To avoid developing diabetes, or to help reverse it, you need to build exercise into your weekly routine. The combination of the optimal diet and optimal exercise in a winning formula. According to a comprehensive review by the American Diabetes Association you need to do two types of exercise – aerobic and resistence:
Aerobic exercise
To improve glycaemic control, assist with weight maintenance, and reduce risk of cardiovascular disease, American Diabetes Association recommends at least 150 minutes per week of moderate-intensity aerobic physical activity.
The physical activity should be distributed over at least 3 days per week and with no more than 2 consecutive days without physical activity.
Even better is doing slightly shorter sessions, maybe high-intensity exercises three times a week, but you will need to follow the guidance of a fitness instructor if you have diabetes.
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Resistance exercise
In the absence of contraindications, people with type 2 diabetes should be encouraged to perform resistance exercise three times a week, including all major muscle groups, progressing to three sets of 8-10 repetitions at a weight that cannot be lifted more than 8-10 times.
These two kinds of exercise, aerobic and resistance, have two different effects. You can think of them as the difference between a long distance runner and a sprinter. The long-distance runner is a lean, while the sprinter has more muscle. The idea is a bit of both, because you want to burn fat, and when you build muscle you naturally raise your level of growth hormone, which helps to improve insulin sensitivity as well as giving you more muscle to burn more fat.
NOTE: Before starting your exercise regime don’t forget to check with your doctor, and remember to start off gently and build up as you get fitter. If you join an exercise class of any kind the trainer will advise you how to begin. The advantage of an exercise class is that, contrary to what you might believe, most people are not super-fit but just ordinary people of all fitness levels working hard to improve their fitness, and the classes are often very friendly.
The type of exercise is as important as the duration
If you are doing the right kind of exercise (that is, a mixture of aerobic and resistance), all you need to do is 20-30 minutes a day. And this will be enough both for losing weight and helping to reverse diabetes. If you want to confine your exercising to five days a week, you can do 30 minutes a day with two days off. If you are doing less strenuous exercise you may need to increase your daily time of exercising to 30-45 minutes a day, but it is important to build up the intensity. My advice is to make an appointment in your diary to exercise, just like you would to attend a meeting or see a friend. Then, don’t break it.
Aerobic exercise
Depending on your current level of fitness, aerobic exercise can ben anything from brisk walking to playing golf, going for a swim or a bike ride or joining an exercise class, but the key is that you get your heart rate into your ‘training heart-rate zone’.
An overweight, out-of-condition person may reach their training heart-rate zone by walking just a few hundred yards. A fitter, leaner person may have to walk briskly for at least five minutes to push their pulse up to their training zone. This is why you need to monitor your pulse while exercising to make sure you do not over- or under-exercise, and to achieve the best benefits for burning fat. As you get fitter and leaner, you will find that you will have to push harder – perhaps by walking faster or adding more hill walking to your programme- to reach your training zone.
Resistance exercise
Resistance exercise is akin to building muscle, but you don’t need to be lifting a whole ton of weight to do this! To understand why this type of exercise is important its good to know that there are three different kinds of muscle fibres and, ideally, you want more of all three. These are:
- Slow (red muscle, which contains more oxygen)
- Fast (white muscle)
- Super-fast (white muscle)
Your aerobic exercise is working mainly the slow muscle. When you work the fast or, even better, the super-fast muscle – for example in a sprint – this is beyond your oxygen capacity and is called ‘anaerobic’ exercise – at the end you will be puffing and painting.
The interesting thing is that if you do the right kind of high-intensity exercise – using and developing super-fast muscle – you don’t need to do it for long. It can literally be a 30-second burst of intense exercise, five to eight times. That’s it. Do this three times a week and you will get a great result. it makes your heart muscle work hard, so you will be really panting at the end of your 30 seconds, and this can increase your growth hormone level by up to five times, which then both re-sensitises you to insulin, and builds muscle.
One of the original proponents of this type of exercising is Phil Campbell, author of Ready Set Go! which is a great book to read if you want to go into this in more detail. He’s a trainer and top athletes and sportsmen, but don’t be put off by that – the principles are really simple. You can see for yourself by watching the YouTube video, made by Dr Joseph Mercola, who describes a version of these principles as the peak 8 system. This is based on eight sprints, in this case done on an exercise bike, but you can do it with any kind of exercise – sprinting, swimming or cycling, for example. The basic guidelines are as follows:
- You warm up for three minutes.
- Now exercise as hard and fast as you can for 30 seconds. You should feel like you couldn’t possibly go on for another few seconds.
- Recover for 90 seconds.
- Then do it again.
- Repeat this cycle a total of eight times.
That’s the goal but Rome wasn’t built in a day, and it is really important to build up to this if you are currently not in good shape. That might mean doing the sequence only two or three times first time, then adding a repetition as you become more able. At the first level, for example, you might be walking for three minutes, then have a 30-second burst of walking or jogging as fast as you can, then you stop. You want to get your heart rate up into the top end of your training heart-rate zone.
You know you have reached it when its hard to breath and talk due to the temporary oxygen debt – you start to sweat, you feel hot and you get some muscle ache. But simply doing this three times a week will make a big difference to your health, building muscle, burning fat and helping restore blood sugar control. This whole sequence takes 20 minutes.
Your weekly routine
Choose the kind of training that appeals to you, making sure the aerobic exercise will raise your heart rate into the training zone. Don’t try to do too much to start with. If you are very unfit or overweight it is good to get some professional guidance and support at the beginning. Now plan your week ahead. A typical weekly routine might look like this, but you will need to build up to it if you are very unfit:
Monday – resistance training (20 minutes)
Tuesday – aerobic exercise (30-plus minutes)
Wednesday – resistance training (20 minutes)
Thursday – aerobic exercise (30-plus minutes)
Friday – resistance training (20 minutes)
Saturday – aerobic exercise (30 minutes)
Sunday – day off
If you are working with a fitness instructor, make sure he or she includes both aerobic and resistance training. You are aiming to exercise for atleast 150 minutes a week, or 20-30 minutes every day, or 30 minutes fives times a week.
When to exercise
The best time to exercise is two hours after eating. No self-respecting animal would eat before exercising. From an evolutionary perspective the purpose of exercise is to get food to eat. If you exercise first thing in the morning, make sure you have breakfast straight after. When you eat after exercising your muscles and liver are geared up to deal with the carbohydrates in your food so you don’t get such big spikes in your blood sugar.
Having said that, going for a stroll after a main meal – for example after Sunday lunch – then having your dessert after the walk, also helps to stabilise blood sugar levels.
Don’t exercise late at night. Also, if possible, exercise in natural day light because you will make vitamin D, which strengthens bones.
Warm up before aerobic exercise by starting off slowly, and before resistance exercises warm up by walking or stretching.
Increase your base-line activity
One great way to increase your general level or exercise is simply to get more active generally. use the stairs instead of the lift. Walk or cycle instead of driving everywhere. Run around with your kids, or take up a sport. There are many ways in a day to develop fitness, and soon this way of living becomes a habit.
Get fit by taking the alternative way
| The fat way | The fit way |
| Take a lift | Use the stairs |
| Use a trolley when shopping | Use a hand basket |
| Drive to work | Walk or cycle some of the way |
| Drive to the shops | Walk to the shops |
| Spend the night watching TV | Take up an active hobby |
| Get other people to bring you one too! | Get up and do it yourself |
| Use powered tools for gardening or DIY work | Use manual tools when it’s just as quick |
| Go upstairs as little as possible at home | Run upstairs as often as possible |
| Use automatic car washes | Wash the car yourself |
| Stick children in front of TV | Actively play with them |
| Have business meetings inside | Go for a walk where possible |
Author: Patrick Holford; Book Name: Say No to Diabetes
