Category Archives: Exercise

Book Review: “Fit With Diabetes”

Front cover

Ginger Vieira introduced me recently to Christel Oerum via email. I was pleased to hear about Christel’s brand new e-book, “Fit With Diabetes.”

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Physical fitness is a major determinant of longevity. It’s truly our only fountain of youth, and it’s available to most everybody. The only way to get and stay physically fit is through regular exercise. Some studies document shorter life spans for PWDs (persons with diabetes). So it’s particularly important for them to maintain a good level of fitness.

I like this e-book and highly recommend it to adults taking insulin for diabetes who need a great physical activity program but don’t know how to go about it. Use of insulin, whether in type 1 or 2 diabetes, significantly complicates exercise due to sometimes mysterious effects on blood sugar. Christel de-mystifies the issue in a clear and science-based manner.

The most dangerous interaction between insulin and exercise is hypoglycemia, although the opposite can be a problem, too. Much of the book is about avoiding dramatic swings in blood sugar, particularly hypoglycemia. Christel teaches the reader how to balance insulin, food, and exercise to keep sugars on an even keel. Aerobic exercise tends to cause hypoglycemia, whereas anaerobic exercise tends to cause high sugar spikes. But your own reaction may be a little different, if not a lot. As you might imagine, monitoring and record-keeping are critical, and Christel shares her own downloadable log.

Trust me, most primary care physicians and many endocrinologists are not going to be much help in the exercise advice department. I only remember one thing my first-ever accountant told me 30 years ago: “No one cares about your money as much as you do.” Likewise, no one cares about your health as much as you do. You’ll have to become your own expert.

The author is like a trusted old friend who’s “been there, done that,” and is sharing freely with you.

Christel has had type 1 diabetes for 21 years and is a diabetes coach. She’s been an avid exerciser since 2010. At that time there were very few resources that addressed vigorous exercise in the setting of T1 diabetes. Learn from her clients’ experience and her own N=1 experimentation so you don’t have to make the same trial-and-error mistakes.

The author works out five days a week. That doesn’t mean you have to. I suspect you can achieve 80–90% of the maximal longevity and other health benefits with just three days a week, maybe two. (Note: I am contradicting several authoritative medical panels!) If you’re sedentary now, two or three days a week should definitely improve your fitness. But you have to exercise right.

Early on, the author talks about how to get motivated for exercise. I like her SMART goal setting-checklist: Goals must be Specific, Measurable, Achievable, Relevant, and Time-bound.

She recommends a combination of aerobic exercise (“cardio”) and weight training. (I wouldn’t be surprised if we find out one day that the right weight-training program alone is good enough.) Christel tells exactly how to get started and maintain both types of exercise. She outlines both home-based and gym-based training programs.

Dietary calories for adults in the U.S. come 16% from protein, 48% from carbohydrates, and 34% from fats. Alternatively, the author recommends dietary calories come 40% from protein, 30% from carbohydrates, and 30% from fats. So 150 carb grams/day if eating 2000 calories, limiting meal carbs to 30 grams. I wonder if most folks will end up closer to 30% protein and 40% fat, especially for those not doing as much exercise as Christel. (Protein is important for muscle building and maintenance.) Many of my patients do well with additional carbohydrate restriction, but most don’t exercise as much as Christel despite my encouragement.

You can easily track your macronutrients and calories at

The author shares some recipes and tells you how to get started on the all-important meal-planning and coming up with your own recipes. There’s even a helpful and realistic chapter on loss of excess weight.

As a reviewer, I always feel like I have to pick a few nits, so here it is. Christel says cardio exercise is great for losing weight. That probably true if you’re competing for $250,000 on TV’s Biggest Loser show. But usually exercise contributes at most 10% to a successful weight-loss program. Diet’s is critical. Exercise does help with prevention of weight regain and has many other benefits.

Again, I like this e-book and highly recommend it to adults taking insulin for diabetes who need a great physical activity program but don’t know how to go about it. Get the e-book here.

Of course, get the blessings of your personal healthcare provider before making any changes to your diet, exercise program, or medications.

Steve Parker, M.D.

PS: Disclosure: Christel kindly gave me a copy of the e-book. Otherwise there was not, and will not be, any remuneration for this review.



Filed under Book Reviews, Exercise

New to Weight Training? P.D. Mangan Cuts Through the Confusion

Women, don’t worry about getting big and bulky with weight training. You don’t have enough testosterone.

I am a huge advocate of weight training (aka resistance or strength training).

Folks new to weight training, or simply thinking about starting a program, are often intimidated by the jargon and contradictory information available. P.D. Mangan clears up a lot of the confusion in a brief article.

I quote:

Misconceptions and wrong ideas abound in weight training, probably because so many enthusiastic amateurs are involved in it. In this article, I’ll try to clear up some of the misconceptions with a look at at science-based weight training.

In recent articles, we saw that brief workouts, at 15 minutes, done infrequently, at twice a week, can produce significant strength gains. We saw that compound lifts, not isolation lifts, are the most effective strength exercises, and are essential for the serious strength trainer. And we saw that hard weight lifting causes muscle damage, which necessitates recovery time.

Here I’ll focus on what science has to say about additional aspects of weight lifting (resistance training). These come from “Evidence-Based Resistance Training Recommendations” by Fisher et al.

Source: Science-Based Weight Training – Rogue Health and Fitness


Filed under Exercise

Brain Benefits of Exercise Diminish After Short Rest, According to Gretchen Reynolds

Run, Spot, Run!

Run, Spot, Run!

Admittedly, Gretchen may not have written the headline to her article at Carlos Slim’s blog. The headline is wrong. The gist is that blood flow to the brain diminishes in older competitive runners if they stop exercising for 10 days. Tests of cognitive function showed no deterioration.

Click the link below to read Gretchen’s article, which is brief. A snippet:

Before you skip another workout, you might think about your brain. A provocative new study finds that some of the benefits of exercise for brain health may evaporate if we take to the couch and stop being active, even just for a week or so.

I have frequently written about how physical activity, especially endurance exercise like running, aids our brains and minds. Studies with animals and people show that working out can lead to the creation of new neurons, blood vessels and synapses and greater overall volume in areas of the brain related to memory and higher-level thinking.

Presumably as a result, people and animals that exercise tend to have sturdier memories and cognitive skills than their sedentary counterparts.

Exercise prompts these changes in large part by increasing blood flow to the brain, many exercise scientists believe. Blood carries fuel and oxygen to brain cells, along with other substances that help to jump-start desirable biochemical processes there, so more blood circulating in the brain is generally a good thing.

Source: Brain Benefits of Exercise Diminish After Short Rest – The New York Times

I believe regular physical activity does help preserve brain function over time. But there’s more involved than blood flow.

Steve Parker, M.D.

PS: I bet your brain blood flow increases, compared to watching Dancing With the Stars on Tell-a-Vision, if you read one of my books.

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Filed under Dementia, Exercise

Type 2 diabetes: Exercise, diet better than medicine, says university study 

Exercise is more helpful for preventing weight gain than for inducing weight loss

From the Vancouver Sun:

“Taking medication to tightly control and lower blood glucose levels is the advice frequently given by doctors to the 400,000 British Columbia residents with Type 2 diabetes — but it’s a “misguided” approach, according to the University of B.C. Therapeutics Initiative [the TI].

More than $1 billion is spent annually on diabetes drugs in this province, but in its latest bulletin to doctors, the TI says a growing body of research casts doubt on the effectiveness of Type 2 diabetes treatment. Doctors should focus instead on prescribing lifestyle modifications such as weight loss, exercise and healthier diets instead of medications to many patients, it says.

Type 2 diabetes, characterized by resistance to insulin, is largely caused by obesity, lack of exercise, high-carbohydrate diets and aging.”

Source: Type 2 diabetes: Exercise, diet better than medicine, says UBC study | Vancouver Sun

Read the short article for an opposing viewpoint. Namely, some diabetes drugs may help prevent cardiovascular disease (I’m not yet convinced).

h/t The Low Carb Diabetic

Hey, I know a diet that helps!

LCHF Mediterranean diet

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Filed under Exercise

Which Cancers Does Exercise Prevent?

Needs a bit more hormetic stress

“Would you spot me, bro?”

I’ve always assumed that exercise reduces the risk of cancer, contributing to the well-established fact that folks who exercise live longer than others.

But a recent study found a positive association between exercise and two cancers: melanoma and prostate. “Positive association” means the more you exercise, the higher your risk of melanoma and prostate cancer (if you have a prostate).

The good news is that exercise was linked to lower risk of 13 other cancers.

Here’s a quote for the New York Times Well blog:

The researchers found a reduced risk of breast, lung and colon cancers, which had been reported in earlier research. But they also found a lower risk of tumors in the liver, esophagus, kidney, stomach, endometrium, blood, bone marrow, head and neck, rectum and bladder.

And the reductions in risk for any of these 13 cancers rose steeply as people exercised more. When the researchers compared the top 10 percent of exercisers, meaning those who spent the most time each week engaging in moderate or vigorous workouts, to the 10 percent who were the least active, the exercisers were as much as 20 percent less likely to develop most of the cancers in the study.

I’m surprised the protective effect of exercise against cancer wasn’t stronger.

Action Plan

So how much physical activity does it take to prevent cancer? And what type of exercise? We await further studies for specific answers.

I’m hedging my bets with a combination of aerobic and strength training two or three times a week.

Steve Parker, M.D.

PS: If you think cancer’s bad, read one of my books. Wait, that didn’t come out right.

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Filed under cancer, Exercise

Turkish Get-Up

I’m going to start doing Turkish get-ups again. I fell out of the habit a couple years ago. Turkish get-ups promote flexibility, balance, joint range of motion, and strength. If you’re just doing the Big Five exercises, TGUs will strengthen some of the smaller muscles (and portions of major muscles) you may be neglecting.

Below are a couple YouTube examples. They are not complete tutorials. You can use a dumbbell or kettlebell. Start with either no weight in your hand, or just a small one. Then work up to higher weights as you get stronger.

These videos may only show how to work one side of the body; you work both sides, of course, and call it a pair. I used to do only five pairs with a 25-lb dumbbell. In weightlifting lingo, you’d call that 1 set of five reps (repetitions). It was exhausting.

Do enough reps and it will be both strength and aerobic training.

Steve Parker, M.D.

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Filed under Exercise

Sure, Exercise Reduces Risk of Type 2 Diabetes, But How Much Does It Take?

Hop on and ride, ride, ride to prevent diabetes

Hop on and ride, ride, ride to prevent diabetes

Even if you have T2 diabetes already, share this post with someone who has prediabetes or risk of getting diabetes. You could save a life and prevent a lot of hassle.

“A new study, published this week in the journal Diabetologia, takes a deeper look at the role of exercise in the development of type 2 diabetes. It is the most in-depth study to examine exercise independent from other influential factors, such as diet. The conclusions from the report are clear: “This research shows that some physical activity is good, but more is better.” (says study co-author Dr. Soren Brage)

Currently, physical activity guidelines in the U.S. and the United Kingdom recommend 150 minutes of moderate activity or 75 minutes of vigorous activity per week; this could include cycling, walking, or sports. However, according to the Centers for Disease Control and Prevention (CDC), fewer than 50 percent of American adults meet these recommendations.

The current study was a result of collaborative work between two institutions – University College London and the University of Cambridge, both of which are based in the U.K. Data from more than 1 million people was collated. In all, the team analyzed 23 studies from the U.S., Asia, Australia, and Europe.


According to the analysis, cycling or walking briskly for 150 minutes each week cuts the risk of developing type 2 diabetes by up to 26 percent.

Those who exercise moderately or vigorously for an hour each day reduced their risk by 40 percent. At the other end of the scale, for those who did not manage to reach the 150 minute target, any amount of physical activity they carried out still reduced the risk of type 2 diabetes, but to a lesser extent.,

Source: Exercise vs. diabetes: New level of detail uncovered – Medical News Today

Steve Parker, M.D.

PS: If you want to start an exercise program, my books will get you started.

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Filed under Causes of Diabetes, Exercise