DEAR DR. DONOHUE: One way of exercising that you haven’t mentioned is water walking. This puts less strain on joints. You can wear weights on the lower legs. I purchased the weights online. — N.L.

ANSWER: Water exercises, including water aerobics, are a terrific way to improve strength, lose weight and restore balance while sparing joints. Everyone can do them — the older, the younger, women, men, people with arthritis and people recovering from an injury or surgery — if their doctors agree.

Walking, running and exercising with weights designed for water immersion are only a few of the ways to do this kind of workout. Perhaps the best idea is to join a class with an instructor who can put you through the proper techniques of exercising while in water. Many Y’s offer such programs.

You need a flotation belt to keep you horizontal when you are in deep water. Water shoes or clean canvas sneakers are another worthwhile purchase for water exercising.

In waist-high water, body weight is only about half of what it is on land. At neck level, it’s around 10 percent to 20 percent of land weight. That’s still enough weight to challenge your muscles. Besides, water resistance increases the demand of exercising when submerged.

A great advantage of this kind of exercise is the lessening of injury should you fall. The water is a cushion. Another advantage is the ability of water to keep the body from overheating.

DEAR DR. DONOHUE: I am a 59-year-old male, 5 feet 5 inches tall and weighing 130 pounds. I recently had blood work done, and the results were normal. I take no medication.

I would like to gain 10 pounds. I eat like a horse but to no avail. I pass a lot of bubbles in my urine. Am I losing protein? Should I take creatine? — R.S.

ANSWER: I get few letters from 59-year-old men wanting to gain weight. Questions from such men are more often questions about weight loss.

Your body mass index is 21.6, quite normal, quite admirable. Body mass index is a better indicator of how much of your weight is fat and how much is muscle and bone. It provides more information that the weight obtained on a scale. You can obtain it by multiplying your weight in pounds by 703 and then dividing that number by height in inches squared (inches times inches). For those at home with metric measurements, it is weight in kilograms divided by height in meters squared.

Even though you eat like a horse, you’re bound to increase your weight by taking in more calories. Boost the portion size of the foods you’re now eating. Have an afternoon snack. A peanut butter sandwich with two tablespoons of peanut butter and two slices of bread provides 300 calories. Fruit, dried fruit and yogurt are other ways to add more calories.

Bubbles in the urine indicate protein loss only if the bubbles form a dense, wide layer like the head on a glass of beer. Bubbles are not a reliable estimate of protein loss. Did you have a urinalysis when you had those other tests? It provides the best information on protein loss.

You don’t need to take creatine.

DEAR DR. DONOHUE: I am in my early 60s and have been physically active all my life. I have a problem with under-the-arm skin flaps. I play tennis three times a week and work out regularly, but my arms look atrocious. The skin hangs. Is my skin losing its elasticity? Will strength training help? — B.J.

ANSWER: Yours is a common problem that comes from a loss of skin elasticity, shrinkage of the triceps muscle on the back of the upper arm and a deposition of fat in that area. Triceps exercise will help some. Plastic surgery to sculpt the upper arms is the answer, but an extreme one.

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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