DEAR DR. DONOHUE: My stomach is so flabby that I can pick it up with my fingers. I have low back problems, so sit-ups are not for me. What do you suggest I do? – R.T.

ANSWER: You can do sit-ups until you’re blue in the face and not remove a single ounce of fat around the stomach. No exercise takes off fat just from the spot where muscles are exercising.

The best way to get rid of a flabby abdomen is aerobic exercise. If you spend at least 30 minutes a day walking, jogging, biking or swimming, you’re bound to lose fat, and some of it is going to come from your midsection.

Does your lower back sway too far inward? If it does, it pushes the stomach out and makes you look like you have a large potbelly. Stand with your back against a wall. If you can put a fist between your back and the wall, the lower back bends too far inward. Straighten it out and make a conscious effort to do so throughout the day when you’re standing, sitting or doing anything.

If abdominal exercises are too hard on your back, don’t do them, but if you can tolerate some exercise, do it. Strong abdominal muscles act like a corset and keep abdominal organs from sticking out. The bicycle exercise is one of the very best abdominal-muscle exercises. Lie on the floor with knees drawn up to about 45 degrees. Then start pedaling as if you were on a bike. You increase the intensity of the exercise by touching your right elbow to the left knee as it comes toward your chest, and vice versa for the left elbow and right knee. If that’s too hard on your back, just lie on the floor and raise yourself upward until your shoulder blades are off the floor. That’s enough exercise to tax abdominal muscles.

The fitness booklet describes aerobic and abdominal exercises. To obtain a copy, write: Dr. Donohue – No. 1301, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I haven’t seen you write much about swimming. Don’t you consider it a good exercise? I swim every day, and I find it keeps weight off me. What’s considered the best swim stroke? – G.P.

ANSWER: Swimming isn’t a good exercise. It’s a great exercise. It builds muscles without much threat of injury.

Swimming is a terrific aerobic exercise, the kind of exercise that’s good for the heart and arteries. Swimmers don’t get their hearts beating as fast as do those who exercise on land. That’s because water buoyancy cancels some of gravity’s pull on the body. While swimming, a heart beats 10 or 20 times more slowly than a heart beats during land exercises, but it still gets an equivalent workout.

The best stroke? They’re all good, and they all should be used. However, the crawl (freestyle) and the butterfly strokes burn the most calories – 750 in an hour. That’s a tremendous number of calories, and it’s exercise of such intensity that few, if any, can spend an uninterrupted hour doing just those strokes.

DEAR DR. DONOHUE: Every year when I go to my cottage, I get swimmer’s ear. I’ve been told I get it because I don’t get all the water out of my ears after swimming. How do I keep from getting it this year? – R.N.

ANSWER: You avoid it by getting all the water out of your ears after swimming. Have you tried rolling up an edge of a washcloth and gently inserting into your ear to wick water out of the ear canal?

Make a solution of equal parts rubbing alcohol and white vinegar. Put a drop or two in each ear canal after swimming and let them stay there for two minutes. Then tilt the head to drain the drops out of the canal. The solution keeps the ear canal at the right acidity and stops the growth of bacteria and fungi that are responsible for swimmer’s ear. The evaporating alcohol dries the ear canal.

DEAR DR. DONOHUE: You stated that Evista offers protection against breast cancer. I read the following: “Eli Lilly has agreed to plead guilty to settle criminal and civil charges related to marketing of Evista. The company executed a scheme to persuade doctors that Evista would reduce the risks of breast cancer.” In light of this, would you like to issue a correction? – D.S.

ANSWER: The quotation is an incomplete summary of the suit. The Department of Justice brought the issue to trial because the FDA has approved Evista only for the treatment of osteoporosis. Medicines cannot be marketed for other uses without FDA approval.

The suit doesn’t vitiate research done by independent scientists that strongly indicates Evista has a protective role in breast cancer prevention. The suit addressed only the issue of marketing without FDA approval.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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