The movie “Tully” aims to be an honest depiction of life balancing the demands of a newborn with two other children, in all of its spit-up filled, sleep deprived, utterly exhausted glory. It’s about a mom called Marlo (played by Charlize Theron) who just had her third child and is on the precipice of postpartum depression, until her brother sends a night nanny (Tully) to her rescue.
I haven’t set any nutty resolutions for 2017 – surviving the year is my primary goal – but I am looking for a health boost. I want more energy, and, sure, if that brings me closer, aesthetically, to Gisele Bündchen, I will accept it. So, I tested out five of the wackiest, most-buzzed-about celebrity diet tricks and trends for a day each to report back to you what is worth your time (and what will make you so gassy you’ll alienate yourself from everyone you’ve ever loved). 5 Best Exercises For Men Over 40 (Do These Today!)
From her pepperoni-pizza pantsuit to her cow print leather top, if you’ve learned anything about Beyoncé lately—aside from the fact that the woman really can wear anything—it’s that she and Jay-Z are on a vegan adventure. The power couple recently embarked on a 22-day plant-based challenge, complete with mouthwatering Instagram pics hashtagged #22daysvegan. But Queen B and her Brooklyn beau aren’t the first to experiment with dieting. Take a look back at some memorable celebrity diets through the years.
Simply cutting back on calories usually isn’t an effective weight loss technique. We need to not only cut back on calories, but also to make sure we are choosing the right types of calories. Lean protein sources such as fish, lean meats, eggs, and tofu feed and preserve our muscle mass, keep us feeling full longer than other foods, and keep the blood sugar steady, preventing the energy spikes and lows that can lead to overeating. Build your meals around protein sources, and include a variety of fresh produce and small amounts of whole grains so that meals are balanced and healthy. Cut back on or eliminate empty calories that do not provide your body with nourishment but do contribute to weight gain, such as white bread, white pasta, and added sugars. Training after 35 Years Old *** STOP LIMITING YOURSELF
22. You’re not doing the right exercise – are you’re going to the gym or doing your exercise classes, and wondering why the weight isn’t falling off? Firstly, exercise alone won’t make much difference to your weight. You need to eat right too. Secondly, your body gets used to long slow cardio, so it’s important to mix it up with some resistance training, burst or high intensity training and core work or stretching. These types of exercise help to maintain muscle, and stimulate growth hormone and testosterone, which increase your metabolism and help you burn fat. Losing Weight After 40 - Super Effective Tips!
WHAT IT IS: Hollywood seems to be juiced over this six-juices-a-day, 1,200-calorie intense cleanse. While on the Pressed Juicery diet (said to be a major bloat beater), followers receive a daily supply of juices specially delivered every morning. Each fresh, nutrient-packed drink is designed to replace meals and snacks, and all alcohol, caffeine, and nicotine should be avoided.
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Many celebs, including Megan Fox and Heidi Klum, have touted the benefits of vinegar to help cleanse your insides and lose weight. The theory here is that apple cider vinegar helps make the digestive tract more alkaline, which helps decrease the toxins stored in your body. Additionally, claims have been made that apple cider vinegar helps activate the liver to rid your body of extra fat and protein. Unfortunately, none of these claims are scientifically verified. Further, the primary purpose of your liver is to cleanse your body, and it doesn’t need the help of vinegar or anything else to do its job.
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“The 40s are a prevention decade,” says Larsen. “It’s time to get on track and stay there.” If those babies are now big kids, and you’re juggling commuting and carpools, it’s easy to slip into sedentary habits. “I see a lot of people let themselves go,” says Larson. “I’m honest with my clients. You do not want to go into middle age or menopause overweight. Because you will not know what hit you. Eat well, stay active, and practice healthy habits as a family.”
The paleo diet has been picking up steam over the years thanks to its promise for a fitter physique and optimal health. Everyday Health explains the paleo diet only allows you to eat foods that were available for human consumption millions of years ago. That means all processed foods are out — but that’s not all. True paleo followers also don’t consume dairy, grains, or legumes.
"When you do resistance training, it causes a degree of microtrauma, or tiny tears, to the muscle tissue," says Dr. Westcott. "Over the next 48 to 72 hours, your body remodels and heals that tissue with amino acids, making it stronger—or, if you're just starting out and need to gain muscle mass, the muscle slowly grows." This throws coals onto your metabolism's calorie-burning fire in two ways: First, the more muscle you build, the more calories you'll burn each day. Second, the rebuilding process itself requires extra energy, boosting your daily calorie burn by 5 to 9%.
Not only is vinegar great on salad, it’s also shown to “switch on” genes that release proteins that break down fat. In a study of 175 overweight Japanese men and women, researchers found that participants who drank one or two tablespoons of apple cider vinegar daily for 12 weeks significantly lowered their body weight, BMI, visceral fat, and waist circumference.
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People naturally lose muscle after 40, especially women after menopause. Because muscle burns more calories than fat, this can slow down your metabolism and make it harder to shake those stubborn pounds. Strength-training exercises -- lifting weights or doing body-weight exercises, like push-ups and squats -- at least twice a week can help you keep those muscles.
This is less of a diet and more of a lifestyle, which makes it one of the more sustainable options for long-term benefits. In essence, a plant-based diet means your meals are primarily composed of fruits, veggies, nuts, whole grains, and seeds. You can still eat meat when you’re plant-based, but it should be viewed as more of a side dish rather than the main component of your meals.
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Very soon, I’ll stand up in front of the graduating class of my former high school and give the commencement speech. I’ll focus on the usual “work hard” and “follow your dream” themes, but, in reality, I just want to shout out to all those 17-year-olds — “have that ice cream cone, you’ll still fit into your skinny jeans tomorrow! ” Or “it’s OK to skip a workout, your muscle mass will help you bounce back!”
I eat mostly whole30 (I have 8 ounces of red wine at night). I am 42 year old mother (20 month old and 7 year old) I am having the hardest time losing my BELLY. I was exercising 3 times a week at the gym with circuit training, but my knees are bad so I had to modify all the exercises. Anyway, I just bought book and I am hoping this will help. I have a bad dairy allergy so will need to omit the butter and dairy. Any other advice or help would be greatly appreciated. I hate being a fat mom.
Studies show that how you eat and live contribute significantly to how you transition through menopause. And while Brenda vigilantly monitored her caloric intake, she was eating too much dairy and other inflammatory foods that created hormonal imbalances in addition to living an action-packed lifestyle with few outlets for stress reduction. Meanwhile, her regular, intense cardio workouts spiked Brenda’s fat-storing hormone insulin and stressed out her (already overworked) adrenal glands.
In an Orlando Health survey of more than a thousand respondents, only 10 percent of people listed their psychological well-being as part of their weight loss journey. The problem? Not being in tune with your emotions and their connection to food is why nearly 66 percent of people gain weight back after losing it. “Most people focus almost entirely on the physical aspects of weight loss, like diet and exercise,” neuropsychologist and Program Director of Integrative Medicine at Orlando Health Diane Robinson, Ph.D. said in a press release. “But there is an emotional component to food that the vast majority of people simply overlook and it can quickly sabotage their efforts.” To stop emotional eating and unlock the door to weight loss success, try keeping a journal that tracks your food choices and current mood. Then look for healthy and unhealthy patterns, which can help you identify the specific life and emotional connections you have with food.
If you’ve never added this delicate green to your salads, now is definitely the time to start. A study in the American Journal of Clinical Nutrition suggests that consuming 85 grams of raw watercress (about two cups) could reduce DNA damage linked to cancer by 17 percent. What’s more, the leafy green is teeming with beta-carotene and vitamin A, two compounds essential for youthful skin. No wonder why watercress is our #1 best superfood healthier than kale!
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The best exercise for weight loss is strength training, or working out with weights. This will not only prevent the muscle loss discussed above, but will also accelerate your metabolism and replace your current body fat with muscle. Strength training provides many other wonderful health benefits as well, including stronger bones, lower blood pressure, a sharper memory, and reduced risks for heart disease, cancer, and type 2 diabetes.
Why does eating lots of fish rich in omega-3 fatty acids (salmon, herring, and tuna) help amp up metabolism? Omega-3s balance blood sugar and reduce inflammation, helping to regulate metabolism. They may also reduce resistance to the hormone leptin, which researchers have linked to how fast fat is burned. A study in Obesity Research found rats that ingested large doses of fish oil while exercising lost weight. Take omega-3 fatty acid supplements; Hyman recommends 1,000 to 2,000 milligrams per day. Hate the fishy after-burp? Try flaxseed oil, walnuts, or eggs fortified with omega-3s. Or check out supplements (by brands such as Nordic Naturals) that have no fishy taste. Real Reasons Why You Can't Lose Weight After 50
Choosing these youth-promoting foods will equip your body with the cancer-fighting, wrinkle-smoothing, and metabolism-revving vitamins and nutrients it needs to help you look and feel young and vibrant—all without the help of a plastic surgeon. So next time you head out for a grub run, make sure to stock up on our stellar list of superfoods to eat after 40, while practicing restraint when it comes to ordering these 40 Meals You Should Never Eat After 40.
"As much as I love words on the page, I'm not fully satisfied until I get to speak them in person with others," Leslie adds. She's honored to travel and share from her passions nationally and internationally at conferences, universities, churches, and retreats. With three master's degrees, she has taught collegiate classes for many years, including six years in Seattle Pacific University's MFA program. If she can't see her audience, radio is a good second. She has appeared on more than 150 radio shows including Family Life Today, Prime Time America, Focus on the Family, and Chris Fabry Live!
We know—you’ve been hearing this seemingly sadistic advice for years. Alcohol strains numerous organ systems, especially the liver, and drives your hormones out of whack. Plus, men in particular consume an additional 433 calories on days they drink, typically in the form of saturated fat, meats, and the booze itself, reports a study in the American Journal of Clinical Nutrition. Kominiarek advises ditching the booze entirely [if you’re trying to lose weight], but adds you should at least limit yourself to two drinks per week.
Getting older means a slowing metabolism. But having a protein shake before hitting the sack may boost it, according to one Florida State University study. Researchers found that men who consumed an evening snack that included 30 grams of protein had a higher resting metabolic rate the next morning than when eating nothing. Protein is more thermogenic than carbs or fat, meaning your body burns more calories digesting it.
Jack Yeager, a nutrition coach in Los Angeles spends much of his time getting celebrities into shape. In fact, Yaeger recently hosted the Discovery network's "Body Challenge Hollywood," a 12-week health and fitness challenge starring such actors as Erik Estrada (CHiPs), Charlene Tilton (Dallas), Susan Olsen and Christopher Knight (both from The Brady Bunch), Kym Whitley (Sparks), and David Anthony Higgins (Malcolm in the Middle).
Beyoncé is reportedly a fan of the Master Cleanse diet, also sometimes referred to (appropriately in this case) as the Lemonade diet. The Master Cleanse is essentially an all-liquid diet that at its core basically consists of lemonade, salt water, and a laxative herbal tea. If it sounds too good to be true, that's likely because it is. Proponents of the diet claim that it's a panacea for all that ails you; you'll lose weight, feel energetic, and lose your cravings for unhealthy food.
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WHAT IT IS: According to their website, The South Beach Diet is “a food-lover’s diet”. Divided into three phases (the first two are the most strict), the program is said to eliminate cravings, kick start weight loss and maintain for life. While there’s no counting calories or strict portion sizes, followers must say goodbye to bread, rice, potatoes, pasta, baked goods, and fruit – at least for the first two weeks. Relatively simple in principle, it replaces “bad carbs” and “bad fats” with “good carbs” and “good fats."
There is no single diet plan that works for everyone. But a diet plan for your 40s should be one that you can use to reach your weight loss goals and then modify and stick to for life. Evaluate your current eating style, think about your past diet history and choose a diet that fits your needs. Evaluate commercial diet plans or create your own eating plan at home.
The secret to Katy Perry's "California Gurl" body? Mushrooms. With the M-Plan diet, Perry eats a mushroom-packed lunch or dinner every day for 14 days, then watches the pounds slip off. Great for removing unwanted bulk from problem areas like the stomach and thighs, the program still allows the dieter to retain her womanly shape—the mushroom meal plan won't effect the bust.
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The gorgeous and exotic Padma Lakshmi is an American actress, author, model and TV personality. Of Indian descent, Padma’s cookbook, Easy Exotic won her the “Best First Book” award at the 1999 Gourmand World Cookbook Awards. She also hosted Top Chef and won an Emmy for Oustanding reality program. Padma is 47 and has been modelling since she was 21. The mother of one has appeared in campaigns for Giorgio Armani, Gianni Versace and Ralph Lauren.
Iron deficiencies can slow down your metabolism. Do you know what’s got plenty of it? Lean meat. Eating three to four daily servings of iron-rich foods will help keep your inner furnace burning. Fortified cereals, dried fruit, and dark leafy greens will get you on your way to meeting your iron goals, but lean meat—with its high muscle-building protein content—will be doubly useful in revving up your metabolism.
Julia Roberts has been named the world’s most beautiful woman of 2017 by People magazine. The 49-year-old Pretty Woman voted top for a record fifth time. One of America’s sweethearts first graced the cover of People magazine as the most beautiful woman in the world for 1991. At that time, she was just 23 years old. Roberts won the title again in 2000, 2005 and 2010. And now at 49, the actress and mother of three is once again the cover for People Magazine’s “World’s Most Beautiful Woman” in 2017.
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Being over 40 doesn't automatically mean that you now have to cut out certain foods to get (or stay) slim—unless you know deep down that a food is truly getting in the way of your goals. "If having a square of chocolate leads to eating an entire bag of chocolate, having a square of chocolate does not work for you," Cederquist says. (Regain control with these 6 tips to stop overeating.) Over 40 Workout for Men (Gain Muscle and Burn Fat)
How to Slow Down Your Metabolism and Gain Weight How to Lose Belly Fat After 40 Working Out & Eating Before Bed Is it Possible for Women Over 50 to Lose Belly Fat? How to Lose Weight When You're Already Thin How Long Does It Take to Lose Weight? How to Lose 2.2 Pounds Per Week Advantages and Disadvantages of Exercise How to Lose Weight and Not Gain Muscle How Women Over 40 Can Lose 10 Pounds Quickly How to Not Gain Weight After Dieting The Best Two-Week Quick Weight-Loss Diet The Average Weight Loss in Six Months Will My Blood Glucose Go Down If I Lose Weight? How to Lose 100 Pounds in a Year The Best Way to Lose Weight in One Month How Fast Can You Lose 20 Pounds? How to Lose Weight in Hips & Thighs How Much Weight Can You Lose in 6 Weeks? What Is a Good Amount of Weight to Lose Per Month?
Without kids or a spouse, a lot of women in their twenties have the freedom to eat out with friends whenever the hell they want. That means you eat way more calories from that yummy Thai restaurant than you would if you actually used your stove, says Ansel. But you can still stay on track without sitting at home. Since most restaurants have at least one healthy option, make it your goal to order first, she says. "Research shows people follow the lead of the first person to order in a group,” says Ansel. And instead of revisiting the same old high-cal spots, do your homework and suggest new (healthier) joints that your friends will like, too. Another option: Eat half of your meal, and box the rest for leftovers tomorrow night.
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Bad things are bound to happen, but women over 40 know how to deal with them. “If you can find the key learning in a difficult situation you emerge from it better, more evolved,” Bernstein notes. “Every difficult situation and person is your teacher, if you have the eyes to see and the ears to hear. By going with the flow of the situation rather than fighting it, it makes the going easier and the learning faster.”
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I’m not referring to the slim style of jeans, I’m talking about too-small jeans! A lot of people keep too-small jeans for years in the hopes that they might fit into them someday. But that’s a slippery slope towards keeping a lot of unnecessary clutter in your closet! It’s best to just get rid of them. Besides, if you do end up losing some weight down the line, buying a cute new pair of jeans is a great way to reward yourself!
The loss of muscle mass mentioned above also decreases the number of calories we need to maintain or lose weight, says Goddard. “Additionally, insulin resistance that results from fat deposition in the mid-section can also make losing weight more difficult. Insulin is a hormone. It makes us feel hungry and causes us to store the carbohydrate we eat as fat instead of using it for quick energy,” she explains.
Aim for a breakfast that has plenty of high-fiber carbs: When researchers at the University of Sydney in Australia compared the effects of high-fat and high-fiber-carbohydrate breakfasts, they discovered that people who ate the fatty meal got hungry sooner afterward. "High-fiber carbohydrates take longer for your body to digest and absorb than fats; thus they don't cause rapid changes in your blood sugar, so your hunger is kept at bay longer," says study coauthor Susanna Holt, Ph.D. Some good choices: a bran-rich breakfast cereal with low-fat milk; whole-grain toast topped with low-fat ricotta and sliced banana or berries; an egg-white veggie omelette with whole-grain toast.
If you're scratching your head wondering why your husband can lose 25 pounds in two months by making some simple lifestyle changes, here's why. “Women naturally have a higher percentage of body fat and lower muscle mass than men do,” explains Gillian Mueller Goddard, M.D., endocrinologist at Park Avenue Endocrinology & Nutrition PLLC in New York City. “Muscle is more metabolically active than fat is, it utilizes more energy in the form of calories. The average man is also just larger than the average woman, so it takes more calories to maintain a larger body mass. Between these two differences, men can consume more calories to maintain or lose weight than women can.”
We all know sitting around too much is really bad for our health: One meta-analysis reported that prolonged sedentary time was associated with harmful health outcomes, and many other studies have shown it can (obviously!) lead to weight gain. Limiting your time in front of the TV at night and even trying to stand more while you're at work — perhaps with a standing desk — can increase your metabolism, helping you lose weight with minimal effort.
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Though people are still talking about the lemon juice and cayenne crash diet that got her into Dreamgirls shape in 2006, these days Bey's much healthier detox method is eliminating all animal products from her diet. It's part of her trainer Marco Borges' 22 Days Nutrition plan—and the singer loves it so much, that she even teamed up with him to create a meal delivery service for the company. "There's no frankenfood," Borges tells us. "It's founded on the principle that it takes 21 days to make or break a habit. It's a plant-based diet designed to create lifelong habits that will empower you to live a healthier lifestyle, lose weight or to reverse serious health concerns." (Our social media editor, Kate Winick, tried it to great results.)
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Celebrity trainer Tracy Anderson recently launched a nationwide food delivery program that guarantees weight loss when combined with Anderson's workout methods. With a menu featuring options like Provençal eggs with eggplant zucchini and coconut flan with mango passion fruit sauce, as well as a separate program for vegetarians, it's no wonder Gwyneth Paltrow and Jennifer Lopez are hooked.
“Hormones dictate how our body utilizes the energy we give it,” says nutritionist Lisa Jubilee. “Between our reproductive, thyroid and growth hormones, appetite, insulin, and hunger hormone leptin and ghrelin, our bodies have to perform a tricky balancing act to keep us lean, energized and viable reproductive beings.” Those tasks have become much more difficult because of the hormone residues we consume via cage-raised foods. If you want to give your metabolism a leg up, Jubilee says, switch to organic, grass-fed, pasture-raised beef, eggs, and dairy products, thereby avoiding those nasty hormones at mealtime.
I was the type of person who up until my late 30s could eat whatever I wanted and never work out and rarely gained a pound. If I wanted to “loose” weight meaning the five pounds of holiday weight I had put on all I had to do was start exercising doing some cardio and it fell off. Then all the sudden that stopped and now I am 20 pounds over weight and almost 41 years old and the only way for me to loose weight is to starve. I have been tested for medical conditions, I do not take any medications. I have been to a nutritionist, several actually. I have revamped my diet, I have done weight watchers, I hired a trainer and I work out 6 days a week. I have been told work out less you will be less hungry, did that nada. Cut carbs, cut diary, tried that too. The conclusion I have come to is that due to my small frame (I am only 5’1) I have to work out daily and not eat more than 1200 calories a day if I want to lose weight. I cannot do that, it makes me utterly miserable and angry. I had my metabolism tested via one of those breathing machines and it was so slow. Doctors will never admit that anyone should eat less than 1200 but my doctor looked at me and basically said 1200 is the maximum you can eat. I have never yo yo dieted, in fact I was never on a diet until I was 38, never needed to be. My Mom had the same exact thing happen to her. At this point I have two choices, be miserable and hungry all of the time, or be 20 pounds over weight and be happy, I chose the latter. Trying to live and eat 1200 calories a day every single day, is not reasonable and is a recipe for failure. I compare this to men who don’t want to admit that as they age they need Viagra. All of them say oh no I have sex like a 20 year old, no you don’t. And they don’t talk about their struggles with each other they just boast. For women I think we may just need to accept that extra 20 pounds that comes along with age, rather than fighting a loosing battle and being miserable.
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Are menopausal changes affecting your weight? Many women struggle with weight loss before, during, and sometimes even long after menopause. Weight gain at this time may be related to changes in your hormones. But this is also a time when many women make changes to their daily routines that may affect their weight. For example, after the kids leave home some women are not as busy during the day with non-exercise physical activities like carrying groceries, lifting laundry baskets and other household chores. Evaluate your lifestyle to make sure that a change in your daily habits isn’t affecting your weight.
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Not only does muscle weigh more than fat, but it uses more energy, too. The average woman in her 30s who strength-trains 30 to 40 minutes twice a week for four months will increase her resting metabolism by 100 calories a day. That means you're resetting your thermostat to keep running at that rate even on the days when you don't make it to the gym, Hunter explains.
Salma Hayek is indisputably one of the most stunning women in the world. From humble telenovela beginnings, this Mexican/American beauty became a household name after starring in a slew of Hollywood titles. The 51-year-old scored lead roles in Dogma, The Hitman’s Bodyguard and Frida, which earned her 11 award show nominations. She also has two films in post-production at the moment.
Funny how as your waistline expands, your interest in tracking the numbers wanes. Don't let it. It's no longer advisable to guesstimate your weight by the way your favorite jeans fit (or don't fit). Headlines that scream, "Stop Being a Slave to Your Scale!" are missing the point: Post-40 weight gain sneaks up on you. If the plane symbolizes your body, then its instrument panel is your scale -- it provides you with important data. Once a week, same time, same scale, weigh yourself and see with your own eyes what's happening with your body.
Frustrating? Of course. Impossible? Hopefully not. “You just need to be a little more savvy and prepared,” says Larson. “Be in the best physical and mental health possible right now, so you can move gracefully into the next decade of your life.” Most important, maintaining a healthy weight helps you avoid scary diseases, so you can enjoy a long and happy life—and play with your grandkids.
Brenda stated exactly what so many women have struggled with in the past, including me. As a doctor of gynecology, I frequently get 40-something women in my office working through self-sabotaging menopausal issues including hot flashes, low energy, near-zero libido, weight gain, and weight loss resistance. Hormonal imbalances contribute to many of these problems. When hormones like estrogen, testosterone, and dehydroepiandrosterone (DHEA) nose dive, you’ve got the perfect storm for menopausal miseries. But it doesn’t have to be this way!
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While maintaining and building lean muscle mass is the best way to keep your metabolism humming, research shows that staying hydrated may also increase calorie burn, especially if your beverage is cold and frosty. How? Your body has to heat up icy drinks to reach body temperature, which requires energy. Making your drink of choice green or oolong tea can also give your metabolism an added boost, according to Japanese researchers.
What you drink is just as important as what you’re eating when it comes to weight loss. A 2016 study published in the Journal of Nutrition and Dietetics reveals that well-hydrated people ate up to 206 fewer calories each day than those who skimped on the H20. For middle-aged women, staying hydrated can have particularly profound effects; drinking ice water is a recommended solution for battling the hot flashes that often accompany menopause. For more ways to hydrate and shed those unwanted pounds, add the 22 Best Teas For Weight Loss to your lineup.
You deserve that glass of Scotch or wine, we know. But the unfortunate truth is that your body doesn’t metabolize alcohol as efficiently as you age. So, not only are you going to add on (or not be able to lose) weight because of alcohol, you also wind up looking older and sleeping worse. “[As you age] it will be increasingly difficult to get a good night’s rest with alcohol in your system and sleepless nights lead to carb and sugar cravings the next day,” says registered dietitian Martha McKittrick in 30 Foods You Should Never Eat After Age 30. Meanwhile, alcohol zaps moisture from your skin making fine lines more noticeable and speeding up your skin’s loss of elasticity.
The pro football player turned outfielder for the New York Mets told GQ in February 2017 that he followed the keto diet and reported his favorite source of fat was avocado. The guy really loves avocados, and says he probably eats about four a day, adding them to everything from guacamole to smoothies. He rounds out his diet with eggs, sea bass, steak, and vegetables like asparagus. How I lost 50 lbs at 47 years old | My Weight Loss Journey
SOURCES: Madelyn Fernstrom, PhD, director of the University of Pittsburgh Medical Center Weight Management Center and associate director of the UPMC Nutrition Center in Pittsburgh. Pamela Peeke, MD, assistant clinical professor of medicine at the University of Maryland School of Medicine in Baltimore. Michi Yukawa, MD, MPH, acting instructor, department of medicine, division of gerontology and geriatric medicine at the University of Washington in Seattle.