Environmental Alternatives

Advantages of getting in shape:
- improve posture
- improve blood circulation
- strengthen the back
- tighten abdominal muscles
- firm buttocks muscles
- tone and firm thigh muscles
- firm leg muscles
- firm calf muscles
- reduce knee joint stress

 Tired?  Out of energy?  No time for exercise?  Take a look at some simple things you can do.
Here is a list of nine natural energizers.

Interested in fitness?Take a look at this site: http://www.fitnesstraffic.com
Want total wellness?  http://www.whywellness.com/dpetrich
Yoga Supplies: http://www.theyogahome.com
Free information and affordable products for all your health and wellness needs: http://www.mac-pharma-network.com

Here are a couple sites full of related links: http://www.healthshaman.com/  and  http://www.1healthyworld.com

Maheono NLP has built a Directory of resources for NLP, Training, Leadership and Complementary Health sites: http://www.nlp.maheono.com

Read about he benefits of swimming exercises and the history of swimming: http://www.michaelphelpsswimspa.com/benefits-of-swimming.php

If you want to avoid a nasty cold this winter, go for a nice, brisk walk. Studies have shown that people who walk briskly for 45 minutes most days of the week have just half the number of sick days caused by colds or sore throats as non-exercisers. David Nieman, PhD, director of the Appalachian State University Human Performance Lab in Boone, North Carolina, has researched the impact of exercise on human cells for more than 20 years, so I called him to find out more about how exercise can maximize health in the grey, cold days of winter, the season of sniffles.

EXERCISE AND IMMUNE BOOSTING
Dr. Nieman says that moderate aerobic exercise creates favorable immune changes, including improvements in the killer T-cell function and improved immune system surveillance, which is the body's ability to detect and defend against pathogens. This improvement is triggered every time you exercise and lasts for one to three hours after the activity. The key, says Dr. Nieman, is frequency. Even though the change is just hours a day, over time it becomes protective. If you prefer, say, three 15-minute segments instead of 45 minutes, Dr. Nieman says it is probably equally effective as a cold fighter, but he can't confirm that until he completes research, now under way.

TOO MUCH OF A GOOD THING
Dr. Nieman does have one important caveat about exercise, however -- beware of the more-must-be-better trap. Overexercising, which is 90-plus minutes per day or running 60 or more miles a week, increases vulnerability to illness. Marathon runners, for example, are six times more likely to get ill in the one to two weeks following a race because excessive exercise suppresses the immune system. Dr. Nieman says that it pops back up to normal quickly, but to get around the suppressed immunity period, superathletes need to be particularly careful to follow the rules of good health -- avoid exposure to germs, eat healthfully and get enough sleep. In fact, studies have proven that lack of sleep as well as rapid weight loss and stress cause immune suppression.

Should you continue exercising if you are getting or have a cold or the flu? Not if you have fever, aches and pains that are symptomatic of flu or other systemic illnesses. Heavy exercising will make symptoms worse and last longer, says Dr. Nieman. In the case of a simple cold, though, exercise is neutral -- it will neither hurt nor help you.

As to the old saw that cold weather can increase vulnerability to colds and flu, Dr. Nieman says it's unlikely, assuming that your body is not cold, so dress warmly. His advice: Get out and move whatever the season -- there is every reason to believe you are doing yourself a favor.

Pilates... yoga... aerobics... stairmaster... treadmill... jogging... water aerobics -- the list of exercise options goes on and on. A friend of mine jogs and loves it and looks great. When I tried it, I just felt lousy and it made no difference in my body shape. Yet, the elliptical machine seems to keep me entertained and in check. For people who are starting an exercise program, it is easy to get discouraged if they pick a program that doesn't work well for them. Once discouraged, bye-bye exercise.

When it comes to weight loss, we all have different "diet and exercise personalities." And if there's one mantra that virtually every fitness professional has come to embrace, it's the one that says, "no one program works for everyone." In diet and in exercise, one size simply doesn't fit all. What works for your neighbor may not work for you, and what your neighbor hates most may be number one on your own personal hit parade. So, how do we choose the right diet and exercise program for our own personal situation?

"There are a number of ways to accomplish weight loss," Wayne Westcott, PhD, one of the leading researchers in the field of exercise, explains. How you approach weight loss depends on your exercise attitude, of which there are several types.

Attitude Type One: "I hate to exercise." If this is your attitude, Dr. Westcott recommends...

Diet: Reduced-calorie diet (typically 1,600 calories or less per day for women, 1,800 for men).
Strength training: Only two times per week, 15 minutes per session (see strength training circuit below for specific exercises).
Aerobic exercise: Only two times per week, 15 minutes per session (aerobics can be anything that gets the heart rate up to 50% to 75% of maximum heart rate for your age -- running, jogging, walking, swimming, step class, etc.). Target heart rates can be found at the American Heart Association Web site at http://www.americanheart.org/presenter.jhtml?identifier=4736).
"That minimum amount of exercise -- just one hour per week -- will actually maintain muscle and cardio fitness," says Dr. Westcott.

Attitude Type Two: "I like exercise but don't like strength training much."

Diet: Less calorie restriction than Type One (1,700 to 1,750 for women...1,900 to 1,950 for men).
Strength training: Same as Type One above (two times per week, 15 minutes each circuit).
Aerobic exercise: Four times per week, 15 minutes per session (or twice a week, 30 minutes per session).
The extra aerobic exercise allows you to eat slightly more than Type One.

Attitude Type Three: "I like to exercise hard."

Diet: Continue what you normally eat.
Strength training: Two to three times a week, 30 minutes per session (circuits).
Aerobic exercise: Two to three times a week, 30 minutes per session.
"Those strength-training circuits burn a lot of calories," says Dr. Westcott. "Remember that the more vigorously you exercise, the more calories you need in your diet. I work with a triathlete who runs 15 miles three times a week and has a 7% body fat index. He needs to have 35% of his diet as good fats to provide adequate calories to maintain stamina."

Dr. Westcott recommends a "circuit" of exercises. A circuit is performed by doing an exercise and moving on to the next with minimum rest in between. When you've performed each exercise in the circuit, you've done "one circuit." You can repeat the circuit up to three times in a session. Studies have shown that unfit people performing just one hard circuit, twice a week with a one-minute or less rest between exercises will get measurable results from this routine. Those who are more fit and conditioned to begin with have to up the ante a bit in order to get serious improvement -- either by performing more circuits or using heavier weights.

The first circuit is composed of exercises that use multiple muscles (called "compound exercises"). The second includes specific arm exercises. Either is effective, and you may alternate. They can be performed at home or at the gym. (Note: For an excellent illustrated explanation of how to perform these exercises with correct form, see Weight Training for Dummies (Wiley) by Liz Neporent and Suzanne Schlosberg.)

Here are two of Dr. Westcott's recommended strength-training circuits -- weight for each exercise should be enough such that you can complete eight to 12 repetitions. If 12 is too easy, and you feel you could continue, raise the weight. If you cannot complete eight, lower the weight until you can...

Strength Training: Circuit One

1. Leg press or squat
2. Dumbbell bench press (if at home) or chest press machine
(if at the gym)
3. Bent-over row (home) or rowing machine (gym)
4. Dumbbell shoulder press (home) or shoulder press machine (gym)
5. Chin-up (home: have someone assist you) or
assisted chin-up (gym)
6. Incline dumbbell bench press (home) or incline chest press machine (gym)
7. Crunches

Strength Training: Circuit Two

1. Leg press or squat
2. Chest press
3. Bent-over row (home) or seated row (gym)
4. Shoulder press
5. Lat pulldown (gym only)
6. Tricep press
7. Bicep curl
8. Crunches.

    As for the aerobic portion of your workout, the key is to make it enjoyable. Be sure to choose an activity that is fun for you -- and remember that it doesn't have to be the same one every time. In fact, your muscles will respond better if you mix it up, so that you exercise slightly different muscle groups each time you work out. You can ride a bicycle one day... use a cross-country ski machine another... and swim on a third. Or, take an aerobics or dance class. In good weather, kayaking will give you a good upper body workout, while cycling or a fast walk will exercise your lower body on alternating days.
    If a certain exercise gives you pain, then don't continue. Pick a different one that doesn't strain your "trouble spot(s)."  Exercise is a very personal activity and choice. Make it your own and it will become part of your life.

When people have arthritis it often hurts to move, so many people with arthritis limit their movement. But inactivity can be crippling -- literally -- for people with any form of this ubiquitous disease.

Whereas a generation or so ago, people with arthritis were sent to bed in an effort to "save their joints," Mitchell W. Krucoff, MD, coauthor of Healing Moves: How to Cure, Relieve and Prevent Common Ailments with Exercise (Harmony), on how exercise can help cure and prevent common ailments such as arthritis, told me scientific evidence now refutes that. "Study after study has shown that people with arthritis who exercise regularly report less pain and joint swelling, improved functioning and increased strength, endurance and flexibility -- without harming their joints," he says.

The psychological benefits are also dramatic. "The mind and body are not separate," added coauthor and yoga instructor Carol Krucoff. "Exercisers experience less depression and anxiety, and greater feelings of control. When you can't function, it's very depressing. You can't walk stairs, or go places. And for seniors, the idea that they might fall down and not be able to get up is very frightening." Basic exercises give seniors a sense of control and the ability to do the functions of daily living. "They feel better about themselves and feel more capable," said Carol.

This is all well and good, but it still hurts to exercise with achy joints. So, what kinds of exercise do the Krucoffs recommend for arthritis sufferers?

1. Range of motion exercises. These are exercises that help reduce stiffness and keep the joints flexible. Dr. Krucoff explained that range of motion simply means the normal distance your joints can move in all directions. There are five primary movements he recommends...

Shoulders. Slow easy arm circles. Starting with your arms at your sides, bring them all the way up toward the ceiling and then as far behind the body as comfortable in a huge circle. Repeat several times.
Hips. Lie on your back with knees bent, feet on the floor and arms down along your sides. Bring one knee to the chest and rotate the knee in an easy gentle circle. Repeat with other knee.
Wrists. Make circles with your wrists, rotating hands in both directions.
Ankles. Draw big circles in the air with your big toe in both clockwise and counterclockwise motion.
Knee. Lie on your back and bring one knee to the chest. Straighten your leg, pointing your foot toward the ceiling and bend a few times. Repeat with the other leg.

2. Endurance exercise (aerobics). "Like anyone interested in good health, people with arthritis need to accumulate 30 minutes a day of cardio activity," Dr. Krucoff told me. He added that for people with arthritis it's especially important to strengthen large muscles, such as those of the legs, allowing more gentle and consistent compression of the sore joints, which in turn stimulates the healing process in the cartilage. When choosing an exercise, it's important to pick something that doesn't exacerbate arthritis. Here's what the Krucoffs suggest...

Walk on a flat even surface. Good choice: A school track, using good supportive shoes. Or a mall or a sidewalk. Avoid bumpy fields or gravel roads.
Water exercise. "For people who can't tolerate walking, water exercise is the gold standard," said Carol. "When you're in the water, it supports the body so there's less stress on hips and spine and knees. The Arthritis Foundation runs classes at YMCAs called PACE classes -- People with Arthritis Can Exercise. These classes are great because they keep you in warm water at chest level. And they take you through a good range of motion and aerobic conditioning."

3. Strengthening exercises.
The idea of people with arthritis pumping iron is very new. "There are some very good studies showing that weight training for people with arthritis is very helpful," said Carol, "particularly for those with rheumatoid arthritis."

Important: Check with your physician before starting this or any exercise program.

When starting, it's best to begin with light weights or even no weights and work up from there. "Your goal is to work out with a weight you can lift at least 10 times without being too tired," said Carol. "If you can't, it's too heavy."

Chair extensions. Sit straight in a chair, knees bent 90 degrees, feet flat on floor. Then extend your leg straight out and bend it back down to starting position. "Do several of these leg extensions for each leg to strengthen the quadriceps muscle," said Carol. "When you can do eight to 12 repetitions, you can strap on light ankle weights."
Toe raises. Work the calves by standing and raising your body up on your tiptoes and back down. Do eight to 10 repetitions.
Chair squats. "These are probably the most useful exercises of all," said Carol. "You sit in a chair and practice standing straight up and sitting back down again, using the muscles of your legs. It strengthens the legs and gives you confidence that you can perform a basic daily task."
The number-one cause of nursing home admissions is not heart disease or Alzheimer's disease or diabetes. "It's weak joints and muscles," said Dr. Krucoff. These people can't do the activities of daily life. They can't get up or down, can't go to the bathroom. "You can prevent these problems with a good exercise program," said Dr. Krucoff. "And the time to start is right now." (After you get approval from your treating physician, of course.)

By now, surely every adult in the country knows that exercise is a vital part of lifelong health -- and that you don't get a pass because of age. But when many Americans think of exercise, they think of gyms, weights and boredom. I called Selene Yeager, author of Selene Yeager's Perfectly Fit (Rodale), to discuss the possibility that older adults might actually have fun while they are getting fit. Fortunately, she tells me, there are many options that aren't boring at all... and are safe for people of all ages and body types.

KAYAKING

Yeager's first suggestion is one that will get you to the water, but not in it -- kayaking. Kayaking involves paddling a one- or two-person boat ("shell") in a continuous motion. It is becoming increasingly popular in both city and rural settings among older adults, she says, and with good reason. Kayaking is a low-impact sport so there are no injuries from pounding, and it can be done at a pace that suits the individual. It is particularly good for strengthening back and upper body muscles, making it easier to stand tall. One of the best aspects of kayaking is that since it's so much fun and generally done in scenic places, people don't realize they're getting a good workout at the same time. Yeager says some people are hesitant because the boats can roll over, but while learning to upright yourself is a necessary safety step (as is wearing a life jacket), in actuality, capsizing seldom happens. For greater comfort, select a boat that has some kind of back support and bring along small cloths, such as washcloths, to put between your knees and the boat's hard edge.

OTHER OUTDOOR OPTIONS

Some hobbies lend themselves to incorporating exercise, says Yeager. Birding, for instance, can become active if, rather than driving, you pack your things into a backpack and walk the mile or two to various sites.

Another popular hobby with surprising exercise rewards is gardening. Yeager says that in some studies, gardeners -- because of their constant bending and lifting -- had stronger bones than the runners in the same study. Gardening is also great for increased flexibility and stretching. You can garden solo of course, but by joining a community garden or club you'll also reap the rewards of creating beauty, community improvement and an increased social network.

For a little more adventure, hiking can range from scaling mountain peaks to taking a pleasant, vigorous walk. Yeager points out that there are trails of some kind in virtually every community, from local parks to wooded areas. All you need is a good pair of hiking shoes and information about where to go. Check with the Chamber of Commerce or at your town's Web site. Or, go on a day's adventure to a hike in a nearby park or town.

Winter is no excuse to stay indoors, and snowshoeing is one of the best forms of exercise there is. Today's snowshoes are far removed from the tennis racquet footgear of old. There are a variety of types, and they all fit easily onto hiking boots. Yeager says the snow base should be at least four to six inches. As you walk along you will discover you hardly sink at all. Skating of course is another good cold-weather exercise, but Yeager doesn't advise it unless you're experienced, due to the risk of falling. This is especially important for people taking medications, such as some high blood pressure drugs, that have occasional balance issue side effects.

One last outdoor activity Yeager is especially enthusiastic about for older adults is bicycling. She says that manufacturers are catering to this market because biking is easy on the joints, it is aerobic, strengthening and a whole lot of fun. A bike she particularly likes is by Electra called the Townie (www.electrabike.com). This model has a low seat that enables riders to put their feet easily on the ground and to sit upright, which allows them to comfortably look around. It is also a more relaxed position than the standard bending forward position of most bikes. Happily, this design does not intrude on the bike's pedaling mechanics. You won't win the Tour de France on the Townie, but you will have fun.

WHEN THE WEATHER TURNS SOUTH

What about on those rainy days? Ballroom dancing is becoming a favorite with many older adults. Whether you decide to learn new steps, perhaps the salsa or merengue, or practice your swing, foxtrot or quickstep, the activity is aerobic and weight bearing, so it's good for your bones. Most communities have a nearby dance school, or you can check with the YMCA, churches and senior and community centers for dance events.

Finally, Yeager says that any discussion of exercise for older adults cannot end without mention of weight work because it is absolutely crucial. Without strength training, muscle mass starts to diminish in your 30s, and after age 60, the loss escalates. But take heart, there are ways to make strength training more fun. Fitness clubs today offer a bevy of classes (and remember that Pilates and gentle yoga build strength as well as flexibility) including those that cater specifically to the older crowd. If you prefer, you can turn standard strength-training sessions into good times with friends. Instead of meeting for lunch, Yeager suggests setting up a workout group. Hire a trainer at a club to supervise your group. This way you'll be socially active, more motivated and together you'll build the muscles you need for better living.

For those who are just getting started in the exercise world, Yeager suggests talking with your doctor to be sure you have a clean bill of health or to get information on how to accommodate any physical problems into your program. Your doctor's okay will give you peace of mind and the freedom to become more vigorous as you get stronger, more experienced and have ever more fun.

Cardiovascular fitness refers to the fitness level of your heart, blood vessels, lungs, and breathing mechanisms.Here’s the scoop on cardiovascular exercise:

• It helps strengthen your heart, so it can pump more blood with each beat.
• It strengthens your lungs, so you can take in more air with each breath.
• It plays a significant role in losing weight.
• It has been shown to lower blood pressure, improve blood cholesterol levels, and reduce your risk of heart disease, diabetes, and colon cancer.
• Moderate cardio exercise also can strengthen your immune system and help relive anxiety and depression.

Besides greatly improving your cardiovascular system, aerobic exercise can help you lose weight.You should strive to burn at least 1,000 extra calories per week – equivalent of jogging 30 minutes every other day.(This is based on the recommended weight loss of one to two pounds per week.)Exercise right, as well as eat right, and you’ll not only lose weight, but you’ll also keep it off permanently.

How to measure your heart rate

When you exercise, your body speeds up, and so does your heart as it works to meet your increase energy needs.But how much is safe?You need the answer to this question in order to maximize your exercise benefits while not overworking your heart.Checking your heart rate can be done a number of ways.

Ideally, your exercise target heart rate should range from 60% to 80% of your maximum heart rate, which is normally calculated as 220 minus your age (for example, for a 30-year-old, the answer would be 190 beats per minute).To improve stamina and performance, your maximum heart rate while exercising should range from 60% to 80% of this number.Multiply your maximum heart rate by 0.6 and 0.8 to get the correct range (114 to 152 for a 30-year-old).

Based on a 30-minute, three to four days a week exercise routine, you should check your heart rate while exercising once or twice a week.Monitoring your heart rate periodically-- and charting it in your journal – can give you an idea of how you’re improving.

Aerobic exercise is exercise at levels of intensity at which your cardiovascular system can keep pace with the demand for oxygen.This steady supply is what allows the activity to comfortably take place.Walking and jogging are some examples of aerobic exercises.These activities strengthen your heart, burn fat, and improve your overall cardiovascular strength.

If you exercise harder, such as going from jogging to running very fast, you are no longer exercising aerobically, but anaerobically.This means that your body is working so hard that you tire more quickly. An example of an anaerobic exercise is sprinting, which relies upon the stored oxygen deep in your tissues.Exercising at anaerobic levels improves cardiovascular endurance and athletic performance, but should be done moderately.

Excellent cardio exercises include:

• Aerobic dance/step aerobics
• Indoor elliptical runners
• Kickboxing
• Jogging/running
• Rowing
• Swimming
• Bicycling
• Hiking

Strength Training

Strength-training exercises isolate muscles and build strength and endurance.

They also increase muscle mass, which burns more fat.

These days, everyone should be lifting weights -- and for good reason.Between the ages of 35 and 40, most people start losing bone and muscle mass.Weight training can slow this loss and even reverse it.Strength training benefits everyone, including older adults and non-athletes.It is effective in developing and maintaining muscular strength and endurance, developing muscle-mass, and stimulating bone density (which helps prevent osteoporosis).Lifting weights can even help you lose weight and keep it off.If you try to slim down through dieting alone, you’ll lose muscle along with fat.Lifting weights increases your muscle-mass, and increasing muscle mass boosts your metabolism.Of course, the most obvious benefit is a firm, toned physique.

Begin by warming up and stretching

Before you begin any exercise, always warm up, then stretch for at least ten minutes.Never stretch cold muscles; they are more likely to tear.Spend about seven minutes on a treadmill or bicycle -- even jogging in place will do.You can also do whatever activity you’ve chosen for that day at a slower, less-challenging pace.

Now that your muscles are warmed up, it’s time to stretch.There are many different ways to stretch your muscles.Any combination will do just make sure you stretch the muscles you plan on exercising.Hold each stretch for at least 15 seconds without bouncing.It’s also a good idea to stretch after you’ve worked out to lower your chances of injury or soreness.

The more you stretch, the more flexible your body becomes.A flexible body can help you walk and run faster and help you heal from injury, or avoid injury altogether.

How much weight should you lift?

The amount of weight to lift will very with the exercise and the muscle or muscle group being exercised.For small muscles and muscle groups, like your triceps or biceps, you will want to lift less weight than what you will lift for large muscles and muscle groups, which include your back, chest, legs, and shoulders.

How much weight you lift will also depend on your strength-training goals.Are you trying to increase muscle strength?If you answer is yes, then lift heavier weights so that your muscles tire out after five or fewer repetitions.If you’re looking for more moderate results (muscle endurance), lift weights that cause your muscles to fatigue after 8 to 15 repetitions.For specific recommendations, consult a personal trainer or exercise coach.

Most experts suggest starting out with lower resistance and higher repetitions for best results and less chance of injury.In addition, many would agree that no one should strength-train more than three to four times per week and never on consecutive days.Muscles need at least 48 hours to recover from a workout.

How many sets should you do?

If you’re lifting weights purely for the health benefits, a single set of each exercise may suffice.An example is a one-time through the circuit course.But if you goal is to develop significant muscle tone and strength, you’ll probably need to perform at least three sets per muscle group.

Rest between reps

The amount of rest you need between each repetition depends on the type of exercise you’re doing.The following is a good rule of thumb to remember:

• rest 30 seconds between each rep when using machines or light weights
• rest 90 seconds between each rep when using free or heavy weights

Be patient. Not everything that’s good for you comes with immediate results.It may take a few months before you start to see a significant increase in strength and tone of you muscles.And even if your biceps aren’t popping out of your sleeves, you’ll probably feel stronger and more energetic within a few weeks.Just don’t give up.

Nutrition

No matter how hard or long you exercise, it won’t help if you don’t eat right.

When seeking out nutritional advice, remember this: everyone’s body is different.There are no absolute rules.Yet there is one thing that almost every nutrition expert would agree on – don’t deprive your body of the essential nutrients it needs.Purposeful eating doesn’t mean depriving your taste-buds.And it certainly doesn’t mean eliminating certain foods or food groups altogether.Yes, your body does need a small amount of fat!

What a good nutrition boils down to is balance – a balance of carbohydrates, protein, and fat.Plus, you need a proper balance of taking in calories and burning them off.For specific dietary recommendations, consult a nutritionist.

How many calories should you eat per day?

The answer depends on your goals as well as your body weight, metabolism, and exercise habits.If you’re at a desirable body weight and have plenty of energy, your caloric intake is right on.If you’re gaining weight and feel tired most of the time, you may want to count your calories and make adjustments.Try keeping track of everything you eat and drink for one week (use the nutritional section on the daily pages of this journal), and add up the calories you ingest per day.If you goal is to lose weight, your net calories (see chart below) must be less than the number of calories required to maintain your current weight (maintenance level).To find your maintenance level, multiply your weight by 15.Next, write down the total calories you consume each day, as well as the total calories you burn.Finally, subtract calories burned from calories consumed.That number is your net calories for the day.In order to lose weight, the net number must be below the maintenance level number.Follow the formula below:

If you want to whittle your waistline without turning your life upside down, plan to lose about one to two pounds a week.To achieve that, you need to create a weekly 3,500-calorie deficit – either by dieting, burning more calories, or a combination of the two.The easiest way is to try cutting back by 200 to 300 calories a day and increasing your daily activity, so you can burn 200 to 300 more calories.Don’t eat fewer than 1,200 calories a day; that’s the minimum you need to get your nutrients and to keep your metabolism humming.

What is your desirable weight?

Body Mass Index (BMI) is a widely used means to define if you are overweight or underweight.To determine your BMI, measure your height in inches without shoes and your weight in pounds without clothing.Multiply your weight by 700.Divide that number by your height.Then divide a second time by your height.For example, if you weight 130 pounds and are 5’4” (64”) tall, your BMI is (130x700/64/64) = 22.2.Your score means:

• Underweight Below 18.5
• Normal 18.5-24.9
• Overweight 25.0-29.9
• Obese 30.0 and up

Exercise

A Weight on Your Shoulders

According to Liz Neporent, MA, CSCS, author of Weight Training for Dummies, the key to osteoporosis treatment is quite simple: "You have to lift weights," said Neporent. "You can throw calcium at the problem all day long, but unless you train your bones to hold onto that calcium, it's not going to do much good. Weight training teaches bones to hold on to calcium and stay strong. The act of weight-bearing exercise sends a signal to the bones that they need to be strong to endure the exercise."

"The one thing most people don't realize," pointed out Neporent, "is that osteoporosis is site specific. What that means is that you might not get it in your legs, but you easily could get it in your upper body if you don't use your arms. That's why a weight-training program has to address all the major muscle groups of the body."

Exercise Made Easy

"Walking is a great way to hold on to bone strength," said Neporent. "Running is great as well, if you do it in moderation." She defined moderation as whatever doesn't cause you to have joint pain. "Both running and walking are terrific for stimulating bone growth in the legs," she said. "They load the bones with weight -- your own -- and help you to keep calcium in the bones where it belongs. Water aerobics, on the other hand, won't stimulate bone growth because there's no impact or weight-bearing on the bones and joints."

But what about the rest of the body? Weight training -- using enough weight to create increased resistance and strength, such as wearing a backpack loaded with some additional weight or using hand and ankle weights.

Neporent designed a basic exercise program aimed at maintaining bone health that can be done in only 20 minutes. You can do it at home or at a gym. "You need to do one good exercise for each of your major body areas," said Neporent.

Choosing the right weight is critical to the success of the program -- you have to present the bones with enough of a challenge to stimulate growth. "Choose a weight that you can do eight to 15 repetitions with," Neporent explained. "If you feel like you can easily go on after the 15 repetitions, it's time to increase the weight."

"Do one set of each exercise, and perform the entire routine twice a week," Neporent told me. This is also the protocol that the prestigious AmericanCollege of Sports Medicine (ACSM) advocates for the maintenance of strong muscles and healthy bones.

Here's the routine...

1. Squat. Stand with feet hip-width apart. Bend your knees till your thighs are parallel to the floor. As you bend down, don't go too far forward with the upper body. Keep your abs tight and don't let your knees shoot out over your toes. (Pretend you have a chair behind you and you're aiming your butt for the chair. Then stand back up.) Add hand weights when you're comfortable. You can hold the weight at your sides or at shoulder level. You even can hold shopping bags filled with cans at your sides. "After all," said Neporent, "weight is weight." 
2. Calf raise. Stand on a step, hold onto something for balance and hang your heels off the edge of the step. Then lift up onto your toes and lower your heels down below the edge of the step. Repeat. When you can do it easily, hold a weight in your free hand. 
3. Leg curl. Kneel on your elbows and knees, extend and lift your right leg straight back, parallel to the floor. Bend the knee and bring the heel towards the ceiling. Lower back down to parallel position and repeat. Then do the left leg. When these become easy, you can add ankle weights. 
4. Crunch. Lay on your back with your knees bent and feet hip-width apart. Bend you arms, and touch your fingers to your neck, right behind your ears. Don't lace your fingers together. Your elbows should be slightly rounded inward. There should be enough space for a grapefruit between your chin and your chest. Slowly curl your upper body up and forward off the floor, tightening up the abs. Go until your shoulder blades clear the floor. It's not necessary to go much higher to get benefit. 
5. Nonmilitary push-up. Get on your hands and knees and do push-ups to the floor with your upper body. This works the entire upper body, especially the chest and shoulders. 
6. Pullover. Stack a couple of big pillows on the floor and sit with them behind you. Lean back against them so that you are at an incline. Take a weight in both hands and hold it directly in front of your chest so you're laying back at an incline with your arms extended directly in front of your chest. Lower your arms over and behind your head, keeping your arms extended, then bring them back to the starting position in front of your chest. Repeat. 
7. Shoulder press. Hold a weight in each hand at shoulder level while sitting or standing. Raise the weights straight up to the ceiling and return to starting position at the shoulders. 
8. Bicep curl. Stand with weights in your hands, palms facing out and feet shoulder-width apart. Keep your upper arms at your sides and bring the weights up toward your shoulders by bending the elbows. Then lower them back down. 
9. Tricep dips. Sit on the edge of a bench or step with your hands on the edge of the bench, fingers facing forward, and feet on the ground in front of you. Lift your butt off the bench and lower it to the floor by bending your arms at the elbows. Stay perpendicular to the ground, with your back straight. Lift up by straightening your arms.