Exercise physiologist Evelyn O'Neill, at the Hebrew Rehabilitation Center in Boston, agrees that the older you are, the less reliable age is as an indicator of fitness. O'Neill, who was on the team that conducted the research, designs exercise routines for people who are close to age Some have disabilities like arthritis, osteoporosis, or cardiovascular disease. Others have a few minor complaints but are generally fit and want to stay that way.

O'Neill took this range of abilities into account in designing "Get Up and Go," her exercise program for people over The program is designed to improve cardiovascular conditioning, balance, strength, and flexibility. Participants are evaluated by an exercise physiologist before each biweekly, minute session.

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Then each participant is assigned the most challenging exercises she can do without risking injury. Individual routines range from weight training to line dancing and include many of the exercises illustrated in this article. According to O'Neill, the very frail tend to do better if they begin with weight machines, which provide stability, then move to free weights and floor exercises once they've become stronger.

Start with your upper arms close to your sides, elbows bent, and forearms perpendicular to the floor. Your palms should face forward and weights should be at shoulder level. Slowly press the weights upward until your arms are extended don't lock your elbows. Weights should be slightly forward, not directly over head. Slowly return to the starting position. Stand 12 inches behind a chair, and hold on to the back for support.

Lean the upper body forward 45 degrees and slowly raise one leg straight back behind you. Lift it as high as you can without bending your knee. Slowly lower your leg. Do 8—15 repetitions, and then repeat with the other leg. When you're ready for more, add ankle weights. When you can do this comfortably, add a second set of repetitions. Hold on to a chair back for support. Keeping the knee straight and the back upright, slowly lift one leg to the side 6—12 inches. Slowly lower the leg. Repeat 8—15 times on each leg.

Lie on your back with your knees bent, feet flat on the floor. Put your hands beneath the small of your back. Slowly raise your head and shoulders a few inches off the floor, pause, then slowly lower them. Aim for 8—15 repetitions. Put your hands next to your hips with palms flat on the floor. Keeping the back straight do not allow it to arch , slowly lift your buttocks as high as you can off the mat, using your hands for balance only.


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Lower your buttocks without touching the mat, then lift again. Stand facing a corner with your arms raised, hands flat against the walls, elbows at shoulder height. Place one foot 12 inches ahead of the other. Bend the front knee and lean your body toward the corner. Keep your back straight don't bend at the waist and your chest and head up.

Hold this position for 30 seconds. Repeat with the other leg forward. This exercise also stretches the back calf. Hip and lower back stretch. Lie on your back with both legs extended. Look down toward your chest without lifting your neck off the floor. Bring one knee up to your chest, pulling it in with your hands.

Relax and then repeat before switching to the other side. As you improve, you can bring both knees up together. Holding the end of a dish towel in one hand, drop the towel down behind your back and grasp the lower end with the other hand.

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Slowly pull up on your lower arm, gently stretching your shoulder. Relax and repeat two or three times. Do the stretch again with the arm positions reversed. Stand straight, holding on to a chair back. Slowly lift up on your toes as high as possible. Pause, then slowly lower your heels to the ground.

Hold the chair with one hand, then one fingertip, then no hands. Finally, try this exercise with your eyes closed. Practice heel-to-toe walking as if you were on a tightrope, placing the heel of one foot just in front of the toes of the opposite foot each time you take a step.

Abdominal obesity and your health

Hold your arms out at your sides for balance if you need to. Excess body fat has serious consequences for health.

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It impairs the body's responsiveness to insulin, raising blood sugar and insulin levels. Excess body fat contributes to major causes of death and disability, including heart attacks, strokes, high blood pressure, cancer, diabetes, osteoarthritis, fatty liver, and depression.

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Faced with these risks, it's no wonder that you want to know how much you should weigh. But this common and important question is actually the wrong question. For health, the issue is not how much you weigh, but how much abdominal fat you have. Methods have changed over the years. But when scientists recognized that what matters is not body weight but body fat, standards began to change. The body mass index BMI , remains enshrined as the standard way to diagnose overweight and obesity.

The BMI provides a good estimate of body fat, and it's more accurate than skinfold measurements. Although the BMI is the official standard, it has several flaws.


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For one thing, highly trained athletes with big muscles can have BMIs of 30, with little body fat. At the other extreme, the BMI may fail to accurately reflect body fatness in adults who have lost substantial amounts of muscle mass. But the most important problem is that the BMI reflects total body fat without regard to how the fat is distributed.

And although no excess fat is good, one type of excess fat is much more dangerous than the others. Research shows that abdominal fat is the worst of the worst. What makes abdominal fat so harmful? Scientists don't know for sure, but research is providing strong clues. To understand these clues, you must first understand that abdominal fat comes in two different forms.

Some of it is located in the fatty tissue just beneath the skin. This subcutaneous fat behaves like the fat elsewhere in the body; it's no friend to health, but it's no special threat either.

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Fat inside the abdomen is another story. This visceral fat is located around the internal organs, and it's the true villain of the piece. One of the earliest explanations for this was that visceral obesity was linked to overactivity of the body's stress response mechanisms, which raise blood pressure, blood sugar levels, and cardiac risk. A newer explanation relies on the concept of lipotoxicity. Unlike subcutaneous fat, visceral fat cells release their metabolic products directly into the portal circulation , which carries blood straight to the liver.

As a result, visceral fat cells that are enlarged and stuffed with excess triglycerides pour free fatty acids into the liver. Free fatty acids also accumulate in the pancreas, heart, and other organs.