There are many myths surrounding the topic of weight loss. Many people think there is one magical exercise, treatment or supplement that will shed those dreadful pounds. The bottom line is it takes proper rest, nutrition and exercise if you want to lose weight. While exercising, perform a combination of cardiovascular exercise and strength training. Both play an important role in weight loss.
Therefore, when you’re following a ketogenic diet plan for beginners, your body is burning fat for energy rather than carbohydrates, so in the process most people lose weight and excess body fat rapidly, even when consuming lots of fat and adequate calories through their daily food intake. Another major benefit of the keto diet is that there’s no need to count calories, feel hungry or attempt to burn loads of calories through hours of intense exercise.

Over the years I've tried many methods recommended by both my friends and family but none of them seemed to work out for me until I chanced upon this holy grail where I've lost almost 33 pounds in just 1 month trying it out! I can now fit in dresses two sizes down and receive many compliments from not only my lovely husband, but colleagues and girlfriends about how great I look right now! I'm here to share with you guys because I really am thankful and hope someone who also needs this can experience similar results as me! Here is the link to my holy grail method! http://bit.ly/flatbelly21dayfix


Dr. Josh Axe, DNM, DC, CNS, is a doctor of natural medicine, clinical nutritionist and author with a passion to help people get well using food as medicine. He’s the author of the books “Eat Dirt: Why Leaky Gut May Be the Root Cause of Your Health Problems,” “Essential Oils: Ancient Medicine” and the upcoming “Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease” (February 2019, published by Little, Brown Spark). He’s a co-founder of Ancient Nutrition, a health company where the mission is to restore health, strength and vitality by providing history’s healthiest whole food nutrients to the modern world.
Exercise is important to gain muscle mess, speed up your metabolism, shape up, improve your heart health, lower your rates of cancer and achieve many other health goals. But exercise is effective only as long as you can stick to it. It’s better to have 3 Pilates sessions a week (even though they are not burning as many calories) than go running once a month. If Pilates is your exercise of choice then it is an excellent way to lose weight and achieve your health goals (check out all surprising benefits of Pilates.)
I have been on a low carb keto diet for more than a year. As T2DM my A1C dropped from 9% to 5.4% & I discontinued meds. All my lipids improved even with ample healthy saturated fat. More than a year now so I wonder why this would be a short term improvement when its obvious that I will not go back to a high A1C and taking 3 diabetes medications including sulphonylureas. It is clear from this article that you lack the necessary experience that would be gained from wholeheartedly trying the diet or monitoring patients doing it properly like me. I would be probably be facing my first amputation if I believed the negativity in your article. So for people with diabetes who may be dissuaded by your article. Ignore it and take back your health by restricting carbs (<25 g a day) or as low as you reasonably can below 130g while being satisfied that you are getting adequate nutrition.

Despite continuous advances in the medical world, obesity continues to remain a major worldwide health hazard with adult mortality as high as 2.8 million per year. The majority of chronic diseases like diabetes, hypertension, and heart disease are largely related to obesity which is usually a product of unhealthy lifestyle and poor dietary habits. Appropriately tailored diet regimens for weight reduction can help manage the obesity epidemic to some extent. One diet regimen that has proven to be very effective for rapid weight loss is a very-low-carbohydrate and high-fat ketogenic diet.[1][2][3]
Essentially, the keto diet for beginners works by “tricking” the body into acting as if its fasting (while reaping intermittent fasting benefits), through a strict elimination of glucose that is found in carbohydrate foods. Today the standard keto diet goes by several different names, including the “low-carbohydrate” or “very-low-carbohydrate ketogenic diet”(LCKD or VLCKD for short).
8. Relax with the marathon workouts. You might feel like a rock star when you double up on fitness classes or outlast the girl on the next elliptical. But unless you're a pro athlete or you're training for a competition, "no one needs to work out for more than an hour and 15 minutes — more is not better," Jackowski says. Overdo it, and you'll set yourself up for stress fractures, insomnia, and exhaustion, all of which could put an end to your exercise routine and stand in the way of your weight loss goals.

3. Fluctuate between different intensities. When you change things up, every system of the body has to adapt, explains Franci Cohen, an exercise physiologist, certified nutritionist, and founder of the Brooklyn, New York-based Fuel Fitness. If that sounds like an awful lot of effort, that's because it is — and that's good. The more work you give your body to do, the more fuel (calories!) it needs to burn to get the job done.


Researchers show that habitual swimmers are biologically 20 years younger than their actual age. According to the data presented by American College of Sports Medicine Conference, habitual swimmer’s blood pressure, cardiovascular system, central nervous system, cholesterol levels and cognitive functioning are all easily comparable to someone much younger than them.
A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.
Regular follow-ups with the dietitian, and medical team, will monitor your or your child’s growth (height and weight, if applicable), health, their epilepsy, and if there is a need for any change to their anti-epileptic drugs (AEDs), such as changing to sugar-free versions. If the diet is followed carefully, individuals do not put on weight, or lose weight inappropriately.
If you haven't used your gym's rowing machine, you're missing out on one of the best pieces of cardio and strength equipment. Working your quads, glutes, hamstrings, core, arms, and back, you get a total-body workout that'll have you pouring sweat. Contrary to what most people think, the power of rowing mostly comes from your legs—not your arms. Engaging your quads and glutes, you drive your legs back to pull the handle towards your chest. Follow these pro tips to perfect your rowing form.
In one head-to-head comparison published in the Journal of the American Medical Association in 2014, researchers analyzed 48 separate diet experiments in which participants were randomly assigned to one of several popular diets. The diets included the low-carb Atkins, South Beach and Zone diets as well as low-fat diets like the Ornish diet and portion-control diets like Jenny Craig and Weight Watchers.
U.S. Masters Swimming encourages adults to enjoy the health, fitness, and social benefits of swimming by providing more than 2,000 adult swimming programs and events across the country, including open water and pool competitions. USMS’s nearly 65,000 members range from age 18 to 99 and include swimmers of all ability levels. The nonprofit also trains and certifies coaches and provides online workouts, a bimonthly member magazine, monthly eNewsletters, and technique articles and videos at usms.org.
In the last few years, the use of the boot camp style (aka high-intensity training) has really taken off. For those of you who need a little bit more than a positive recommendation and a few transformation photos to convince you that joining a boot camp class is a great way for you to lose weight and achieve your fitness goals, here is a bit more information that will help to explain the hype and help you decide if this type of training is really for you.
Sleep enough – for most people at least seven hours per night on average – and keep stress under control. Sleep deprivation and stress hormones raise blood sugar levels, slowing ketosis and weight loss a bit. Plus they might make it harder to stick to a keto diet, and resist temptations. So while handling sleep and stress will not get you into ketosis on it’s own, it’s still worth thinking about.
Chickpeas are naturally high in carbs — a single cup contains 45 grams of carbohydrates.31 However, you can modify the recipe to make it more nutritious. Try this recipe from Pete Evans, which replaces the chickpeas with beetroot.32 Beware, though, that beets have the highest sugar content of all vegetables, so consume them in very controlled amounts.

My personal style of teaching includes a variety of influences – I also teach Booty Barre and have a fitness background, so I like to mix things up. I add in different sequences and exercises from barre and fitness into reformer classes. We use lots of props – I love resistance bands, weighted balls and over balls. I love to throw in jump board intervals. I keep them moving and always emphasize form, form and more FORM! Most importantly, we laugh. They are working hard but smiling and laughing, because its so important to connect your exercise to a feeling of enjoyment and happiness!

Net carbs is simply total carbs minus fiber and non-digestible sugar alcohols, like erythritol. (This doesn’t apply to high glycemic sugar alcohols, like maltitol.) We don’t have to count fiber and certain sugar alcohols in net carbs, because they either don’t get broken down by our bodies, are not absorbed, or are absorbed but not metabolized. (Read more about sugar alcohols here.)


Almost all major and small muscle groups are used to propel you through the water. Different strokes will use different muscles, effectively allowing you to target or use every single muscle in your body during a work out session, given you add variety to your set(s). Water is twelve times more dense than air. Propelling through the water acts as resistance exercise…which is the best way to build muscle tone and strength.
Whether you’re doing cardio or strength, working out in intervals is the best way to maximize your calorie burn in a short amount of time. Alternate between short bursts of intense effort and periods of lower intensity or rest. The intensity resets your metabolism to a higher rate during your workout, so it takes hours for your body to cool down again. This is what's known as EPOC (excess post-exercise oxygen consumption). That means you burn more calories long after you’ve finished your workout compared to doing a workout at a continuous moderate pace, according to a 2017 study from the European Journal of Applied Physiology.
Don't be fooled by the elliptical! It might look an easy machine, casually spinning your legs while watching TV or reading a magazine. But if you crank up the resistance and work at a hard pace, it'll leave you breathless. Be sure to stand up straight to lengthen your abs and engage your upper-body muscles. Making use of the handles and swinging your arms will help you blast more fat and calories. Are you guilty of making any of these common elliptical mistakes? Follow these pro tips to fix them.
"It's great if you practice Pilates regularly, but if you get off your mat and you don't bring anything that you learned in class into the real world, it might not benefit you as much," she said. "Ideally, in a successful Pilates experience, you would come away with an ability to take in new knowledge and understand what you need to improve in day to day life."
15. Rethink your pre-workout snack. Experts disagree on whether non-athletes should eat before exercise. When you work out on an empty stomach, explains Cohen, there's no food for your body to use as fuel, so you default to burning fat right away. While that might sound ideal, the downside is that low energy often accompanies an empty stomach: If you're starving and lethargic, you won't work out at your full capacity. So you could end up burning fewer calories than you might have had you hit the gym with something in your system.
Weight loss is a difficult journey to undertake on your own. It’s great to have support for what you’re going through. There is also so much mis-information out there about weight loss, and having a group to discuss with can help you sift through the BS. I’d recommend the community reddit.com/r/loseit for online weight-loss discussion. For swimming-specific discussion I’d recommend the MySwimPro Community Moments Facebook group. I personally drew inspiration from Patty Deters, a member of the Facebook group who lost 75 lbs by using the MySwimPro app.
Ellipticals are staples in most gyms, but the latest versions are stacked with high-tech, touchscreen consoles meant to put you through the paces with high-intensity interval training (HIIT), a hot fitness trend. Look to the newest ellipticals for features that allow you to quickly and conveniently go from full-throttle effort to a light/moderate recovery pace, and back again. This routine is key for promoting fat loss with interval training. Get even better results on your fitness journey by making sure you avoid these weight loss mistakes most people make.
The University of Florida completed a 3 month study of swimming and determined that certain individuals actually gained weight when following a swimming regiment. This research determined that some people have their appetites stimulated after prolonged exposure to cold water temperatures. Be aware of this and refrain from eating back all those calories you burned during your workout.
But every body is different, and research suggests that some people lose more or less weight than others—even when they do the same amount of exercise. However, making exercises, like swimming, a part of your regular routine can help you reach or maintain a healthy weight. If you’re trying to drop pounds, consider aiming to do moderate or vigorous exercises like swimming for around an hour a day.

Differences between ketosis and ketoacidosis Ketosis and ketoacidosis both involve increased levels of ketones in the body. However, they are not the same thing. Nutritional ketosis is the aim of the ketogenic diet, and it is generally safe, whereas ketoacidosis is a complication of type 1 diabetes that can be life-threatening. Learn more here. Read now

The bulk of our immune system lives along our digestive tract. Consequently, food can have a detrimental impact if it’s promoting things like leaky gut and inflammatory responses. Those conditions hurt energy levels and recovery. Goglia notes there are some basic inflammatory foods: “no yeast, no mold, no dairy, no gluten, no refined sugars.” He recommends replacing bread with single-ingredient carbohydrates such as rice and yams.
The best way to burn fat with a jump rope: While very few people can jump rope for 30 minutes straight, it’s best to do intervals of fast and slow jumps to keep you going. Can’t do that very well? Jump as fast as you can for one minute, then rest for 20-30 seconds. Repeat until you’re done. If you’re a frequent traveler, throw a jump rope in your suitcase for a great workout without ever having to leave the hotel room.

This aerobic exercise strengthens the heart by helping it to become larger; making it more efficient in pumping — which leads to better blood flow throughout your body. Thirty minutes of swimming a day can reduce coronary heart disease in women by 30 to 40 percent. Regular aerobic exercise can reduce blood pressure. Studies have also shown that aerobic exercise like swimming can also keep the layer of cells lining your arteries flexible and in good shape.
But which type of exercise burns more calories? According to a 2012 study in the Journal of Strength and Conditioning Research, running on a treadmill can burn more calories (25 to 39 percent) than doing kettlebell swings at the same level of exertion. However, the study also suggests that kettlebell work and other forms of strength training can help increase your metabolism, so you burn more fat and calories even during rest.

Keeping your elbows pinned to your sides and your abs pulled in and up, begin jogging and lifting your knees hip-height as you do (A). After about eight knee lifts, and without breaking stride, begin kicking your bottom with your heels (B), keeping your elbows pinned and your chest lifted. After eight bottom kicks, either move on to the next exercise or complete another set, this time reducing your lifts and kicks to six, then four, then two.

If in doubt, start at a lower level. You can always skip ahead if you feel it is too easy or switch to a more difficult plan. The great thing is that all of the plans burn calories and all of the plans require commitment. As long as you give it your best at every workout (and watch your calorie intake!), you will make progress, will burn calories, will drop the pounds and will get stronger.

The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.

Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!
Cut out or at least cut way down on wheat and dairy. This is due to the way they are manufactured these days more so than anything. There are entire books written on this. Because of genetic engineering of wheat, there are tens of brand new gluten proteins created that our bodies don’t know how to process. This is causing symptoms like brain fog, irritability, fatigue, bloating, digestion issues and weight gain. No thanks! Dairy is also a very common irritant to many that don’t realize it. There are so many healthy alternatives these days that it’s not hard to go dairy and wheat free. It has made a huge difference for many of my clients as well as for myself.
When you take a swimming lesson, you can learn about different strokes, such as the crawl, backstroke, and the butterfly. Many people who know how to swim are familiar with a few of them, but a lesson can help you identify the best stroke for your body. There are some strokes that are less strenuous than others, which may be more appropriate if you are out of shape.
Plan some rewards for your hard work. For example, give yourself a reward when you have ridden your first 100 miles. And the first 200 … and so on. Pick a reward you like that will not actively sabotage your goals! For example, reward yourself with a puppy when you hit 1,000 miles. That way, you will have to start doing some walking as well! My dogs cause me to go for a walk every single morning, which has to be a good thing.
EAT BREAKFAST within an hour of rising and continue to eat smaller, well balanced meals (think lean protein, good complex carbs and good fats ) throughout the day every 3 hours. If you don’t plan out what you will be eating the next day, this easily falls by the wayside, so get in the habit of making food ahead of time – hard boiled eggs, grilled chicken, cut up raw veggies.
It is also useful to record your weight loss progress with a good fitness app. Personally I find the free version of My Fitness Pal works really well. It has a great calorie counter, and it is easy to use it to record your rides. I tried pairing it with Strava, and found this did not work that well – I had to keep correcting the automatic exercise records. For example, if I recorded a hike with Strava, My Fitness Pal would record it as an (extremely slow) bike ride! Other than that, it is a great fitness app.
If your goal is to try to lose weight, you might want to consider doing cardiovascular exercises as opposed to weight training. Cardio training is important for burning fat and losing weight, whereas weight training helps to tone and maintain muscle mass. Cardio work that increases the heart rate and breathing is more effective at burning fat than is adding muscle.
Use organic, virgin coconut oil for everything! I take a tablespoon every morning. I use it to cook. I mix baking soda with it to cleanse and exfoliate my face. I condition my hair and cuticles with it. I use it under my eyes at night and on my lashes, that I swear are longer and thicker! Coconut oil has unbelievable properties – anti-microbial, healing, metabolism booster, increases skin texture and elasticity and improves immune function to name a few. Just use it, you won’t regret it!

Hi Barb, That can definitely be it. Losing when you are close to goal can be more difficult. It could also be that your body’s healthy weight is a little higher than what you’d like – which doesn’t mean you can’t lose, but makes it more difficult. If just eating Keto foods isn’t working, double check the macros for your weight and see if the amount you’re eating needs to be adjusted. You’ll find more help and support in our support group here.

Here's the thing: Working out isn't enough on its own to make weight loss happen. There's so much else that goes into weight loss and body fat loss; in fact, exercise isn't even technically necessary in many cases. If you want to lose weight—and it's totally cool if you do and totally cool if you don't—adopting healthy eating habits has got to be step numero uno. To get technical, you need to create a calorie deficit, which means using more calories in a day than you consume—and the consumption part plays a much bigger role in that than burning calories in the gym, or while carrying your groceries home, or any of the other myriad ways you put your muscles to work each day. Other lifestyle habits, like sleep and stress management, and health conditions (think thyroid issues, to name just one of many) also affect your weight. Point is, weight loss is a complicated and extremely personal journey that doesn't look or work the exact same way from one person to the next.

Near the start of 2018, I decided that I needed to make a change. I made a promise to myself that I would work out 4 times a week, focus on my diet, and make a lifestyle change before my health got any worse. I’ve been working on MySwimPro for almost 3 years and was always finding excuses for not swimming regularly. I was now determined to figure out how I could stick to a plan and not bail.


To maximally reduce your body fat percent, you’re going to have to start in the kitchen. You may have heard the saying that abs are made in the kitchen, which is true - you can lose fat and not even pick up a single weight or run a single step. But in order to build muscle, increase muscular strength and cardiovascular fitness, you’re going to have to hit the gym. So, to stimulate as much fat loss as possible, your program will consist of 3 full body workouts per week (alternating between Workout A and Workout B) with 2 days of cardio and 2 days off.
Whether you love or hate it, running is one of the best and simplest ways to burn calories. And, you don't need a treadmill to do it. Just lace up your shoes and hit the road. But pounding pavement doesn't have to be a mindless workout. Running in intervals—speeding up and slowing down your pace—will help make the minutes and miles go by quickly. Run in fartleks, which means speedplay in Swedish, where you pick up the pace every other street lamp or water hydrant you hit, and then slow down after you pass the next one. Follow these running tips in the video below:
Keto diets "can help us lose weight, but compared to other diet strategies, they're not more helpful," said Melissa Majumdar, a dietitian at the Brigham and Women's Center for Metabolic and Bariatric Surgery, and a spokesperson for the Academy of Nutrition and Dietetics. Much of the weight lost in the initial stages of a keto diet is water weight, because carbohydrate stores in the body carry water molecules with them, Majumdar told Live Science. That can move the scale an exciting amount initially, but weight loss inevitably slows with time.

Meat products make up a big part of the keto diet, but experts stress the importance of choosing quality. "Since the keto diet is based a lot on animal proteins, it's important to buy organic poultry and grass-fed, organic beef," says Aimee Aristotelous, RD. "Not only do organic selections help with limiting environmental toxins, but grass-fed options of red meats even change the composition of fats." The result, she explains, is that your body is able to better absorb those healthy fats.


Most surprising to me, though, is that if you're upping your fiber intake but not also regularly filling up your water bottle, things tend to get a wee bit, er, backed up. "It's important to add fiber gradually and increase water intake at the same time. Otherwise, instead of helping with digestion, fiber may actually lead to constipation," notes Anna-Lisa Finger, R.D., a certified personal trainer and dietitian. Turns out, I often consume nearly double the recommended 25 grams of fiber daily. Gulp. (Related: Is it Possible to Consume Too Much Fiber?)
The end result of the “ketone diet” is staying fueled off of circulating high ketones (which are also sometimes called ketone bodies) — which is what’s responsible for altering your metabolism in a way that some people like to say turns you into a “fat-burning machine.” Both in terms of how it feels physically and mentally, along with the impact it has on the body, being in ketosis is very different than a “glycolytic state,” where blood glucose (sugar) serves as the body’s energy source.
We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.
The stroke that will burn the most calories is unsurprisingly the butterfly and you can burn even 150 calories in 10 minutes using this style. But, as you might now, this requires some swimming skills and most of us would have difficulty swimming with that stroke for 10 minutes. That’s why we recommend the next best thing which is freestyle – it is much easier to learn and to swim with and it is still a great choice if you want to lose some unwanted weight.

But when it comes to which type of cardio is best for burning fat, you have to decide which lean body type you’re going for. “If you train like a distance runner, you’ll get a distance runner’s body: little muscle, very lean from lots of miles logged at relatively slower paces,” explains Chris Ryan, C.S.C.S., a physical trainer and the founder of Chris Ryan Fitness. “If you train like a sprinter—short, high-intensity workouts—you’ll get a sprinter’s body with muscle growth and fat loss.”
This will depend on your level of fitness. If you’re just starting swimming for weight loss purposes, start with 30 minutes of moderate intensity and incrementally increase your time each week. You should commit about 3-5 days per week to swimming if this is your main form of exercise. You can always add resistance gear to up the intensity and calorie burning!
An hour of Pilates a few times per week is unlikely to lead to rapid weight loss, but by evaluating your daily calorie intake, you can achieve weight loss with Pilates. Because counting calories can be a challenging process, the American Council on Exercise recommends reducing the size of your meals by 10 to 15 percent, filling your diet with healthy, low-calorie foods and cutting out your consumption of alcohol, which is loaded with empty calories.
At the other end of the scale is ‘High Intensity Interval Training’ or HITT. This involves pedalling really hard for short intervals with easy breaks in between. These rides burn through carbohydrate stores and you’ll need to up your carbohydrate intake on the day you complete one. Though they don’t specifically burn fat, some experts still believe these sessions are best for weight loss because the high intensity means you burn more calories during the day and you’ll also build more muscle through a session like this.

It starts with limiting carbohydrate intake to just 20–30 net grams per day. “Net carbs” describes the amount of carbs remaining once dietary fiber is taken into account. Because fiber is indigestible once consumed, simply don’t count grams of fiber toward their daily carb allotment. So that means subtracting grams of fiber from total carb games, to give you the total net carbs.

Keto is not hard to follow at all. See, this is why I took my diet and nutrition into my own hands. I have PCOS and the ketogenic diet has worked wonders for me. I’m finally pregnant at the age of 32 and after 11 years of marriage because the ketogenic diet made me lose over 100 lbs and brought my insulin resistance under control. I feel better than I’ve ever felt. Sometimes doctors don’t seem to know as much as they should, or as much as they assume they do, and that’s pretty disturbing. Just like they’re still using the old school and very inaccurate BMI charts that are just pure bs. I’ll just take care of myself outside of certain situations involving illness or injury. I’m doing great on my own.
There is much debate about which of these ways of exercising is better for fat-burning. The consensus seems to be that interval training is more effective for fat burning, gets you fit faster, and is the most effective for fighting aging. The Journal of Applied Physiology reported that two weeks of alternate-day interval training boosted cyclists’ fat-burning ability by a whopping 36%. And the Journal of Cell Metabolism reported that high intensity interval training on bikes was the most effective way for people to fight aging – with the positive results being most pronounced in older people.
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