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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Exercise'

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Exercise to Control A1C

June 12th, 2011 · 1 Comment

For years the experts have been telling us that exercise is important for us to control our diabetes. But they never told us how important it is.

Even the experts didn’t know. Until now.

Tomorrow, the American Medical Association’s professional journal, JAMA, will publish a systematic review and meta-analysis of previously published studies. Each of those studies was at least 12 weeks long and randomized and controlled clinical trials. Meeting these criteria were 47 trials that included 8,538 people.

Daniel Umpierre of the Hospital de Clinicas de Porto Alegre, Brazil, and eight colleagues call their meta-analysis “Physical Activity Advice Only or Structured Exercise Training and Association With HBA1c Levels in Type 2 Diabetes.” JAMA made the full-text of the meta-analysis available to me under embargo until this afternoon, and the abstract is online.
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Posted in: Exercise

The New York Times: “Is Sugar Toxic?”

May 21st, 2011 · 1 Comment

In 1961 I started to read The New York Times when I went to work in Washington. But its magazine always disappointed me.

Until Sunday. This week’s issue focuses on “Health and Wellness 2011.” All four of the magazine’s main articles are essential reading for everyone.

The cover story by Gary Taubes, “Is Sugar Toxic?,” makes the case against sugar. This isn’t his first time to tilt at the medical establishment in this magazine. Nine years ago his article, “What if It’s All Been a Big Fat Lie?,” began his crusade to expose the myth that fat was bad and carbohydrates are good.

His 2007 book, Good Calories, Bad Calories, built on that article so well that it convinced me and thousands of others to follow a very low-carb diet. In “Addicted to Carbs” I wrote here three years ago about how that book changed my life. With his book, Why We Get Fat: and What to Do About It, Taubes takes his argument to a wider, non-scientific audience.

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Posted in: Exercise, Food

Doing Tai Chi for Balance

March 3rd, 2011 · 1 Comment

When you have diabetes, you know that falls come with the territory. If you are a senior citizen, this is doubly true.

Even worse is when you hike a lot on mountain trails, as I do. In the past few years I took several tumbles, fortunately not falling off a cliff or breaking a hip.

That never worried me much, but I was concerned that a fall could bring back an old knee injury that not long ago had made climbing difficult. When you are 75 years old with a history of 16 years of diabetes and a hiker, you’ve got to be careful.

And just being careful isn’t enough. All of us who have diabetes, who have more than a few years of life experience, or who hike need good balance.

So when a friend told me last year that the Tai Chi Chuan she was learning improved her balance, I listened. I remembered that Tai Chi is an ancient Chinese martial art that millions of people around the world practice for its defensive training or its health benefits. Tai Chi enhances our balance and body awareness through slow, graceful, and precise body movements.

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Posted in: Exercise

Walking Meditation

March 3rd, 2011 · No Comments

As I hiked out of the wilderness all I could think about was how much my feet hurt. It was one of the most wonderful experiences of my life.

Wearing a brand new pair of boots on a long backpacking trip into West Virginia’s Dolly Sods Wilderness about 35 years ago could have been a big mistake. The new boots gave my feet terrible blisters, and I had forgotten to take any moleskin. Returning to the trailhead after four or five days, I knew I had just one other way to control the pain. Deliberate walking meditation put my entire consciousness into my feet.

I don’t punish my feet any more to get the high that walking meditation brings. But I still hike or walk and meditate at the same time.

A leading exponent of walking meditation is Thich Nhat Hanh, a Buddhist monk, teacher, author, poet and peace activist who is one of the important influences in the development of Western Buddhism. His book with Nguyen Anh-Huong, Walking Meditation (Sounds True: Boulder, Colorado, 2006), says that when we practice walking meditation, “We walk for the sake of walking…We walk slowly, in a relaxed way, keeping a light smile on our lips.”

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Posted in: Exercise, Psychosocial

The Korean Paradox

November 30th, 2010 · 4 Comments

South Korea is different from the United States.

In some important respects this Asian country is more like America than most of us would think. This country is a democracy with a booming economy.

But the differences are great and go beyond Korea’s use of a different language and even a different alphabet than Westerners use. The differences go far beyond history and tradition. The biggest differences that I have seen during my visit this month are in the people themselves.

I saw with my own eyes how thin almost all Koreans are. Coming from the United States — even though I live in the thinnest state — I have been amazed to see almost no obesity here.

So, of course, I expected that almost no one in Korea would have diabetes. After all, didn’t the American weight problem lead to the rapid rise of diabetes in our country?

We know that some sort of link between being overweight and having diabetes exists. We do know that being overweight doesn’t cause diabetes, because two-thirds of American are overweight and about one-tenth of us have diabetes. But as our weight has gone up so too has the proportion of people with diabetes. Those two conditions have to have some association. [Read more →]

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Posted in: Exercise, People

A Stand-Up Guy and His Desk

November 13th, 2010 · 2 Comments

When I tell you that I am a stand-up guy, I wouldn’t blame you for assuming that I was boasting. After all, part of the standard Mafia definition of this term is one who “can be trusted.”

While I do hope that you can trust me, I call myself a stand-up guy because one of my own posts here inspired me to stand up a lot more. So, when I say that I am a stand-up guy, this is a fact, not a boast.

In a post here, “Standing Up for Your Heart,” I reviewed a study by Alpa Patel, Ph.D., and her associates that explored the connection between sitting and mortality. They found that the amount of time people spend sitting is associated with an increased risk of death from heart disease, which happens to be the biggest complication of diabetes.

When I digested the impact of that study, it reinforced my long-standing plan of converting my computer time from sitting to standing. Dr. James Levine, a Mayo Clinic endocrinologist, was my original my model. Four years ago I wrote here about how he mounted his computer over a treadmill, and while he works, he walks at the rate of 0.7 miles per hour.

Even before reading the new study led by Dr. Patel, I had told Abhijit Mhapsekar, who programs my mendosa.com website, about walking on a treadmill while he worked. I knew that it would help heal his bad back. And Abhijit actually did get a treadmill with his computer mounted over a desk.

But I dawdled. My apartment doesn’t have enough room for a treadmill and treadmill desk in addition to the wonderful teak desk that I’ve had since 1969.

Instead, I priced stand-up desks on the Internet and a local store for me to use without a treadmill. Those desks run from $1,300 to $,2300. And they weren’t awfully stable.

Instead, I had a handyman make me a stand-up desk. It is as simple as possible: just two tracks screwed into the wall with three brackets that are adjustable (and I have already adjusted them), with a board 24 inches deep by 43 inches wide, large enough for one of my computers and accessories. The new desk ran me about $300 and is very stable. Anyone with more skill than I have could make one for much less.

When I commissioned my new stand-up desk, I expected to use it a small part of the time. In fact, I now use it much more than my old desk.

I also think more clearly when I am standing up. Judge for yourself. I wrote this standing.

As a writer, I have always known that I learn more from my articles than even the most diligent readers do. This is just like teachers learn more than their students because of all the preparation that goes into their lessons.

And as a caring person my goal in life is to help other people who like me have to live with diabetes. The Talmud says that “to save one person is to save the world,” and even if I haven’t moved you yet to stand up more, my review of Dr. Patel’s work already inspired both Abdijit and me to get off our butts more.

That’s not all. After I got my new stand-up desk I told Dr. Patel about it. “Congratulations! I hope to move from sitting on my exercise ball to a stand-up desk soon myself.”

Can I inspire you too?

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Complications, Exercise

Weight Control Registry

June 29th, 2010 · No Comments

The National Weight Control Registry is the best guide we have showing us how people actually lose weight and keep it off. These are the people who have succeeded in a major weight loss program and in keeping off the pounds.

Diabetes doctors typically tell us to loose 10 percent of our body weight. I know from my own experience that this helps to control our blood glucose level. And I know too that getting down to a normal body mass index, or BMI, is even better for maintaining a low A1C level.

The National Weight Control Registry started in 1994 and now tracks more than 5,000 people. And because I am one of them, the people at the registry sent me a copy of a publication that summarizes their findings as thanks for returning a one-year questionnaire. The article, “Long-term weight loss maintenance,” appeared in the American Journal of Clinical Nutrition.

To be included in the registry, people have to be at least 18 and have kept off at least 30 pounds for a year or more. I reached that milestone four years ago. And a couple of years ago my friend Gretchen Becker encouraged me to share my results with the registry.

I haven’t seen any statistics about how many of the people included in the registry have diabetes. But I know that my weight loss strategies have been different from most. Using Byetta got me started with my weight loss program, and a very low-carb diet intensified it.

Most people, however, say that they have lost weight by following a low-calorie, low-fat diet. Without question, weight loss means a low-calorie diet. Almost certainly, following a diet of any sort is also a key to success. In fact, participants who maintained a consistent diet during the week and year after year were much more likely to maintain their weight than those who varied their approach.

Other keys include:

Eating breakfast every day, followed by 78 percent of registry members.

High levels of physical activity. Fully 94 percent report that they get more exercise now than they did before they lost weight, and 90 percent report that on the average they exercise an hour a day. Walking is the most common activity, reported by 78 percent of the participants.

Regular weighing. More than 44 percent report that they weigh themselves at least once a day.

I know from my own experience that when my scales broke in February just before I went on a long trip that not weighing myself regularly was disastrous for my weight. In a three-month period I gained 12 pounds and am now fighting to take them off.

The really good news is that it gets easier. People who successfully maintained their weight loss for two to five years had a much greater chance of long-term success.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Exercise, Food

Vacation Control

April 30th, 2010 · No Comments

At the end of my five-week vacation on the South Island of New Zealand I am returning to the reality of my everyday life with diabetes. For me, reality means controlling my blood glucose level with diet and exercise. Since 2007 I haven’t had to use any diabetes medications to keep good control.

But, like all of us, I do have to watch my diet and exercise. And like most people on vacation my attention sometimes wandered.

While I have diligently following a very low-carb diet since 2007, I readily admit that I enjoyed a few servings of potatoes in New Zealand. Worse, I ate two slices of toast. While I have broken my addiction to all types and forms of grain, the toast in eggs benedict was sometimes impossible for me to ignore.

On the other hand, I ate more seafood than ever before in my life. Seafood is our best source of heart-healthy omega-3 fats. I ate everything from the well-known salmon, prawns, shrimp, oysters, and calamari to butterfish, groper, smooth dory, gurnard, ling, monkfish, and blue cod and on to fish I never heard of before — warehou, tarakihi, whitebait, bluenose, trumpeter, and green shell mussels. They all tasted wonderful to me while at the same time helping to balance out my dietary lapses.

Wild game also has a better ratio of omega 3 to omega 6 fats. That helped me to feel virtuous while enjoying a venison cassarole that a ranger on the Milford Track prepared for my lunch. I wrote about this and my other New Zealand adventures on my “Fitness and Photography for Fun ” blog.

Normally, I minimize the amount of fructose that I eat, since it’s so hard on the liver. I do eat some berries when I am at home. The berries that I especially enjoyed in New Zealand are called kiwiberries, miniature (grape-sized) versions of the kiwi fruit we have in America. But kiwiberries are especially sweet and juicy.

New Zealand is rightfully famous for its dairy products. I don’t think that the country has any of the infamous concentrated animal feeding operations (CAFOs), where we tightly pen our lifestock and chickens and feed them a grain diet, which in turn worsens our omega-3 to omega-6 ratio.

New Zealand dairy products are therefore not only healthier than most of ours but also taste better. I particularly enjoyed their cheese and their “Fresh’n Fruity” brand of natural (no fruit) Greek style yoghurt (as they spell it).

The other major deviation from my diet besides some additional carbohydrates was going back on coffee after almost a year without. I stopped drinking coffee because it was giving me awful headaches. But I can handle one cup a day now. I make sure that it’s a good cup, which the Kiwis do know how to make. In all the better restaurants I can find excellent coffee that is somewhat diluted espresso that for some reason the Kiwis call a “long black.”

In contrast to my somewhat slacker dietary habits on vacation I have been walking and hiking more than usual. I convinced myself that I need the extra calories to give me strength on the trail. I’m hoping that it has been a wash.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Exercise, Food, People

Winter Walking Destinations

February 17th, 2010 · No Comments

This morning I got my exercise by shopping for food. After the weekend I didn’t have anything in my apartment that I wanted to eat for lunch and dinner.

So I walked about four and one-half miles to the nearest natural foods store, which is a Whole Foods Market. I picked up salad greens for lunch, grass-fed ground beef for dinner, and a few other items that I needed. Then, I walked back home with my groceries in my daypack.

This was a winter walking destination for me. During the rest of the year I get my exercise every other day or so with a long hike in the Rocky Mountains that rise just west of here. Now, in the winter, I still get up there, but on my snowshoes and less often than the hikes at other times of the year. [Read more →]

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Posted in: Exercise

Exercise May Reduce Belly Fat

October 11th, 2009 · 3 Comments

When we have a lot of belly fat, we are at greater risk of heart disease because of the inflammatory molecules that this fat produces. But a new study by scientists at the University of Illinois suggests that even moderate amounts of exercise can reduce the inflammation.

Since people with diabetes are at an especially high risk of heart disease, this is an encouraging finding for us.

The study examined the effects of diet and exercise on the inflammation of visceral fat tissue — belly fat — in mice. Maybe people will react differently, but only the sedentary mice got the inflammation that usually results from having big bellies.

“The surprise was that the combination of diet and exercise didn’t yield dramatically different and better results than diet or exercise alone,” says Victoria Vieira, a University of Illinois Ph.D. candidate and the study’s lead author. [Read more →]

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Posted in: Complications, Exercise