Category Archives: Exercise

Book Review: The Heart Healthy Lifestyle – The Prevention and Treatment of Type 2 Diabetes, by Sean Preuss

I recently finished an ebook, The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes by Sean Preuss, published in 2013. Per Amazon.com’s rating system, I give it five stars (I love it).

♦   ♦   ♦

This is an invaluable resource for 1) anyone recently diagnosed with type 2 diabetes or prediabetes, 2) those who aren’t responding well to their current therapeutic regimen, and 3) type 2 diabetics who want to reduce their drug use.

Strength Training Helps Get Excess Blood Sugar Out of Circulation

Strength Training Helps Get Excess Blood Sugar Out of Circulation

Mr. Preuss is a fitness trainer who has worked with many type 2 diabetics. He demonstrates great familiarity with the issues diabetics face on a daily basis. His science-based recommendations are familiar to me since I reviewed many of his references at on of my other blogs, Diabetic Mediterranean Diet.

Like me, Mr. Preuss recognizes the primacy of lifestyle modification over drug therapy for type 2 diabetes, as long as drugs can safely be avoided or postponed. The main lifestyle factors are diet and exercise. Too many physicians don’t spend enough time on these, preferring instead to whip out the prescription pad and say, “Here ya go. I’ll see you in three months.”

I have gradually come to realize that most of my sedentary type 2 diabetes patients need to start a work-out program in a gym where they can get some personal attention. That’s Mr. Preuss’s opinion, too. The clearly explained strength training program he recommends utilizes machines most commonly found in a gym, although some home gyms will have them also. His regimen is easily done in 15-20 minute sessions two or three times a week.

He also recommends aerobic activity, such as walking at least several days a week. He recommends a minimum of 113 minutes a week of low intensity aerobic work, citing evidence that it’s more effective than higher intensity effort for improving insulin sensitivity.

I don’t recall specific mention of High Intensity Interval Training. HIIT holds great promise for delivering the benefits of aerobic exercise in only a quarter of the time devoted to lower intensity aerobics. It may be that it just hasn’t been studied in type 2 diabetics yet.

I was glad to see all of Mr. Preuss’s scientific references involved humans, particularly those with type 2 diabetes. No mouse studies here!

Another strength of the book is that Sean tells you how to use psychological tricks to make the necessary lifestyle changes.

The author notes that vinegar can help control blood sugars. He suggests, if you can tolerate it, drinking straight (undiluted) red wine vinegar or apple cider vinegar – 2 tbsp at bedtime or before carbohydrate consumption. I’ve heard rumors that this could be harmful to teeth, so I’d do some research or ask my dentist before drinking straight vinegar regularly. For all I know, it could be perfectly harmless. If you have a definitive answer, please share in the comments section below.

I read a pertinent vinegar study out of the University of Arizona from 2010 and reviewed it at one of my blogs. The most effective dose of vinegar was 10 g (about two teaspoons or 10 ml) of 5% acetic acid vinegar (either Heinz apple cider vinegar or Star Fine Foods raspberry vinegar).  This equates to two tablespoons of vinaigrette dressing (two parts oil/1 part vinegar) as might be used on a salad.  The study authors also say that “…two teaspoons of vinegar could be consumed palatably in hot tea with lemon at mealtime.”

The diet advice herein focuses on replacement of a portion of carbohydrates with proteins, healthy oils, and vegetables.

I highly recommend this book. And sign up for Mr. Preuss’s related tweets at @HeartHealthyTw.

Steve Parker, M.D.

Disclosure: Mr. Preuss gave me a free copy of the book, otherwise I have received no monetary compensation for this review. I met him once, about two years ago.

Stretch If You Want, But It Won’t Prevent Sports Injuries

This is a U.S. Army-style sit-up. I do sit-ups with my arms folded across my chest, hands on my shoulders

This is a U.S. Army-style sit-up. I do sit-ups with my arms folded across my chest, hands on my shoulders

I’ve thought that for awhile. Now I’ve got a scientific reference to back it up. Also from the abstract:

Strength training reduced sports injuries to less than 1/3 and overuse injuries could be almost halved.

h/t James Steele II

Exercise Cuts Fall Risk by a Third

…in the elderly, according to an article at MedPageToday. (I thought we already knew that.) Add this to your list of reasons to exercise. Successful aging is a war against gravity.

Tai Chi was the exercise in two of the trials, but the rest consisted of gait, balance, and functional training for activities performed in daily life. Most trials also included strength/resistance training exercises.

***

All the exercises that proved to be effective for fall prevention emphasized balance training, which the researchers said is “ample evidence that this type of program improves balance ability.”

Exercise reduces the risk of fractures by about 40%.

Click for the original research report, a meta-analysis.

Get Fit With Body Weight Exercises

James Fell features a guest post by Al Kavadlo on fitness via body weight exercises. No gym access? No free weights? No machines?

No problem!

Lou Schuler’s Advice to Weight Training Newbies

Steve Parker MD, Advanced Mediterranean Diet, Ketogenic Mediterranean Diet

Not me or Mr. Schuler

I was glad to see that four of my basic exercises were listed by Schuler as foundational: squat, deadlift, pushup, and row. A little more from him:

Every good training program is based on bedrock principles like progressive overload. You give your body a stimulus. You repeat the stimulus an optimal number of times. And then you give your body the opportunity to recover from it. Every good lifter eventually learns how to apply the principles in a way that works for him or her, but it always starts with the basics: learn the movements, apply the movements, build on the movements.

Every bad training program ignores these fundamentals, but it ignores them in a unique way. Too much stimulus with too little recovery. Too little stimulus with too much recovery. Poor exercise selection for the individual’s abilities and goals.

Read the whole thing.

h/t Yoni Freedhoff, M.D.

QOTD: Ken Hutchins on Recreation Versus Exercise

Recreation, not exercise

Recreation, not exercise

Perhaps the most destructive as well as most misunderstood concept in fitness today among researchers, the commercial health facilities, and the general public alike is  the confusion of exercise and recreation.

Ken Hutchins

Who Needs Medical Clearance Before Starting an Exercise Program?

medical clearance, treadmill stress test

This treadmill stress test is looking for hidden heart disease

To protect yourself from injury, I suggest that you obtain “medical clearance” from a personal physician before starting an exercise program. A physician is in the best position to determine if your plans are safe for you, thereby avoiding complications such as injury and death.

Nevertheless, most adults can start a moderate-intensity exercise program with little risk. An example of moderate intensity would be walking briskly (3–4 mph or 4.8–6.4 km/h) for 30 minutes daily.

Men over 40 and women over 50 who anticipate a more vigorous program should consult a physician to ensure safety. The physician may well recommend diagnostic blood work, an electrocardiogram (heart electrical tracing), and an exercise stress test (often on a treadmill). The goal is not to generate fees for the doctor, but to find the occasional person for whom exercise will be dangerous, if not fatal. Those who drop dead at the start of a vigorous exercise program often have an undiagnosed heart condition, such as blockages in the arteries that supply the heart muscle. The doctor will also look for other dangerous undiagnosed “silent” conditions, such as leaky heart valves, hereditary heart conditions, aneurysms, extremely high blood pressure, and severe diabetes.

She looks healthy enough, but how can you be sure?

She looks healthy enough, but how can you be sure?

The American Diabetes Association’s Standards of Care state that routine testing of all diabetics for heart artery blockages before an exercise program is not recommended; the doctor should use judgment case-by-case. Many diabetics (and their doctors) are unaware that they already have “silent” coronary artery disease (CAD). CAD is defined by blocked or clogged heart arteries, which reduced the blood flow to the hard-working heart muscle. Your heart pumps 100,000 times a day, every day, for years without rest. CAD raises the odds of fainting, heart attack, or sudden death during strenuous exercise. I recommend a cardiac stress test (or the equivalent) to all diabetics prior to moderate or vigorous exercise programs, particularly if over 40 years old. CAD can thus be diagnosed and treated before complications arise. Ask your personal physician for her opinion.

Regardless of age and diabetes, other folks who may benefit from a medical consultation before starting an exercise program include those with known high blood pressure, high cholesterol, joint problems (e.g., arthritis, degenerated discs), neurologic problems, poor circulation, lung disease, or any other significant chronic medical condition. Also be sure to check with a doctor first if you’ve been experiencing chest pains, palpitations, dizziness, fainting spells, headaches, frequent urination, or any unusual symptoms (particularly during exertion).

Physicians, physiatrists, physical therapists, and exercise physiologists can also be helpful in design of a safe, effective exercise program for those with established chronic medical conditions.

Steve Parker, M.D.

Another Path to Maximum Fitness Results in Minimal Time

Push-ups are one of the 12 exercises

Push-ups are one of the 12 exercises

Medical Daily has the details, or you can go straight to the research report. A quote from the former:

It’ll be an uncomfortable seven minutes, but it could be a more effective workout than hours spent running or weight training, Florida researchers say. In a new study published in the American College of Sports Medicine’s Health & Fitness Journal, two experts said that a combination of 12 exercises done over the course of seven minutes could be just as good for you as hours spent on other kinds of exercise….

It’s called high-intensity circuit training. These are body weight exercises, so you can’t blame lack of equipment as an excuse not to workout.

Steve Parker, M.D.

Only One in Five Adults Get Enough Exercise

…according to the U.S. Department of Health and Human Services. I hope my regular readers here are doing better than that!

Here’s the goal from MedPageToday:

The guidelines call for adults to engage in these forms of activity, outside of work, at the following levels:

  • Aerobic: at least 150 minutes/week of moderate-intensity, 75 minutes/week of vigorous exercise, or a combination of the two such that, by multiplying the duration of vigorous activity in minutes by two, the total is at least 150 minutes/week
  • Muscle-strengthening: at least two episodes of such activity per week

I’m not convinced that much is really necessary.

Join Us For Dietriffic’s 30-Day Exercise Challenge

exercise for weight loss and management, dumbbells

If you’re not familiar with weight training, a personal trainer is an great idea

Melanie Thomassian at Dietriffic has issued a social media-based challenge to see if you can form an exercise habit over the course of 30 days starting April 15.

Much of the psychology literature I’ve seen suggests that habit formation takes more like eight to 12 weeks.

You’ve got very little to lose, and much to gain if you’re currently a couch potato. Why not join us?

Details here.