Tag Archives: exercise

Does Exercise Help With Weight Loss?

Posted on September 3, 2012 | 4 comments

 

Enjoy your dinner!

Skyler Tanner slaughters some sacred cows in his blog post June 4, 2012. I pulled the following bullet points from his post. Click on his embedded links for details.

Comparing the effects of food and exercise on weight loss, what you eat, and how much, are more important than your physical activity.  By far.

  • Your genetics largely determines your response to an exercise program
  • Physical activity isn’t a great way to lose weight
  • School-based or other programs to increase childhood physical activity probably won’t reverse childhood obesity statistics
  • Disregarding weight loss, exercise has other worthwhile metabolic advantages
  • Highly advanced societies shouldn’t blame our overweight problem on decreased levels of physical activity

Steve Parker, M.D.

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Nephrologist and Type 1 Diabetic Keith Runyan Tried the Paleo Diet

Posted on July 30, 2012 | 3 comments

Jimmy posted a recent interview with type 1 diabetic Dr. Keith R. Runyan, who is a nephrologist and internist.

Dr. Runyan is training for the Great Floridian Triathlon this coming October so he naturally has a great interest in high level athleticism as it intersects with diabetes.  He fuels his workouts with dietary fats and proteins rather than the standard carbohydrates.

Dr. Runyan’s current carb consumption level didn’t come up specifically in the interview, but his website indicates he’s on a ketogenic diet heavily influenced by Dr. Richard Bernstein.  I figure he’s eating under 50 grams of digestible carbohydrate daily.  He also tried Loren Cordain’s paleo diet; my sense is that it didn’t help much with his diabetes, but perhaps some.  My sense is that he incorporates at least a few paleo features into his current eating plan.

People with type 2 diabetes can probably tolerate a higher level of carbohydrates, compared to type 1’s, generally speaking.  This didn’t come up in the podcast interview.

Overall, the interview strongly supports carbohydrate-restricted eating for folks with diabetes.  Definitely worth a listen for anyone with diabetes who’s not sold on a very-low-carb diet.  If you’re sitting on the fence, at least check out Dr. Runyan’s “About Me” page.

Steve Parker, M.D.

Triathlon: run, swim, bike

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Posted in Diabetic Diet, Exercise, Low-Carb, Paleo Diet, Testimonials

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Exercise Motivation

Posted on June 11, 2012 | 1 comment

No crowds and no roads: You have to be in good shape to get up here

This last winter I slacked off on my physical activity.  But in April I started Chris Highcock’s Hillfit program.  It’s based on resistance exercise, and I supplemented with high-intensity interval training on a treadmill.  All in less than an hour a week.

To help me judge effectiveness of the new plan, I measured and recorded my baseline fitness.

Exercise isn’t fun.  You need good reasons to do it.  Here are mine:

  • it keeps you young (fountain of youth)
  • longevity
  • less low back aching
  • injury resistance
  • dementia prevention
  • lowered risk of heart disease and cancer
  • I’m a sheepdog, not a sheep
  • weight management
  • emergency preparedness
  • more energy to enjoy life (hiking, camping, horseback riding, long walks with others, etc.)

If you hope to exercise regularly, you’ll need your own list of reasons.  You’ll have days, weeks, or months when you just don’t want to exercise.  Review your list then.

Steve Parker, M.D.

PS: Here’s my report after six weeks of Hillfit.

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Your Fitness Program Is Different From Mine

Posted on May 30, 2012 | Comments Off on Your Fitness Program Is Different From Mine

Eighteen months ago I was sedentary.  I had developed some mysterious shoulder pain that I was able to cure with a rehab program.  Soon after that, the family went bowling for the first time in years.  After just three lines (games), my bowling arm got weak and sore.  That was a wake-up call for me. 

I needed a fitness program with a strength training component.

Assembling a fitness program for yourself is like figuring out your weight loss and management plan.  Lots of idiosyncrasies and variables to consider.  You have to determine what works for you, sometimes through trial and error.  Your plan may not work for your neighbor.

You could always go to a personal trainer who’ll devise a plan for you and supervise implementation.  That’s not a bad idea at all, and probably the best choice for someone not familiar with exercise yet serious about long-term health and weight management.

Future posts will address exercise-related issues peculiar to people with diabetes.  These are important.

I remember reading somewhere on the ‘net over the last year about “the big five” exercises for strength training (aka resistance training).    Turns out there are lots of Big Five lists.  Here’s one:

  • squats
  • deadlifts
  • bench press
  • overhead press
  • chin-ups
And another, similar list (a blog commenter said these were the five free-weight exercises at the top of Dr. Doug McGuff’s list):
  • squats
  • deadlifts
  • bench press
  • standing overhead press (same as military press?)
  • bent-over barbell row

If you’re not familiar with these, go to YouTube and browse.

In case you’re wondering, I’m not interested, at my age, in growing large muscles. My goal is to be injury resistant and as strong as I can be without spending too much time at it, regardless of muscle size.  Size doesn’t necessarily translate directly into strength.  My wife, on the other hand, appreciates large arms—think  Thor in The Avengers movie.

I’m tempted to put together a program composed of man-makers, Turkish get-ups, High Knee Walk to Spiderman With Hip Lift and Overhead Reach (HKWTSWHLOR?), and treadmill HIIT.  I’m saving that for another day, however.

I’ll share my new program tomorrow.

Steve Parker, M.D. 

PS: In case the appropriate link above is broken, the shoulder rehab exercises I did were from an online pamphlet from The Nicholas Institute of Sports Medicine and Athletic Trauma, probably in the Physical Therapy section.

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What’s Our Preferred Fuel?

Posted on May 16, 2012 | 2 comments

Dr. Jay Wortman has been thinking about whether our bodies prefer to run on carbohydrates (as a source of glucose) or, instead, on fats. The standard American diet provides derives about half of its energy from carbs, 35% from fats, and 15% from proteins. So you might guess our bodies prefer carbohydrates as a fuel source. Dr. Wortman writes:

Now, consider the possibility that we weren’t meant to burn glucose at all as a primary fuel. Consider the possibility that fat was meant to be our primary fuel. In my current state of dietary practice, I am burning fat as my main source of energy. My liver is converting some of it to ketones which are needed to fuel the majority of my brain cells. A small fraction of the brain cells, around 15%, need glucose along with a few other tissues like the renal cortex, the lens of the eye, red blood cells and sperm. Their needs are met by glucose that my liver produces from proteins. The rest of my energy needs are met with fatty acids and these come from the fats I eat.

Dr. Wortman, who has type 2 diabetes, in the same long post also writes about oolichan grease (from fish), an ancestral food of Canandian west coast First Nations people.

Drs. Jeff Volek and Stephen Finney have done research on athletes using a low-carb, high-fat diet.

Steve Parker, M.D.

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Posted in Dietary Fat, Exercise, Low-Carb

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Aerobic Versus Strength Training?

Posted on May 2, 2012 | 2 comments

“Resistance training, similarly to aerobic training, improves metabolic features and insulin sensitivity and reduces abdominal fat in type 2 diabetic patients,” according to a recent report in Diabetes Care.

Italian researchers randomized 40 type 2 diabetics to follow either an aerobic or strength training program for four months.  The increase in peak oxygen consumption (VO2 peak) was greater in the aerobic group, whereas the strength training group gained more strength.  Hemoglobin A1c was similarly reduced in both groups, about 0.37%.  Body fat content was reduced in both groups, and insulin sensitivity and lean limb mass were similarly increased.  Pancreas beta-cell function didn’t change.

According to this one study, neither type of training seems superior overall.  If you’re just going to do one type of exercise program, choose your goal.  Do you want more strength, or more sustainable “windpower”?

The Pennington Biomedical Research Center found somewhat different results in their larger and more complex study published in 2010.  However, they were primarily testing for diabetes control (as judged by hemoglobin A1c improvement), rather the improvements in strength or aerobic power.  They found the combination of aerobic and strength training is needed to improve diabetic blood sugar levels.  Both types of exercise—when considered alone—did not improve diabetes control.

As for me, I do both strength and aerobic training.

By the way, I only read the abstract of the current research, not the full report.

Steve Parker, M.D.

PS: PWD = people or person with diabetes.  Do you like that term or would you prefer “diabetic”?

Reference:  Bacchi. Elizabeth, et al.  Metabolic Effects of Aerobic Training and Resistance Training in Type 2 Diabetic Subjects
A randomized controlled trial (the RAED2 study).  Diabetes Care.  Published online before print February 16, 2012, doi: 10.2337/dc11-1655

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Minimalist Exercise

Posted on March 23, 2012 | Comments Off on Minimalist Exercise

Not Darrin Carlson

Darrin Carlson on March 23, 2012, shared his ideas on the minimal amount of exercise and equipment needed to achieve reasonable fitness benefits.

Public health authorities for years have recommended physical activity in the range of 150 minutes a week.  That ain’t gonna happen for most folks.  Darrin says “Two hours a week will work for most people….”

Jonathan Bailor, Chris Highcock, and others suggest 30-60 minutes a week may be enough.  Even Darrin admits as much, for the super-dedicated.

-Steve

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Link to Evidence in Favor of High-Intensity Interval Training

Posted on February 29, 2012 | 4 comments

Tabata's team used stationary bicycles

I ran across this recent scientific review article on HIIT (high-intensity interval training) and thought you might be interested.  Looks like it’s slated for publication in The Journal of Physiology.

I’m interested in HIIT as a means to achieve fitness in much less time than the 150 minutes a week of exercise recommended by various public health authorities.

Why didn’t the authors at least mention the oft-cited and apparently pioneering work of Izumi Tabata et al from 1996?

Steve Parker, M.D.

References:

Gibala et al.  Adaptations to low-volume, high-intensity interval training (preliminary draft).  Journal of Physiology, doi: 10.1113/jphysiol.2011.224725

Tabata, I., et al.  Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max.  Medicine and Science in Sports and Medicine, 1996 Oct;28(10):1327-30.

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How Active Were Stone Age Humans?

Posted on October 3, 2011 | 2 comments

The Paleolithic standard for daily physical activity was about 490 calories (2.1 MJ), according to estimates by S. Boyd Eaton and Stanley B. Eaton in a 2003 article.

The Eatons estimated late Stone Age activity levels based on recent hunter-gatherer societies and skeletal remains from 50,000 to 20,000 years ago.  In case you didn’t know, our bones reflect how much work we ask them to do.  Heavy physical work loads over time lead to thicker, stronger bones, even changing the cross-sectional shape of long bones from round to oval. 

From a diabetes viewpoint, the scientists expect that our prehistoric ancestors had excellent insulin sensitivity in view of their relatively larger muscle mass and high activity levels.  They would have been less prone to develop type 2 diabetes.

Habitual high levels of physical activity of our ancestors put them in the same class as today’s elite cross-training athletes.

The Eatons suggest that replication of the Paleolithic activity level would require we exercise about an hour a day, not the 30 minutes recommended by some public health authorities. 

Steve Parker, M.D.

Reference: Eaton, S. Boyd, and Eaton, Stanley B.  An evolutionary perspective on human physical activity: implications for health.  Comparative Biochemistry and Physiology: Part A Molecular and Integrative Physiology, 136 (2003): 153-159.

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