Improving Health Through Exercise
“Middle-aged men who exercise `may live a little longer’,” announced a newspaper headline. The article went on to tell about a study reported in the New England Journal of Medicine. More than 10,000 Harvard University graduates took part in the long-term study, showing that vigorous exercise can add about 10 months to your life—more if you start young, less if you start very late in life. Even if you start after the age of 75, you can still expect some benefit!
Although 10 months may seem like a small reward for so much effort, the study also showed that good regular exercise can help prevent such diseases as heart attack and diabetes. And when you consider that heart attack is now competing with cancer for first place among the people-killers, and diabetes is among the top five or 10 in many nations, the reward looks even better.
In fact, the Journal of the American Medical Association (July 1992) goes so far as to say that exercising five times a week can almost cut in half your chances of getting type II (non-insulin-dependent) diabetes. That’s worth the effort!
Most people get interested when they see an offer of something advertised as “Fee!” Unfortunately, however, few people are taking advantage of the free offer of better health which exercise can give.
Almost anyone can benefit from regular exercise. For the diabetic, exercise may help to keep diabetes under control and prevent its complications. Here’s how:
*Exercise makes the tissues more sensitive to insulin. This simply means that, when you exercise properly, your body can use both insulin and glucose more efficiently. Because of this, many type II diabetics can control their diabetes without medicines simply by good eating habits and regular exercise. And many insulin-dependent diabetics are able to reduce the amount of insulin they need simply by getting good regular exercise. That’s why some people call exercise “invisible insulin”—because it has the same blood-glucose-lowering effect as insulin.
*Exercise usually lowers the blood glucose level. (However, if your blood sugar level is very high—300 mg/dl, or 17 mmol/l, or higher—exercise may actually be harmful. When there is not enough insulin to help the muscle tissues take in glucose from the blood, exercise forces the muscles to get their fuel by breaking down fat. This may lead to the serious condition called ketoacidosis.
*Exercise reduces the risk of heart attack and stroke. With exercise, the blood cholesterol and triglyceride levels become lower. At the same time, there is a rise in the level of “good cholesterol”—high density lipoproteins—which help to prevent heart attacks. Regular exercise also helps to prevent heart attack by increasing the heart’s pumping power and slowing the pulse rate.
*Exercise improves the blood circulation through the small vessels. This may be a great help in preventing or reducing complications of diabetes, especially the foot and leg problems so common to diabetes. Many diabetics decide not to exercise because it hurts, due to nerve or blood vessel damage in the feet or legs. Yet exercise is the best thing they could do for themselves to keep the blood flowing, to keep the muscles flexible, and often even to help the pain go away.
*Exercise can help with weight control. Since overweight is one of the big causes of type II diabetes, keeping your weight down is one of the most important ways of controlling diabetes.
Nutritionists say that in order to lose one pound of body weight, you need to get rid of 3,500 calories. You can do this by eating 3,500 calories less than usual during a certain period of time (during one week, for example). Or you may burn up an extra 3,500 calories through exercise. The ideal is to combine both ways—eating less and exercising more.
*Exercise helps to prevent many other diseases. Although there is no sure prevention for cancer, diabetes, the flu, and many other diseases, a person who exercises regularly has a much better chance of staying healthy. With good exercise, the lungs work more efficiently and can thus provide more oxygen for the body. The person who exercises regularly will have fewer problems with colds, flu, pneumonia, or other lung diseases.
Average Number of Calories Burned by
Various Types of Exercise
Calories used up
in 30 minutes
Light housework 60 - 75
Moderate housework 75 - 120
Scrubbing floors 150 - 180
Walking slowly, 2 miles/hour 75 - 120*
Walking, 3 miles/hour 120 - 150*
Walking briskly, 4 miles/hour 180 - 210*
Run-walking, 5 miles/hour 210 - 240*
Jogging, 5 miles/hour 240 - 300
Running, 5-6 miles/hour 300 - 330
Golf, using caddy or power cart 75 - 120
Golf, carrying own clubs 150 - 180
Bowling 120 - 150
Calisthenics and ballet exercises 150 - 180
Cycling, 6 miles/hour 120 - 150
Cycling, 8 miles/hour 150 - 180
Cycling, 10 miles/hour 180 - 210
Cycling, 12 miles/hour 240 - 300
Swimming, 25 yards/minute 180 - 210
Swimming, 40 yards/minute 270 - 300
Swimming, 50 yards/minute 330 - 360
Skating, ice or roller 180 - 210
Tennis (singles) 210 - 240
Tennis (doubles) 150 - 180
Table tennis 150 - 180
Badminton or volleyball 150 - 180
Squash or handball 300 - 350
*For easier calculation, some health experts say that all walking
uses approximately 100 calories per mile (1.6 kilometers).
*Exercise can help to relieve stress. This is important to the diabetic because too much stress causes the blood sugar level to rise and makes diabetes control more difficult.
How does exercise reduce stress? First of all, exercise usually takes you away from the stressful situation. More than that, however, exercise causes the body to release chemicals called endorphins into the bloodstream. These endorphins are called the “happy hormones” because they do improve a person’s mood, and they reduce anxiety, depression and stress.
*Exercise can be enjoyable. Group activities are good for the emotional health. For someone with diabetes—especially a young person—sports can be a very important part of adjustment to life and acceptance by others.
Much of our social life centers around food. For the diabetic, however, spending time with friends on the tennis court, on the jogging track, in the swimming pool, or in some other sports spot is much healthier than spending that time sitting around snacking and eating.
When you exercise regularly, you often have the opportunity to meet many new people who enjoy the same sport. Good friendships can grow out of these acquaintances, and having more friends may be good for your self-esteem.
Another very good reason for making friends with people who are interested in sports is that they are also likely to be concerned about taking good care of their health. And, because they are interested in their own health, they won’t be likely to try to persuade you to “enjoy” bad health habits.
*Exercise makes you look and feel more fit. Exercise improves the condition of your muscles. Interestingly, if a person is underweight, proper exercise balanced with good diet can help him gain weight by increasing his appetite and building up his muscles. In other words, exercise helps a person reach and maintain his ideal weight.
The fitness also comes in the form of stronger bones with less of the osteoporosis that often comes with age.
Another benefit for the elderly is less arthritis and joint pain. By the time “Uncle” Willis was 70, his joints were so frozen up with arthritis that he could hardly raise his hands above his waist. He could barely move his shoulder joints. Finally a doctor recommended that he go to a special lifestyle change program. There he found that exercise was a major part of the daily routine. At first, all the stretching, rotating, arm-raising and other exercises were extremely difficult for him. Gradually, however, the joints loosened up and Uncle Willis became a free man again.
When he was 75, although he had been retired for many years already, he and his wife conducted a two-week health seminar for all the teachers where I worked. And every morning found all of us younger folks out on the football field struggling to keep up with Uncle Willis as he led us in calisthenics, fast walking, and the whole exercise routine.
How Much Exercise Do I Need?
If you want your exercise to be beneficial, you need to exercise for at least 30 minutes each time, and you should exercise at least three or four times every week.
Many people like to check their level of fitness when they exercise. Some athletes time themselves to see how fast they can run a certain distance. Others test their endurance by seeing how long they can keep doing a particular exercise or how many times they can do it without stopping.
But doctors recommend checking your fitness simply by checking your pulse rate. The better your physical condition, the slower your heart will beat after exercise. If you have ever had heart disease, high blood pressure, or other serious illness, you should monitor your pulse closely.
You can determine what a safe heart rate is for yourself by subtracting your age from 220, and then finding 70 percent of that (220 – your age x .70). Doctors call this your “target rate” or your “training heart rate”.
For example, if you are 45 years old, your target rate would be 220 – 45 (=175) x .70 = 122 beats per minute. So, while a 45-year-old is exercising, his pulse rate should be about 122.
A variation of 10 percent more or less than this (110-134 for the 45-year-old) is considered his safe range. To see at a glance what your normal target rate is, look at the table below:
Age Range 60 –Second 10-Second
Pulse Count Pulse Count
20-24 120-160 20-27
25-29 117-156 20-26
30-34 114-152 19-25
35-39 111-148 19-25
40-44 108-144 18-24
45-49 105-140 18-23
50-54 102-136 17-23
55-59 99-132 17-22
60-64 96-128 16-21
65-69 93-124 16-20
70-74 90-120 15-20
What Kind of Exercise Is Best?
A diabetic can participate in almost any kind of exercise that nondiabetics enjoy. There are just a few which are not recommended for people with diabetes because of the risks involved.
Deep sea divining, hang gliding, sky diving and similar activities may be more dangerous for the diabetic. If he should have a hypoglycemic reaction while in the sky or under water, he could be unable to eat or drink the sweet glucose-providing snack which his body desperately needs. He might then become unconscious and lose control before he could reach help.
Body building is not recommended for anyone with the diabetic eye complication known as retinopathy because of the extra pressure in the eyes when one strains to lift heavy weights. Yet one young man did begin his athletic training and go on to become a state champion body builder after he became an insulin-dependent diabetic.
Some doctors advise against contact sports in which a diabetic may be injured. Many athletes, however, feel that as long as they keep their diabetes in good control, they are willing to take the risks.
Britain’s Gary Mabbutt, for example, has been playing professional football for years in spite of his insulin dependence. So has my friend Roger Lee. To them, it is worth the risk.
One further word of advice: It is usually advisable for someone with insulin-dependent diabetes to do vigorous exercise with someone else rather than alone. It’s just safer that way. Your sports companion should know that you have diabetes. He should be able to recognize the signs of a reaction. And he should know what to do about a diabetic emergency.
At school, the teachers and the athletic instructor or coach should also know about your diabetes and be prepared to act in an emergency situation.
Which Exercise Should I Choose?
Of all the exercises available to mankind, walking is the best. Walking costs nothing and it requires no special equipment. A good walk exercises almost every part of your body, and only rarely does walking cause injury. Walking can be done at any time and any place. And almost anyone can walk.
There are actually many activities which diabetics can enjoy. Here are some—take your choice!
Archery, backpacking, badminton, baseball, basketball, bicycling, boating, bowling, boxing, calisthenics, camping, dancing, fishing, football, golf, gymnastics, handball, hiking, horseback riding, jogging, jumping rope, karate, mountain climbing, rock climbing, roller skating, running, sailing, soccer, surfboarding, swimming, table tennis, tennis, track, volleyball, walking, water skiing, wrestling….and the list could probably go on and on!
The important thing is to choose something you enjoy—then stick with it. If you choose an activity which you do enjoy, you are much more likely to continue with a good exercise program.
It may be helpful to exercise with someone else who can help you not to give up. Some time ago I went to visit some close friends for a weekend. During the late afternoon, my young doctor friend decided to get some exercise before going for his evening clinic. So, in his shorts and bare feet, he started running in place in the middle of the sitting room. Three minutes later, he was done!
“What? Finished so soon?” I exclaimed.
“No time. Got to get ready for work.”
But I wasn’t going to give up so easily. Once he was gone to the clinic, his wife and I began to chat. Before long, the topic of exercise came up again. “I know, he really needs to get more exercise,” his sensible and attractive young wife said. “I keep telling him he needs to do more.”
She seemed totally surprised when I suggested that she—and possibly the children also—could go out jogging with him. Maybe he would exercise more faithfully if she helped to make exercise a family time. Her face suddenly brightened as the new idea struck her. “I never thought of that—I must try it!”
It is much too easy to make excuses and say, “I can’t exercise because…” But excuses won’t prevent the complications of diabetes like regular exercise might.
Mrs. Lim is in her mid-sixties, and already beginning to feel an occasional muscle cramp in her feet or legs. Yet, she is always too busy to exercise. Besides, she has to look after her three-year-old grandson every evening. But really, now, that little grandson is a perfect excuse to exercise—not to avoid it! What little fellow that size wouldn’t enjoy a regular evening walk in the lovely park near their home? And they both would benefit from that fresh air and exercise and fun time together.
What if you live in an area where it is difficult to go outside for exercise? To begin with, you might buy some home exercise equipment, such as a stationary bike or a rowing machine. One 61-year-old diabetic bought a stationary bicycle to help him get the exercise he knew he needed. He “rode” his bike for half an hour every morning, keeping a record of his exercise. By the time he was 75—after 14 years of daily riding—he had logged more than 72,000 kilometers (45,000 miles)!
You could buy or rent an exercise videotape or watch an exercise program on television. Several people I know do their exercise along with the program, although the fresh air and sunshine of outdoor exercise certainly is preferable.
If there are stairs where you live, you could walk up and down the stairs for your exercise. About 25-30 flights of stair-climbing per day gives adequate exercise.
One middle-aged friend of mine wanted to exercise but lived in an area where she felt it was unsafe to go out alone. That didn’t stop her. She lived in a two-story house, so she opened all the windows and spent 30 minutes each morning stepping quickly up and down the stairs. It must have been good exercise, because she later hiked up Mt. Kinabalu—Southeast Asia’s highest mountain peak—passing up many young men half her age!
You could jump rope. Or you could just pretend to jump a rope—that way you don’t have to worry about tripping over the rope as you “turn” it. Even the elderly can “jump rope” by stepping over the rope or imaginary rope one foot at a time.
Another possibility is to join a health club which has activities which you enjoy, such as swimming, lawn tennis, table tennis, et cetera.
Gardening is one of my favorite forms of exercise. Besides the exercise I get from digging and planting, I get to enjoy the flowers or vegetables afterwards.
Whether you exercise outdoors in the open air, or whether you are forced to get your exercise indoors, the important thing is to choose something that you can enjoy and something that is in a location convenient for you.