Exercise For Diabetes

Walk More, Sit Less

When Dr. Bob Sallis called me, he was standing in line at an airport. I was sitting down.

My mistake.

We had scheduled an interview for this article about walking. But the message that he wanted to get out was both about walking and sitting.

“Some of the recent studies are showing that if you sit the rest of the day after exercise you negate the benefits of your exercise,” Dr. Sallis told me. “You have to be conscious of too much sitting.”

One of my wives once told me, only half in jest, that she never stands when she could sit and never sits when she could lie down. That’s only a slight exaggeration of what most of us have become.

I used to sit as much as my late wife did. But last year when I learned that “Standing Helps Heart Health,” I finally got my act together. Soon, I got a desk where I can work standing up.

The message that Dr. Sallis asked me to write is that getting sedentary people to get up and walk just a few times a week will make a tremendous difference in their health. For people with diabetes getting up and out to walk is even more important than for other people. Walking and standing more certainly has improved my health.

“Diabetes is the signature disease for physical activity benefits,” he says. “With it you lower the incidence of diabetes, and you improve the control of it.”

Dr. Bob Sallis told me only that he has been a family physician for 23 years at Kaiser Permanente in Fontana, California. He’s modest. After I interviewed, I looked him up on the Web.

Robert E. Sallis, M.D., FACSM, is the chairman of the American College of Sports Medicine’s Exercise in Medicine initiative. He previously served as president of the American College of Sports Medicine. Now, Dr. Sallis is leading the Every Body Walk! campaign to get Americans — young and old — off the couch and walking for better health. Here is a link to that site’s “Anatomy of Walking.”

He says to do something simple — just get out and walk. “It’s as simple as that.”

I wanted to know how much we should walk. I had heard that we should walk at least half an hour every day. I don’t take a daily walk. Instead I take long hikes of three or four hours two or three times a week. I wondered what Dr. Sallis would say to that.

“Most of the recommendations are for a weekly amount of exercise,” he replied. “You get the maximum benefit from 150 minutes a week at a brisk pace. It doesn’t seem to matter if you spread it over one, two, or three days or if you do a little bit each day. The health benefits appear equivalent. The way your schedule works out that if you can do, say, a couple of hikes a week for an hour and one-half each that is probably good enough. This is comparable to doing five 30-minute hikes a week.”

We have two ways of determining if we are walking at a brisk pace, Dr. Sallis says. We can measure our pulse and estimate our maximum pulse with a simple formula: 220 minus our age in years. He says that we want to keep our heart rate between 50 and 70 percent of our maximum pulse rate. “That would put you at a moderately brisk pace.”

Another way would be simply to gauge by how winded we are. He says that we should be winded enough that we couldn’t sing while we are walking, but aren’t so winded that we couldn’t talk.

Ah, but you are talking about “a brisk pace,” I said. I am a notoriously slow hiker. I can walk as fast as anyone, but I enjoy walking at a slow pace a lot more. Besides, I stop all the time to take photographs for my photo essays.

Dr. Sallis reassured me. “If you go for longer amounts of time at a slower pace,” he replied, “you get similar benefits as you would at a quicker pace for a shorter time. You burn the same amount of calories when you walk a mile as when you jog a mile.”

So far in our discussion, the good doctor had seemed quite flexible. So I asked him a question where I thought that he might still come down hard  on me.

“What about working out at a gym two times a week, like I’ve read we are supposed to do? That bores me. Can I make up for that with more walking out in nature?”

“Sure,” Dr. Sallis replied. “The benefits of resistance training are more strength and endurance and helping to build stronger bones. If you can do it, I think it’s helpful. But certainly you can make up for it by doing more aerobic [like walking] exercise.”

I like to do Tai Chi. Is that a type of resistance exercise?

“Yes,” he replied. “It is of great benefit for flexibility. Some of the studies are showing that doing regular resistance training like weight lifting and Tai Chi can have the same cardiovascular benefits. This offers people the opportunity to select from a menu of things that they like — to select what works best for them.”

We have lots of choices in the types of physical activity we get. The only choice that is out is no exercise.

Dr. Sallis is motivating me, and I hope I can motivate you. I went out for a hike right after he called me and just came back from a walk to the Post Office.

And I made up for my mistake of sitting down when I interviewed him. I wrote this article while standing at my desk.

This article is based on an earlier version of my article published by HealthCentral.

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1 Comment

  • Reply Jill Hixton November 16, 2011 at 3:29 am

    I think that its really good to stand than always sitting down. I think that we should have good exercise to have a healthy life. We should always take good care of our health.

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