are accountable to someone else. |
The current guidelines for getting enough physical activity are to do at least two types of exercise each week for at least 150 minutes (2 hours and 30 minutes). This goal can be achieved by exercising 4 to 7 days a week, up to 3 times a day for at least 10 minutes. Here, we provide some suggestions for types of exercise that are helpful for weight control and optimal health. If you would like more information or ideas for combinations of exercise to get the most benefit, we recommend visiting the Centers for Disease Control and Prevention web page on physical activity.
Low-impact exercise / high-impact benefit
Walking, bicycling, yoga, tai chi, Pilates, low-impact aerobics, swimming, and water aerobics are types of low-impact exercises. Regardless of their age, those living with long-term arthritis and its associated pain can participate in low-impact exercises. A bonus, is that low-impact exercise decreases stress levels and helps to improve the way you feel.
Don’t wait to work with weights
Except during acute joint inflammation, working out with weights is an important part of your exercise program. This type of exercise lubricates joints and helps control joint swelling and pain. Weight work helps strengthen muscles, thus improving your endurance and mobility. Strong muscles are better able to support bones and help to put less stress on joints affected by inflammatory arthritis. Also, weight training increases bone density, which is especially useful for those with osteoporosis. It is best to avoid lifting heavy weights, but they are not necessary to get the benefits of strength training. To get the best effect, we recommend working with a physiotherapist or fitness trainer with arthritis training.
There are two types of strengthening exercises: isometric and isotonic. Isometric exercise is the contraction of a specific muscle, without moving the joints. Isotonic exercise involves using your own body weight, added weight, or exercise equipment to create resistance on the muscles.
Staying in motion
Range of motion (ROM) exercises move your joints through their full normal range. These exercises should be done at least once a day to keep, or increase, joint flexibility, reduce stiffness and pain, and to help with performing everyday activities.
Stretching is done to gradually increase muscle flexibility. To avoid injury during an exercise routine, stretch beforehand as a warm-up. However, it should be noted that overstretching an actively inflamed joint could cause damage. Therefore, we recommend consulting with a health professional if you are uncertain about how to do stretching exercise or to find out if stretching is suitable for your joint condition.
Yoga U
For many, yoga is joining the treadmill and stationary bike as a way to safely and effectively increase physical activity. Having arthritis should not prevent people from trying yoga as an alternative to traditional exercise. However, for many, yoga in particular, may bring to mind pretzel-like poses requiring considerable strength and balance.
More than 75 scientific trials have been published on yoga in major medical journals that show that yoga is a safe and effective way to increase physical activity. Yoga can increase muscle strength, improve flexibility, enhance respiratory endurance, and promote balance—all elements that may be especially helpful for people with arthritis. And, because of its meditative nature, yoga has many psychological benefits, such as relieving depression, anxiety, and stress.
Healing waters
ARC reports that water provides an excellent medium for exercising. The buoyancy of your body in water means less weight on the main weight-bearing joints, (feet, ankles, knees, and hips) to allow for freer, less painful movement while still providing resistance to muscles. Simply walking through the water in a swimming pool protects joints and lessens possible pain, while providing a workout with 12 times the resistance of walking on land.
Participants in a warm water exercise program in Toronto, Ontario reported that exercising in a pool heated to 34°C, soothed the pain of arthritis inflammation and allowed them to perform stretching and strengthening exercises they otherwise could not, according to the website of Baycrest, an academic health science centre that focuses on aging.
| Another benefit of exercise is that it can help boost your mood and confidence. People living with pain are more likely to feel depressed, therefore uninterested in exercising. The less exercise they do, the more pain they may experience, which may then lead to further depression. To learn more about the cycle of depression and arthritis, please see our January 2011 issue of JointHealth™ monthly. |
Rounding out your exercise plan:
Warm me up
Warming up before exercising is a good idea for everyone, but is particularly important if you have arthritis. Vigorous exercise without a proper warm up can make joint pain worse. Start your exercise routine with stretching and range of motion exercises before moving on to strengthening or aerobic activities. Applying a heating pad or hot pack to your joints or taking a warm shower or bath before exercising can help loosen your muscles and joints. When you begin exercising, use gentle movements to avoid stressing stiff joints, and gradually increase the intensity of your movements as your joints relax.
Nutrition and arthritis:
food for better health
Although there are no dietary miracles for arthritis, a diet based on nutrient balance, variety, and moderation may help you lose weight and feel better. Certain types of arthritis, such as osteoarthritis and gout may see more improvement than other forms due to diet and lifestyle changes, especially when the changes result in reaching a healthy body weight. Regardless of the arthritis type you live with, you cannot go wrong by eating a healthy diet and in almost every case, exercising regularly.
Try to eat a wide variety of foods. A well balanced diet is the best way to get most of your vitamins and minerals. The Eating Well with Canada’s Food Guide is a good resource for getting information on the right foods in the proper amounts. Educating yourself and making permanent changes to your lifestyle can optimize your health, and long-term weight control is often the result.
Some people may need supplements, but it is important to speak with your doctor or pharmacist to ensure you are not taking anything that may interfere with your medications. You may want to consider the fact that most supplements are expensive and may not be worth the cost for everyone.
Finding the right balance in your diet and lifestyle is not complicated, but it can take a while to break bad habits. Do the best you can and be patient with yourself. Here are some diet basics to get you started:
Vegetables and fruit
Only 40% of Canadians eat the recommended number of servings, which is seven to ten each day. Try to eat at least one green vegetable and one orange one each day, plus get a good variety of other colours with each meal.
Grain products
Six to eight servings per day is recommended, but most people over consume from this group. Try to choose grains that are high in fibre and low in fat. If possible, limit white breads, white rice, and sugar cereals.
Milk and alternatives
This group is a key source of calcium, protein and riboflavin, which are important for maintaining bone health. The recommendation is two to three servings a day. Try to stick to lower fat options, such as skimmed or 1% milk or yoghurt and cheeses with less than 18% milk fat.
Meat and alternatives
Consume fish at least twice a week because they are a good source of omega-3 fatty acids, and choose leaner meats. Note that people with gout should avoid foods rich in purine, a chemical that is converted into uric acid in the body. These foods may include red meats and seafood generally, and especially organ meats, like liver, kidney, and brain, as well as shellfish.
Choose meat alternatives more often because they are a good source of protein and fibre.
| Avoid soda pop, especially diet drinks. Here’s why: Besides offering no nutritional benefit, diet sodas may be linked to weight gain, metabolic disorders, high blood pressure, and insulin resistance. One theory is that the fake sweetness of the diet pop confuses the body, making it “think” that it is about to take in lots of calories when it is not. This confusion may cause the body to crave more food or want to expend less energy. |
NAAP Year Two:
Defining new channels for conversations about arthritis
Zoomer Magazine signs on as media partner
A key media partner we have confirmed for NAAP Year Two is Zoomer Magazine—one of Canada’s leading lifestyle magazines for men & women age 45 and up. Zoomer covers a wide range of groundbreaking lifestyle trends with a particular focus on health and wellness. The media partnership with Zoomer includes prominent advertising and advertorials in the magazine and its online editions as well as Zoomer Magazine’s participation at the NAAP’s booths at two leading national Canadian healthcare conferences.
Zoomer provides the NAAP an incredible opportunity to reach its target market. Zoomer Magazine has been identified by PMB (Fall 2010) as the most efficient media vehicle in Canada to reach the demographic of affluent and influential Canadians 45-plus (82% of its 481,000 total readers are over 45).
As part of our partnership, Zoomer is offering all of our constituents a special on subscriptions for their home or office—www.zoomermag.com/naap.
Other channels of communication for NAAP Year Two
Social media is a powerful tool to help people engage with your cause and ACE has experienced that first hand with the Arthritis is cured! (if you want it) National Arthritis Awareness Program (NAAP). To help expand the national conversation about arthritis, the NAAP uses numerous social media activities. The feedback has been tremendous and many consumers have found the social media tools valuable and motivating.
For NAAP Year Two, we elected to enhance our already effective social media strategy by building a stronger online following and raising awareness of the release of the ArthritisID apps for iPhone, resulting in a closer relationship with consumers and healthcare professionals.
NAAP website
In Year One, ACE launched a NAAP website, arthritisiscured.org, featuring specially developed videos, evidence-based treatment and prevention information and a Facebook page for Canadians and international visitors to swap treatment ideas and access educationally driven tools. This year the website has been updated and enhanced to include:
- An up-to-date NAAP arthritis point-of-practice tool with new ACR/EULAR rheumatoid arthritis classification criteria
- NAAP Clinical Exam videos
- Quick Joint Exam
- Shoulder Arthritis Exam
- Knee Arthritis Exam
- Hip Arthritis Exam
- Elbow Arthritis Exam
NAAP has enlisted the support of program volunteers across Canada to serve as community managers for the NAAP Facebook page and we plan to incorporate photos from events, media coverage, press releases, announcements, and arthritis treatment and prevention tips.
Each community manager will be equipped to initiate interactive elements: poll, quiz, recommendations from followers/friends/watchers, etc.
We opened a NAAP Twitter account to expand engagement with current and new followers by sharing treatment and prevention tips, interacting with followers, and addressing their arthritis health issues.
We started a group for the NAAP on Linkedin to connect with healthcare professionals.
The NAAP created a great YouTube channel showcasing ‘favourites’, media coverage, and topical videos.
Listening to you
We hope you find this information of use. Please tell us what you think by writing to us or emailing us at info@jointhealth.org. Through your ongoing and active participation, ACE can make its work more relevant to all Canadians living with arthritis.
Update your email or postal address
Please let us know of any changes by contacting ACE at info@jointhealth.org. This will ensure that you continue to receive your free email or print copy of JointHealth™ monthly.
Arthritis Consumer Experts (ACE)
Who We Are
Arthritis Consumer Experts (ACE) provides research-based education, advocacy training, advocacy leadership and information to Canadians with arthritis. We help empower people living with all forms of arthritis to take control of their disease and to take action in healthcare and research decision making. ACE activities are guided by its members and led by people with arthritis, leading medical professionals and the ACE Advisory Board. To learn more about ACE, visit: www.jointhealth.org
Acknowledgements
Over the past 12 months, ACE received unrestricted grants-in-aid from: Abbott Laboratories Ltd., Amgen Canada, Arthritis Research Centre of Canada, Bristol-Myers Squibb Canada, Canadian Institutes of Health Research, GlaxoSmithKline, Hoffman-La Roche Canada Ltd., Merck & Co. Canada, Novartis Canada, Pfizer Canada, Sanofi-aventis Canada Inc., Takeda Canada, Inc., and UCB Canada Inc. ACE also receives unsolicited donations from its community members (people with arthritis) across Canada.
ACE thanks these private and public organizations and individuals.
Disclaimer
The material contained on this website is provided for general information only. This website should not be relied on to suggest a course of treatment for a particular individual or as a substitute for consultation with qualified health professionals who are familiar with your individual medical needs. Should you have any healthcare related questions, you should contact your physician. You should never disregard medical advice or delay in seeking it because of something you have read on this or any website.
This site may provide links to other Internet sites only for the convenience of World Wide Web users. ACE is not responsible for the availability or content of these external sites, nor does ACE endorse, warrant or guarantee the products, services or information described or offered at these other Internet sites.
Although the information presented on this website is believed to be accurate at the time it is posted, this website could include inaccuracies, typographical errors or out-of-date information. This website may be changed at any time without prior notice.
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