Exercise and Diabetes

The latest research has shown that exercise is very helpful in the prevention, control and treatment of diabetes because it decreases insulin resistance. Following regular exercise training, cells can better respond to insulin and effectively take glucose out of the blood and into the cell. Exercise also helps to decrease the risk of cardiovascular disease by decreasing blood pressure, cholesterol levels and body fat.

Exercise Recommendations

If you have type II diabetes, you should adhere to the following exercise guidelines:

·         Always consult with your physician before starting any exercise program to determine the potential risks associated with exercise.

·         Cardiovascular exercise—Strive to accumulate a minimum of 1,000 kcal expended through physical activity each week. Pending current conditioning levels, this may require three to seven days per week of low-to-moderate intensity exercise for 20 to 60 minutes (walking and other non-weight bearing activities such as water aerobics and cycling are good choices). Daily exercise is highly recommended.

·         Resistance training—Perform resistance-training activities at least two days per week, targeting the major muscle groups. Complete a minimum of one set of 10 to 15 repetitions of each exercise at a low-to-moderate intensity.

·         Flexibility—Perform stretching exercises at least two to three days per week, stretching major muscle groups to the point of tension (not pain) for 15 to 30 seconds. Complete two to four repetitions of each stretch.

·         The ultimate goal is to expend a minimum of 1,000 calories per week via physical activity for health benefits, or 2,000 calories per week for weight loss. Keep in mind that these are goals that you should work up to gradually over time.

What are the precautions?

If you have type II diabetes, you must monitor your glucose before and after exercise to understand how you respond to certain types of activities.  Finally, don’t forget to check with your physician prior to beginning a physical-activity program and return regularly to assess the diabetic complications. If complications of the eyes, kidney or heart are present, your physician should provide you with clear boundaries regarding the intensity of any physical activity.

Cross Training

Cross-training is simply a way of adding variety to your exercise program. You can vary your aerobic routine and incorporate some muscular strength and flexibility training as well.

Athletes have been cross-training since the days of the Olympic decathlons and pentathlons of ancient Greece. The past decade has seen the popularity of the triathlon reach international proportions, introducing the concept of cross-training to even the most recreational athletes.

The benefits of cross-training are numerous. It reduces the risk of injury because the same muscles, bones and joints are not continuously subjected to the stresses of the same activity.

Cross-training also adds variety to your workouts, making your routine more interesting and easier to stick with. For the athlete, it provides a break from the rigors and stresses of single-sport training. Cross-training will improve your overall fitness and, over an extended period of time, may ultimately lead to improved performance.

Whether you are new to exercise or you are a competitive athlete, the essentials of cross-training are the same. You can choose to vary your routine from workout to workout, or simply add a new component to your existing exercise program.

One of the easiest ways to start cross-training is to alternate between activities—walking one day and swimming or bicycling the next. Or, you can alternate these activities within a single workout, spending five minutes on a treadmill, five minutes on a stationary cycle, and so on for a total of 30 minutes.

More experienced exercisers might begin an hour-long workout with a 15-minute jog to a nearby pool. After a 20-minute swim and perhaps a few minutes of calisthenics, they can finish off their workout with a 15-minute jog back home and several minutes of flexibility exercises.

If you’re looking to increase your endurance level, try alternating low-level aerobic activities, such as 20 minutes of stationary cycling, with 10 minutes of higher-intensity exercise, such as stair-stepping or jumping rope. Gradually increase the amount of time you spend on the more intense activity.

These formulas can be used with just about any type of activity—as long as you enjoy it. Combining a group of aerobic activities into one workout at steady or varying intensities is an excellent way to fight the boredom that comes from performing the same daily workout routine.

All exercise sessions, whether they involve cross-training or not, should begin and end with low-level aerobic exercise and stretching to effectively warm up and cool down. And remember, it’s always a good idea to check with your doctor before beginning a new exercise program. 

Benefits of Strength Training

Anyone can benefit from strength training. A well-designed strength-training program can provide the following benefits:

Increased strength of bones, muscles and connective tissues (the tendons and ligaments), this increased strength decreases the risk of injury.

Increased muscle mass—most adults lose about one-half pound of muscle per year after the age of 25, largely due to decreased activity. Muscle tissue is partly responsible for the number of calories burned at rest. As muscle mass increases, it will be easier to maintain a healthy body weight.

Enhanced quality of life—as general strength increases, the performance of daily routines (carrying groceries, working in the garden) will be easier to perform.

Many exercises can be combined into a program that works all the major muscle groups. Neglecting certain groups can lead to strength imbalances and postural difficulties. I can help you develop a safe, effective program. One set of 8 to 12 repetitions, working the muscles to the point of fatigue, is usually sufficient.  When you are able to perform 12 repetitions of an exercise correctly (without cheating), increase the amount of resistance by 5 to 10% to continue making safe progress.

An encouraging aspect of strength training is the fact that you’ll likely experience rapid improvements in strength and muscle tone right from the start of your program. Don’t be discouraged, however, if visible improvements begin to taper off after a few weeks.

It’s only natural that, as your fitness level improves, improvements in strength and appearance will come at a slightly slower pace. To help keep your motivation up, find a partner to train with you.

Aim to exercise each muscle group at least two times per week, with a minimum of two days of rest between workouts. Training more frequently or adding more sets may lead to slightly greater gains, but the minimal added benefit may not be worth the extra time and effort (not to mention the added risk of injury).

Four Exercise Myths

Myth 1: Stretch first.

Many of us were taught to perform stretching before a cardiovascular or strength-training workout. It was part of the warm-up and believed to help prevent injuries. Yet, there’s no scientific evidence linking reduced risk of injury or post-workout soreness with a regular stretching routine. Recent studies indicate that pre-event stretching can actually impair performance in sports requiring explosive power, like jumping or sprinting. While flexibility training helps maintain a full range of motion around joints, for optimal results, stretch after your workout.

Myth 2: Don’t let your knees go past your toes while doing a squat or lunge.

Avoiding excessive forward movement of the knee during a squat or lunge is important. However, in everyday activities such as climbing stairs, the knee and torso naturally move forward slightly in parallel with each other for balance — and to propel the body forward and upward. Restricting this movement when performing squats and lunges increases hip stress and could increase the load on your lower back.

Myth 3: To burn fat, exercise at a lower intensity.

Forget the “fat-burning zone”, or low intensity zone. Just get out there and move. Your body burns both fat and carbohydrate calories to meet the demands of exercise. The proportion of fat or carbohydrate burned in a given workout depends on exercise intensity and duration, but when it comes to weight control, the type of calories burned with exercise doesn't really matter. If you burn more calories than you consume, you’ll lose weight. If you don’t, you won’t.

Low-to-moderate intensity exercise can be sustained for longer periods than higher-intensity exercise, which burns more calories per minute. Base your exercise intensity on your goals, your fitness level, health status and how it makes you feel. Don’t worry about whether you’re burning fat or carbohydrates. For weight control, the key is to choose an intensity level that makes your exercise program sustainable.

Myth 4: Strength training will make you gain weight.

If you’re concerned about preventing weight gain, strength training is actually something you should be doing. On average, adults who don’t engage in any strength training exercises lose about 4-6 lbs. of muscle tissue per decade, silently chipping away at their resting metabolic rates. Unless caloric intake is also reduced, fat weight tends to increase.

Belly Fat

A new study reports that even normal-weight people with belly fat and heart disease have an increased risk of death compared to folks whose fat is concentrated elsewhere.

Belly fat is as significant a risk factor as smoking a pack of cigarettes a day or having very high blood cholesterol, the study said. And the risk is greater for men.

That spare tire is even more significant than your overall body mass index (BMI, a ratio of weight to height) in predicting risk of death, the researchers said, noting their findings discount a puzzling theory known as the "obesity paradox." That surprising finding from earlier studies linked a higher BMI and coronary artery disease with better survival chances than normal-weight people.

BMI is just a measure of weight in proportion to height. What seems to be more important is how the fat is distributed on the body," she said in a clinic news release.

The study is published in the May 10 issue of the Journal of the American College of Cardiology.

The researchers looked at data from five studies conducted around the world, involving almost 16,000 people with coronary artery disease. The risk of death was nearly doubled for people with coronary artery disease and central obesity, which was determined by waist circumference and waist-to-hip ratio, the study found.

What exactly is the difference between belly fat and thigh fat, for instance?

"Visceral [belly] fat has been found to be more metabolically active," Dr. Francisco Lopez-Jimenez, the study's lead investigator and director of Mayo's Cardiometabolic Program, explained in the news release. "It produces more changes in cholesterol, blood pressure and blood sugar. However, people who have fat mostly in other locations in the body, specifically the legs and buttocks, don't show this increased risk."

http://www.acefitness.org/findanacepro/acecertifiedprofessionalprofile.aspx?acecp=282388

Balance Exercises

http://www.youtube.com/watch?v=AWuKEt96Jjs

Exercising Vigorously

Exercising vigorously may boost calorie burn for hours afterward. The calorie-burning benefits of exercise do not stop after the treadmill does. A study finds that after exercising vigorously, a substantial calorie burn may follow.

The small study involved 10 healthy men, age 22 to 33, of various body mass indexes and aerobic fitness levels. Their calorie expenditure was measured after they exercised vigorously for 45 minutes, as well as on a rest day. Activity, rest, plus eating meals and snacks were all done under carefully controlled conditions so researchers could get an accurate assessment of calories taken in and burned.

The 45-minute exercise session (done on a cycle ergo meter) burned an average 519 calories -- not bad for a workout. But the big news is what came afterward. In 14.2 hours following the exercise bout, calorie expenditure was elevated, resulting in about 190 extra calories burned.

While that may not seem like much, think of it as being able to eat about three Pepperidge Farms Milano cookies with no consequences, or getting the calorie burn of a 30-minute walk at 4 mph for free.

The authors wrote that the calorie burn could be substantial if two or three of those high-intensity bouts of exercise are done a week, and eating is kept under control.

The study appears online in the journal of Medicine & Science in Sports & Exercise.

Strength Training for Osteoporosis Prevention

Some middle-aged women can lose up to 20-30% of their peak bone mass during their menopausal years. Especially if they are inactive, not taking calcium or utilizing hormone replacement therapy. This can increase their risk of fracture by 40% over their lifespan. The best program (Bone, Estrogen, and Strength Training study) began in 1995 to see how strength training may affect bone density.

While weight-bearing exercises are said to have the best value for bone density, strength training is often overlooked. The best program's main objective was to explore a high load, low repetition approach to strength training. Over 260 women ranging in age from 45-65 who were postmenopausal for 3-10 years were used in the study. These women completed 2 sets of 6-8 repetitions at 70% of 1 RM, two days per week or 80% 1 day per week.

The study found that women who lifted weights 2 or more times per week had greater bone density effects. It is important to remember that this program was designed to prevent osteoporosis, not to treat it, since the best treatment is prevention. Therefore, strength training is extremely important for those women who have a family history or medical condition that could lead to osteoporosis in order to decrease the loss of bone density. Not to say, that, if you do have osteoporosis, there is no need to strength train. Lifting weights and walking should help to keep the condition from worsening.