Exercise and Fitness
Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call. Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes. One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care, but perhaps it should be.
New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer. The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997. The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated. “When in doubt, sit it out.” The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously. The new guidelines should help better identify athletes who have suffered concussions and improve how concussions are managed and treated.
As a huge, snowy Nor’easter barrels into New England, I’m thinking about all the shoveling I’ll be doing over the next couple days. Luckily I have three teenagers to help. But now that I’m of an AARP age, I have to be more mindful of the cardiovascular effects of shoveling. Snow shoveling is a known trigger for heart attacks. Emergency rooms in the snowbelt gear up for extra cases during significant snow storms. What’s the connection? Many people who shovel snow rarely exercise. Picking up a shovel and moving hundreds of pounds of snow, particularly after doing nothing physical for several months, can put a big strain on the heart. Pushing a heavy snow blower can do the same thing. Cold weather also contributes. Tips for protecting the heart include shoveling many light loads instead of fewer heavy ones, taking frequent breaks, and hiring a teenager.
Many exercise programs these days spotlight the ever-present abs (abdominal muscles) but pay little attention to the other muscles that form the body’s core. Yet building up all of your core muscles is essential for staying strong and flexible and improving performance in almost any sport. It’s also vital for sidestepping debilitating back pain. Your core includes your back, side, pelvic, and buttock muscles, as well as the abdominal muscles. The core forms a sturdy central link between your upper and lower body. Much like the trunk of a tree, core muscles need to be strong yet flexible. A strong, flexible core underpins almost everything you do, from everyday actions like bending to put on shoes to on-the-job tasks, sports and sexual activity, and more. A strong core can also help you keep your back healthy or recover from back pain. It’s unwise to aim all your efforts at developing rippling abs. Overtraining abdominal muscles while snubbing muscles of the back and hip can set you up for injuries and cut athletic prowess.
Do you have trouble sleeping? If you’re carrying extra pounds, especially around your belly, losing weight and some of that muffin top may help you get better ZZZs. So say researchers from Johns Hopkins University School of Medicine, who presented their findings at this year’s annual meeting of the American Heart Association. In a six-month trial that included 77 overweight volunteers, weight loss through diet plus exercise or diet alone improved sleep. A reduction in belly fat was the best predictor of improved sleep. Among people who are overweight, weight loss can reduce sleep apnea, a nighttime breathing problem that leads to frequent awakenings. Exercise has also been shown to improve sleep quality. Despite what thousands of websites want you to believe, there are no exercises or potions that “melt away” belly fat. Instead, the solution is old-fashioned exercise and a healthy diet.
Many medical studies confirm what we know or suspect. Every once in a while, though, one surprises us, turning “conventional wisdom” on its head. That just happened with the sudden shutdown of a long-running diabetes trial called Look AHEAD (Action for Health in Diabetes). Begun in 2001 and scheduled to last another two years, Look AHEAD was designed to see if an intensive diet and weight loss program could reduce the number of heart attacks, strokes, and other cardiovascular problems in people with type 2 diabetes. An early peek at the data showed that the program had little apparent effect, and the investigators concluded it would be futile to continue. This does not mean that we should ignore diet and exercise in treating of type 2 diabetes. Instead, the details of the study results, which haven’t yet been published, are likely to reveal other explanations.
Bicycling is a terrific way to get from one place to another. It’s also an excellent form of exercise. Some men and women avoid bicycling, though, because they worry that it may damage their reproductive organs and harm their sexual function. This mainly happens to people who cycle a lot. And it isn’t inevitable. One problem is the design of many bicycle seats, which put pressure on the perineum, a region of the body that runs from the anus to the sex organs. It contains the nerves and arteries that supply the penis in men and the clitoris and labia in women. You don’t have to give up biking to preserve your sexual function. Take a few simple precautions, like picking a wider seat, and shifting your position and taking breaks during long rides. These precautions will ensure that your passion for exercise doesn’t interfere with your passion in the bedroom.
What would you pay to keep from getting sick as you get older? How about a daily walk or other exercise? A new study suggests that’s exactly the right investment. In the study, people who were the most fit at midlife lived longer and spent less time being sick than middle-aged folks who weren’t fit. There are many benefits to staying physically active and exercising daily. One important effect of exercise that doesn’t get enough attention is that it improves fitness. Fitness is a measure of how well your heart, blood vessels, blood, and lungs work together to supply muscles with oxygen during sustained exercise. How do you improve your fitness? Increase the amount and the intensity of exercise over time. Don’t rush it. Improving fitness starts within weeks but will continue for months.
Compared to the pumping intensity of spin or Zumba, a tai chi class looks like it’s being performed in slow motion. But this exercise program is far more dynamic than it looks. As an aerobic workout, tai chi is roughly the equivalent of a brisk walk. And as a resistance training routine, some studies have found it similar to more vigorous forms of weight training. It is especially useful for improving balance and preventing falls—a major concern for older adults. Tai chi helps improve balance because it targets all the physical components needed to stay upright—leg strength, flexibility, range of motion, and reflexes—all of which tend to decline with age. It also offers an emotional boost to balance by removing the fear of falling that can make some people afraid to exercise.
We tend to think of type 2 diabetes as a disease that afflicts people who are overweight. But it can also appear in people with perfectly healthy weights—and be more deadly in them. A study published in the Journal of the American Medical Association indicates that normal-weight people diagnosed with type 2 diabetes have double the risk of dying from heart disease and other causes than overweight people with diabetes. Such apparent “protection” by excess weight has been called the obesity paradox. It’s been seen with other conditions, like heart failure and end-stage kidney disease. That doesn’t mean gaining weight is a healthy strategy. Instead, it probably means that something else besides weight—like the amount of fat around the waist—may be contributing to the onset and severity of type 2 diabetes. These new findings underscore the importance of strength training for everyone, no matter what their weight.