Frequently asked questions for a healthier lifestyle

2. How does exercise lower your stress levels?

Regular exercise can improve your response to stress. Apart from other healthy ways to prevent, deal with, reframe or avoid stress, Mayo Clinic research shows us that exercise in almost any form can act as a stress reliever. Being active can boost your feel-good hormones and distract you from being overwhelmed by daily worries. Regular exercise can increase self-confidence, it can relax you, and it can lower the symptoms associated with mild depression and anxiety.

How does exercise do this?

Exercise is an excellent treatment for stress because it counteracts all your body reactions to stress in a healthy way. When you exercise, you release the muscle tension — your brain registers that things are looking better and this allows you to relax more. Your blood pressure and blood glucose levels also come down, especially with regular activity. Physical activity helps increase the production of your brain’s feel-good neurotransmitters, called endorphins. Endorphins are your body’s natural anti–depressant — they make you feel better. Although this physiological response is often referred to as a ‘runner’s high’, a game of tennis, a mountain bike ride, a nature hike or a correctly prescribed gym workout can contribute to this same feeling.

After exercise, your body and your mind become more relaxed, so activity may also improve your sleep, which is often disrupted by stress, depression or anxiety. All of these exercise benefits can ease your stress levels and give you a sense of command over your body and your life.

So, what’s the dose doc?

Exercise does not have to be at a high intensity to relieve stress. Low intensity exercise like walking, gardening, or swimming for at least 20 minutes a day will do the trick. Just get moving, set reachable targets and once you get going, you will see and feel the benefits.

3. To be fit or to lose weight. Which is a more important predictor of longevity in Type 2 diabetes and heart disease?

We know that the majority of people with Type 2 Diabetes struggle with obesity. In 1998, Dr Steven Blair presented his findings from a large, landmark study called the “Cooper centre longitudinal study,” analysing the fitness of 25 341 men and 7 080 women over a 20–year period. The subjects categorised as ”inactive and unfit”, had the highest heart disease and stroke death rates. The risk of being “inactive and unfit” appeared to be a higher risk factor for heart disease and stroke than high blood pressure, high cholesterol, diabetes and being overweight¹.

Dr. Ming Wei observed 1 200 subjects with Type 2 Diabetes in the above mentioned study. He concluded his study by saying that the unfit, inactive Type 2 Diabetes subject was an extremely high risk for coronary heart disease. He then went on to say that the fit, active person with Type 2 Diabetes was half the risk of the unfit person and probably stood to gain more from regular exercise than any other chronically ill person¹.

The above–mentioned researchers asked the following important question:
Which long–term risk for heart disease is higher?
“To be overweight or inactive?”

Dr. Steven Blair and Dr. Ming Wei disclosed in their findings that:

• Obese men who were at least moderately fit had a significantly lower risk of heart disease than obese unfit men.
• In fact, obese fit men had a far lower death rate than unfit men of normal weight¹.

In other words, the above-mentioned study revealed that as long as you were relatively fit or relatively active for 45-60 minutes per day, even if you were overweight, you would have significant protection against heart disease and stroke. These findings were extremely important in the diabetes context, considering that 80-90% of people with Type 2 Diabetes struggle with their weight.

Reference:
1. Wei M, Gibbons LW, Kampert JB, Milton Z. Nichaman, MD and Blair SN. Low Cardiorespiratory Fitness and Physical Inactivity as predictors of Mortality in Men with Type 2 Diabetes. Annals of Internal Medicine 2000: 132(8) 605-611.

4. How can we motivate people to become active daily?

Most educated people know that we should be active on a daily basis, but at times, it’s hard to summon up the energy or motivation to initiate and maintain it. The most effective motivation generally comes from people’s doctors or health care providers. A survey in the United States suggested that doctors who exercise themselves are more likely to recommend exercise and promote physical activity².

Exercise with a partner or in a group may be more motivating for some, than exercising alone. Fitness trackers/watches or your smartphone have become an important additional, and a popular way to motivate people to become more active and keep track of one’s activity and progress.

Reference:
2. Lobelo F, Garcia de Quevedo I The Evidence in Support of Physicians and Health Care Providers as Physical Activity Role Models. Am J Lifestyle Med. 2016 Jan-Feb; 10(1): 36–52.

5. What exercise is more important for blood glucose control? Resistance or endurance exercise?

Both endurance exercises such as walking, cycling, swimming or jogging (at a low intensity for more than 10 minutes at a time), or resistance exercise such as a low-intensity resistance gym circuit will improve blood glucose control in diabetes. However, the latest research suggests that a combination of resistance exercises and endurance exercises are the most beneficial.

The national diabetes guidelines suggest that people should be performing endurance exercises for 30 minutes on most days of the week. They should also include resistance exercise for 2-3 days a week for 15-20 minutes.

The fitter person with lower cardiac risk can also add interval training to their routine. An example of interval training would be
walking for one minute and then running for one minute, or cycling at a low resistance for one minute followed by cycling at a high
resistance for one minute. This method of exercise can be added to your routine for 6-10 minutes either in the middle or at end of the endurance routine.

6. How much exercise is necessary to improve one’s health? Have you had your daily dosage of exercise?

How much exercise/activity is necessary to improve one’s health? In the Harvard study and the Cooper Clinic aerobic study, two landmark studies on the benefits of an active lifestyle versus a sedentary lifestyle, it was recommended that people participate in some form of activity for 45-60 minutes each day. In fact, being active on a daily basis was seen in the same light as taking your daily medication for a chronic condition. If you missed your daily dose of activity, it was as if you missed your diabetes or blood pressure pill for the day. People should aim to achieve at least 45 minutes of activity per day, or 10 000 steps measured on your cell phone or fitness tracker watch. This amount of activity should be built up slowly over time and can be divided throughout the day. Try not to sit for more than 45 minutes at a time. In other words, get up from your desk every 45 minutes and walk around the house or office for 3-5 minutes.

If you go to a gym, your daily gym routine should ideally last 45-60 minutes to achieve the maximum benefit. If you cannot get to a gym daily, try to gym on alternate days and perform leisure activities like gardening, housework, or shopping on the
in-between days.

7. What is a safe training heart rate or intensity when walking, cycling or running?

If you have diabetes and a cardiac condition, you should follow a 70/30 split of endurance to resistance training. If you are not on a beta-blocker (blood pressure medication that slows one’s heart rate), your Physician or Biokineticist can work out a safe training heart rate.

One method for calculating your safe heart rate range for training is as follows:

• lower training heart rate = (220 - age - resting heart rate x 0.6 + resting heart rate)
• upper training heart rate = (220 - age - resting heart rate x 0.8 + resting heart rate)

Example:
If a patient is 50 years old and has a resting heart rate of 60 beats per minute, his safe training heart rate range would be 126-148 beats per minute. Numerous heart rate monitors are available on the market and most pieces of Cardiovascular gym equipment have built in heart rate monitors.

8. Does exercise lead to weight loss?

Exercise is not renowned for bringing about significant weight loss. A lower calorie intake generally leads to more weight loss. However, regular exercise may reduce abdominal fat percentage and waist circumference, which may be more beneficial in lowering one’s risk factors for heart disease and Type 2 Diabetes.

Exercise is more renowned for maintaining weight lost. In fact, some exercise researchers suggest that it is easier to maintain weight lost through regular activity than it is to continue following a calorie restricted diet. In other words, once you have reached your goal weight, try to make sure you are participating in regular activity to maintain your goal weight.

To get the best weight loss potential out of your routine, you should exercise at the highest intensity that is safe for you. In other words, if you are able to get to the gym three times a week, try to exercise for 45–60 minutes and slowly increase the intensity of your workout as you get fitter. Track your improvement by measuring your waist circumference, body weight and body fat percentage every 4-6 weeks. Preferably, do this with the same practitioner on the same scale and utilising the same body fat percentage method.

9. How important is activity at work and home?

According to the latest findings in the USA, people are not active enough at work. USA exercise literature suggests that people sit on average 11 hours per day at work and at home. Furthermore, only 6.5% of the entire USA population are reaching a level of activity that is conducive to attaining health benefits and longevity. We believe that South Africa probably has similar inactivity stats. Sitting for 11 hours a day can only be detrimental to one’s health. The human body functions more efficiently when you are standing and moving.

Therefore, your medical practitioner, your family and your fitness tracker are collectively important to motivate you to do daily activity, both at work and at home. If you walk around your desk or your office, or down the passage for 5 minutes, every 45 minutes, by the end of the day you would have walked for at least 35-45 minutes. At home, mow the lawn, rake leaves, or clean the pool. Go shopping and walk from one side of the shopping centre to the other.

Reference :
Sitting Disease, Is It Possible to Overcome? by Adria Biasi | Sep 9, 2020 | Symbiotic Blog

10. What time of the day is the best time to exercise?

There is no specific time for activity that is more beneficial than another.

There is nothing more tempting than getting the maximum amount of sleep you can before having to jump out of bed. Training in the early morning means cutting down on sleep time. However, think of it in the sense that you’ll be starting your day off the healthy way, especially if you tend to talk yourself out of that afternoon session during your work day. You will feel good throughout the day if you have had a workout first thing in the morning.

Set goals for yourself
Set goals for yourself, in terms of weight loss, distance and the time you want to take to do these activities. Begin with small increments and increase each day until you achieve your goal.