Category Archives: Exercise

January 28, 2024 · 11:21 AM

Faster Walking Speed is Linked to Lower Risk of Type 2 Diabetes

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You probably want to shoot for a speed of 3 miles per hour or higher. Or 4.8 kilometers/hr or faster.

The British Journal of Sports Medicine published an article by researchers based in Iran. They analyzed 10 cohort studies that looked at average habitual walking speed and the incidence of type 2 diabetes. Study subjects were not in Iran, but in the U.S., U.K., and Japan.

An easy, casual walking speed is 2 miles per hour (mph) or less. Brisk walking speed is 3-4 mph. The researchers found that a habitual walking speed of even 2.5 mph was linked to a slightly lower risk of type 2 diabetes compared to the casual walkers. A more definitive reduction of diabetes incidence (25%) was seen in those who walk at 3 to 4 mph.

For those of you who think in terms of km/hr: An easy, casual walking speed is 3.2 km/hr or less. Brisk walking speed is 4.8-6.4 km/hr. The researchers found that a habitual walking speed of even 4 km/hr was linked to a slightly lower risk of type 2 diabetes compared to the casual walkers. A more definitive reduction of diabetes incidence (25%) was seen in those who walk at 4.8-6.4 km/hr.

This doesn’t necessarily mean that you’ll cut your risk of developing type 2 diabetes if you increase your habitual walking speed from an easy stroll to 3 mph or higher. But it is suggestive and there is physiological science to support that suggestion. The problem is that this study was observational. Which means it’s possible that faster walkers are simply overall healthier than slower ones. They walk faster because they’re healthier and are just constitutionally (genetically?) less prone to illness. To prove that faster walking speeds prevent some cases of type 2 diabetes, you’d have to take 2,000 slow walkers and somehow motivate 1,000 of them to walk faster habitually, while making sure the slow-pokes stay slow for 5-10 years. Keep everything else the same for all 2,000. After 5-10 years, you compare the incidence of diabetes. That study will not, probably cannot, be done.

  Steve Parker, M.D.

h/t to Diabetes Daily for a well-written article on this.

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January 18, 2024 · 3:25 AM

10,000 Steps a Day: C’mon, Man! Is That Really Necessary?

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For perhaps 15-20 years, many health experts have recommended you walk 10,000 steps/day as important for maximizing your health and longevity. Depending on your stride length, that’s roughly 5 miles (8 km). When I walk my dogs 4 miles, it takes about 90 minutes, which is a big time commitment. Frankly, it’s often boring. But not for the dogs. So many fascinating odors!

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The good news is, you don’t need to walk the 10,000 steps in one fell swoop. Your walking around your residence and workplace throughout the day counts, too.

More good news. If you’re an older woman, maybe 4,400 steps/day is enough for a longevity benefit. In other populations studied, 6,000 to 8,000 steps/day was optimal.

I admitted a patient to the hospital a few days ago who told me her health insurer sends her a small check monthly if she meets their step goal. She’s saving them money via lower healthcare expenditures, and they’re sharing with her. I love it!

  Steve Parker, M.D.

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May 25, 2023 · 2:22 AM

Management Options for Knee Osteoarthritis

Photo credit: Steven Paul Parker II

Dr. Howard J. Luks is an orthopedist who published a reasonable and fairly comprehensive article on knee osteoarthritis management. Thankfully, knee replacement surgery is a last resort for this surgeon. He discusses exercise, tai chi, diet, yoga, knee injections, NSAIDs, ice, heat, etc.

Osteoarthritis of the knee is a prevalent health issue.  Despite a diagnosis of arthritis of the knee, the majority of you can live an active, happy life.  But you’ve heard awful phrases used to describe your Xrays– phrases like Bone on Bone, bone spurs, degeneration, wearing away, etc. Those phrases scare you.  I get that! 

Life does not stop after a diagnosis of arthritis. Exercise is perhaps the best medicine for your arthritis.  Exercising a joint that you’ve been told is wearing out may seem counterintuitive.  Exercise is essential if your goal is to avoid surgery for as long as possible.  Being active will not cause your arthritis to worsen.  Not all pain implies harm

Click for Dr. Luks’ exercise recommendations for stronger legs.

Steve Parker, M.D.

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March 13, 2021 · 7:00 AM

Don’t Let Aging Reduce Your Muscle Mass

Exercise is a fountain of youth available to every one

Axel Sigurdsson, MD, PhD, published a great article on prevention of age-related sarcopenia (loss of muscle mass). Click through for details. To stay vigorous as you age, you want to preserve muscle mass and the strength it provides. If you’ve lost muscle mass, you can re-build it. Summary from the good doctor:

Age-related loss of muscle mass (sarcopenia)may start as early as in our thirties and appears to continue for the rest of our lives.

There is also a loss of muscle strength and muscle function. The consequences may often be severe, particularly in the elderly.

Increased physical activity and adequate nutrition are the most powerful tools at our disposal to delay age-related loss of muscle mass.

Well-rounded exercise programs consisting of aerobic and resistance exercises are believed to be most effective

Modification of dietary habits may be an important tool to prevent the decline in muscle mass and function that occurs with aging.

Adequate protein intake is of key importance. Animal-derived protein may provide a higher and broader biological value than vegetable protein.

Fish consumption is recommended and fruits and vegetables should be consumed regularly.

Nutritional supplements containing essential amino acids may be helpful. This is particularly true for whey protein.

Fish-derived protein hydrolysates also appear promising.

Adequate intake of vitamin D is essential.

“Fish-derived protein hydrolysates” doesn’t sound very appetizing. I’ll stick with whole fish for now, especially cold-water fatty fish.

Steve Parker, M.D.

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November 6, 2020 · 8:00 AM

Overweight Men Reduce Insulin Resistance Via Resistance Exercise Training

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    At least he’s trying…
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    Testosterone is one reason men are better than women at push-ups
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    Weight machines may be safer than free weights for some folks
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Didn’t we already know this?

Insulin is a blood-borne hormone that the pancreas gland secretes in order to keep blood sugar levels from getting too high. (Insulin does many other things, but table that for now.) Insulin triggers certain body cells to absorb glucose from the bloodstream. “Insulin resistance” means that these cells don’t respond to insulin as well as they should, so either the pancreas secretes even more insulin (hyperinsulinemia) or blood sugar levels rise. Insulin resistance is a harbinger of type 2 diabetes mellitus. Most overweight or obese type 2 diabetics have insulin resistance. Many experts think hyperinsulinemia causes disease by itself, regardless of blood sugar levels. So it may be best to avoid insulin resistance and hyperinsulinemia.

The aim of the study was to investigate the effects of 6 weeks of resistance exercise training, composed of one set of each exercise to voluntary failure, on insulin sensitivity and the time course of adaptations in muscle strength/mass. Ten overweight men (age 36 ± 8 years; height 175 ± 9 cm; weight 89 ± 14 kg; body mass index 29 ± 3 kg m−2) were recruited to the study. Resistance exercise training involved three sessions per week for 6 weeks. Each session involved one set of nine exercises, performed at 80% of one‐repetition maximum to volitional failure. Sessions lasted 15–20 min. Oral glucose tolerance tests were performed at baseline and post‐intervention. Vastus lateralis muscle thickness, knee‐extensor maximal isometric torque and rate of torque development (measured between 0 and 50, 0 and 100, 0 and 200, and 0 and 300 ms) were measured at baseline, each week of the intervention, and after the intervention. Resistance training resulted in a 16.3 ± 18.7% (P < 0.05) increase in insulin sensitivity (Cederholm index). Muscle thickness, maximal isometric torque and one‐repetition maximum increased with training, and at the end of the intervention were 10.3 ± 2.5, 26.9 ± 8.3, 18.3 ± 4.5% higher (P < 0.05 for both) than baseline, respectively. The rate of torque development at 50 and 100 ms, but not at 200 and 300 ms, increased (P < 0.05) over the intervention period. Six weeks of single‐set resistance exercise to failure results in improvements in insulin sensitivity and increases in muscle size and strength in young overweight men.

Source: The effect of short‐duration resistance training on insulin sensitivity and muscle adaptations in overweight men – Ismail – 2019 – Experimental Physiology – Wiley Online Library

Steve Parker, M.D.

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November 5, 2020 · 7:00 AM

Compare Fitness Trackers

ConsumersAdvocate.org has an article comparing and contrasting some of the available fitness trackers:

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HOW WE FOUND THE BEST FITNESS TRACKERFEATURES

We checked for fitness trackers with diverse features that users could choose to best match their lifestyle and goals. This includes multiple health and activity monitoring options.

CONNECTIVITY

Many fitness trackers sync with smartphones or Bluetooth to receive calls, get message notifications, and send data to their corresponding fitness apps. We looked at trackers that were easy to connect.

COST

Regular fitness trackers can range from $50 to $200, while hybrid smartwatches can cost over $400. We compared prices to special features to make sure consumers get the most out of their investment.

CUSTOMER EXPERIENCE

Fitness trackers should be durable, lightweight, and comfortable. We interviewed customers and read dozens of reviews and testimonies for thorough feedback on each product.

Source: The Best Fitness Trackers For 2020

Click through for details. I use none of these trackers, so have no dog in the fight.

Steve Parker, M.D.

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October 3, 2020 · 8:00 AM

The Best Exercises to Fight Obesity

From Obesity Reviews:

Current international guidelines recommend people living with obesity should be prescribed a minimum of 300 min of moderately intense activity per week for weight loss. However, the most efficacious exercise prescription to improve anthropometry, cardiorespiratory fitness (CRF) and metabolic health in this population remains unknown. Thus, this network meta‐analysis was conducted to assess and rank comparative efficacy of different exercise interventions on anthropometry, CRF and other metabolic risk factors.

* * *

Results reveal that while any type of exercise intervention is more effective than control, weight loss induced is modest. Interventions that combine high‐intensity aerobic and high‐load resistance training exert beneficial effects that are superior to any other exercise modality at decreasing abdominal adiposity, improving lean body mass and increasing cardiorespiratory fitness. Clinicians should consider this evidence when prescribing exercise for adults living with obesity, to ensure optimal effectiveness.

Source: What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta‐analysis – O’Donoghue – – Obesity Reviews – Wiley Online Library

Steve Parker, M.D.

 

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April 25, 2020 · 8:00 AM

Don’t Be “That Guy”: Re-Rack Your Weights…

Arizona Governor Ducey, stop your unconstitutional business closures and let my gym re-open! Now. You’re doing more harm than good.

Steve Parker, M.D.

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January 25, 2020 · 9:00 AM

High-Intensity Interval Training May Prevent Dementia

Steve Parker MD

A slow leisurely pace won’t cut it

Dementia is a devastating and expensive development for an individual and his family. Most dementias are progressive and incurable. If it can be prevented, it should be. Exercise is one preventative. But how much and what kind of exercise?

Nine percent of U.S. adults over 65 have dementia. That’s 3.650,000 folks. The initial clue to incipient dementia is usually memory impairment.

From The Globe and Mail:

In 2017, a team led by the lab’s director, Jennifer Heisz, published a five-year study of more than 1,600 adults older than 65 that concluded that genetics and exercise habits contribute roughly equally to the risk of eventually developing dementia. Only one of those two factors is under your control, so researchers around the world have been striving to pin down exactly what sort of workout routine will best nourish your neurons.

Heisz’s latest study, published last month in the journal Applied Physiology, Nutrition, and Metabolism, offers a tentative answer to this much-debated question. Older adults who sweated through 12 weeks of high-intensity interval training improved their performance on a memory test by 30 per cent compared with those who did a more moderate exercise routine.

This was a small study, only about 20 sedentary participants (all over 60 years old) subjected to one of three protocols for twelve weeks, exercising thrice weekly:

  1. Four-minute bouts of vigorous treadmill walking at 90-95% of maximum heart rate, repeated four times, with three minutes easy walking between the high-intensity spells intervals (HIIT)
  2. Walking at 70-75% of max heart rate for 47 minutes (burning the same number of calories as group #1
  3. Thirty minutes of relaxed stretching

Alex Hutchinson’s full article is well worth a couple minutes of your time if you want to avoid dementia.

Source: New study shows the right workout routine can help fight dementia – The Globe and Mail

Most experts agree that diabetes is a risk factor for dementia, and the Mediterranean diet helps prevent it.

Steve Parker, M.D.

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December 11, 2019 · 11:52 AM

Taking an Exercise Break? Fitness Deteriorates After Just Two Weeks

A workout partner may motivate you

From UPI:

A new study proves that the old adage “use it or lose it” is definitely true when it comes to fitness.After just two weeks of sedentary behavior, formerly fit people had:

—A decline in heart and lung health

—Increased waist circumference

—Greater body fat and liver fat

—Higher levels of insulin resistance

Source: Study: Two weeks of no exercise enough to damage fit people’s bodies – UPI.com

On the other hand, taking a two-week break from exercise twice a year probably won’t have any lasting effect on health and longevity. And it may prevent burn-out and abandonment of fitness entirely.

It’s a small study, just 28 subjects, so may not be reproducible.

Steve Parker, M.D.

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