Adapted from Edinburgh RM et al. Journal of Clinical Endocrinology and Metabolism 21 Oct 2019
Research suggests that blood sugar levels can be better controlled by planned eating and exercise timings.
This study was conducted in Bath and Birmingham and involved a six week trial of 30 overweight or obese men. They were divided into three groups. One group ate breakfast before exercise, one group after exercise and the third group made no changes to their diet or exercise (or lack of it). Groups one and two swapped over after the first six weeks.
The researchers showed that you doubled the amount of fat burned during exercise if breakfast was delayed. This was mainly because the group had lower insulin levels due to their prolonged overnight fast. They could therefore burn more fat in their fat stores or muscle. The groups did not do more exercise than the pre-workout breakfast group.
Groups one and two swapped over after the first three weeks. The men’s BMI averaged at 30 and was closely matched in each group. Although insulin sensitivity was improved in the longer fasting group, there was not any significant weight loss.
From: BeTravelFit blog:
While I was traveling I saw myself faced with situations in which I didn’t have access to any sort of gym, not even a bar to do Pull-Ups with, hell, not even a damn park bench to do Tricep-Dips on because every single bench in the park was used by loved up couples and other people who don’t work out because they actually do have a social life and other things do to then lifting (what a bunch of losers).
So here’s a workout that you can perform anytime, anywhere, with absolutely no equipment needed – just as promised.
The workout consists of three different circuits with three different exercises in each circuit. The exercises in each circuit are to be performed directly one after another with no rest in between. That way the heart-rate stays elevated over an extended period of time and more calories are burned as a result.
Circuit 1: Upper Body (Chest, Shoulders and Triceps) – To be performed 5 times, 60 secs rest
Hindu Push* up x 5
Diamond Push-Up x 5
Push-Up x amrap (as many repetitions as possible) Circuit 2: Lower Body (Quads, Glutes, Hamstrings and Calves) – To be performed 5 times, 30 secs rest
Single Leg Box Squat x 10
Single Leg Romanian Deadlift x 10
Single Leg Calf-Raise x 15 Circuit 3: Core (Abs And Lower Back) – To be performed 5 times, 30 secs rest
Oblique Crunch x 10
Crunch x 20
Plank for 60 secs
And there you go, here’s your first full body, zero equipment, bodyweight only workout!
It burns a ton of calories, engages all major muscle groups and keeps you occupied for at least an hour to an hour and a half. Feel free to add extra repetitions or sets to make the workout more challenging as you progress and don’t feel intimidated if you can’t perform as many repetitions as suggested in the routine. Just give it your best shot and you’ll be fine!
Assume the downward dog position. Move your upper body backwards, into child’s pose, and then move your head and trunk forwards taking your weight in your arms till you then extend your head up with your trunk in the upward dog position.
New Year’s resolutions? Pah! One, you can makes changes any time you want, and two, most of us see them as miserable—the lose weight, take up punitive exercise regimes kind. In this part of the world, January is a challenging month. The weather’s dreich, the nights are long and the pennies few and far between. Who wants to add starvation and exhaustion to the mix?
One resolution I do intend to stick to is my campaign to Make Sundays Special again. Years ago, my husband and I used to make a point of doing something on Sundays. He works most Saturdays, so the Sundays were the one day a week we could visit castles, go to Edinburgh, take the motorbike out for a spin, bike to Balloch, drink too much and cycle back via the main road while piddled*. Last year, we fell into the habit of doing nothing. He’d be downstairs catching up on Colombo (why, why, why?), and I’d hide away upstairs working or writing. We added doing the supermarket shopping to a Sunday. As I love food, I don’t mind the supermarket shop but does it belong on a precious day off? I think not.
Cut the screen time
In 2019, I’ve vowed to spend less time in front of a screen. I’m there for work and as a hobby, and I dread to think how many hours I spend hunched over my laptop. On the plus side, I use a standing desk so it’s not as sedentary as it could be. On the other hand, it’s still not healthy. Time to reinstate the Sunday activities, such as:
I have Ben Lomond in my sights. Hill climbing is one of the best activities you can do in Scotland. The Munro is right on my doorstep, and the shame is I’ve yet to climb it.
Three Lochs Walk
I’d also like to walk from Balloch to Helensburgh with Sandy. I’ve done it a couple of times with my friends, and it’s a fabulous walk because of the views you get of Loch Lomond.
We’re members of Historic Scotland and we’ve yet to visit Linlithgow Palace so a train trip there and a pub lunch is in order.
The University of Glasgow offers walking tours. As I work there, it will be fascinating to find out more about this iconic Glasgow building. Another tour that has always piqued my interest is the one you can do of Glasgow Central station. If I book now, we might get there in the summer. (It’s terrifically popular.)
Finally, it’s nice to include special meals in your Sunday plans. As a child, I didn’t like the Sunday roast—probably because it meant sitting at the table waiting for adults to finish so we children could be excused, and I have memories of thick slabs of meat and nasty bits of under-cooked fat. These days, I’m a fully paid up member of the Sunday roast forever club. While the meat is nice, the best bits are the accompaniments – home-made gravy with a decent amount of wine thrown in, roasted parsnips and carrots, crackling if you’re making pork (or just make it as a side dish anyway) and one roast potato as a treat.
Bring on the special Sundays!
What’s your idea of a treat on a Sunday? Is cutting back your time online part of your plans for 2019, and if so what do you intend to do instead?
A study published in Heart reports that your resting pulse generally indicates how fit you are. It also modestly predicts mortality rates from the obvious cardiovascular disease but just as strongly with such things as breast, colorectal and lung cancers. A difference of 10 beats per minute equates to a 10-20% difference in mortality.
Also reported in Neurology, Swedish women had their baseline fitness tested in 1968 by ergometry while cycling. There neuropsychiatric status was checked at intervals since. Women in the highest fitness group delayed in onset of dementia by 9.5 years compared to the low fitness group and by 5 years in the medium fitness group.
Keep it up Emma, all that running about is doing you good. Meanwhile I’m sitting here typing with my resting pulse at 56. Maybe I don’t need to?
From articles originally published in Minerva BMJ 28 April 18 and 7 July 18
An Australian study has shown that getting a good sleep at night and being active during the day was the most effective way to boost mood in retirees.
105 people took part in the Life After Work study. They were followed for six month before retirement to 12 months afterwards. They carefully logged their activities and their mood was measured.
The time spent on chores, physical activity, quiet time, screen time, self care, sleep, transport and work, all changed over this period of time. The most favourable substitution was replacing work time with physical activity and sleep. Replacing work with screen time and social activity showed less effect on mood enhancement.
After retirement, depression, anxiety and stress all reduced.
Olds T et al One day you will wake up and won’t have to go to work: The impact of changes in time use on mental health following retirement. PLoS ONE.2018;13(6);e0199605.doi:101371/journal.pone.0199605. PMID:29953472
I celebrated an anniversary earlier this month – one year of counting my steps every day. So, what has it taught me?
I’m very competitive – with myself. So, I have done at least 10,000 steps every day now for a year. I can’t bear to have a day where that doesn’t happen. I’ll get up early, if necessary, to walk.
I’m also boring about it. When I told my husband about the anniversary of doing those 10k steps, he said, “a year of hearing about it too”. My NY resolution is to stop going on about it.
A step counter does make you more active in general. If I’m doing housework, for example, I do it inefficiently. I don’t gather up all the stuff that needs to go upstairs or downstairs in one bundle. I take it up and down in a few trips. Going to the library, popping out for supplies from the shops, bringing in the bins…everything becomes an opportunity to add to the step count.
I’m a geek. The UP app is the one I use most on my phone. Have I done my steps yet? How does today compare to yesterday? What’s my average like for this week? The app also tracks your sleep, though that’s not quite as interesting.
You can use exercise instead of insulin. Proceed with caution here, my insulin-dependent friends. This is an individual thing that won’t work for everyone. But walks after lunch do the same job as insulin for me – sometimes.
Exercise won’t help you lose weight, but it will help you maintain. I’ve kept my weight consistent over the whole year, or at least I think it is as I don’t weigh myself. Everything in my wardrobe fits, though, and some of them date back more than ten years.
I feel better. Being active every day makes you feel TERRIFIC.
I’d definitely recommend one. I use the Jawbone Up, the basic model that costs about £5.99. I didn’t want a FitBit as they are much more expensive, and you need to charge them every five days, whereas my entry level tracker needs the battery replaced every two months. The Fitbit also seems invasive. I’m obsessive enough without something on my wrist bleeping at me if I haven’t moved for an hour or so.
Do you find exercise and activity helpful for the management of your diabetes?
Adapted from Scarlett McNally’s article in the BMJ 21 Oct 17
The NHS and social care are inextricably intertwined. The rising number of older people is frequently blamed. The rising social care costs in this age group can be modified however. NICE in 2015 said, “disability, dementia and frailty can be prevented or delayed”.
The need for relatives or paid carers arises when someone can no longer perform the activities of daily living such as washing, dressing and feeding themselves. For some people the ability to get to the toilet in time is the critical thing between having carers come to their own home twice a day and being admitted to a full time care facility.
The cost of care rises five times for those admitted to residential facilities. An average residential placement costs £32,600 a year and may be needed for months, years or decades.
A cultural change is needed so that people of all ages aspire to physical fitness as a way of maintaining independence into old age. There just doesn’t seem to be the local or national infrastructure to support this however.
Ageing is a normal, if unwelcome, biological process that leads to a decline in vision, hearing, skin elasticity, immune function and resilience, which is the ability to bounce back.
The decline in fitness with age starts around the age of 30 and accelerates after the age of 45. Things move downhill even faster if someone has a sedentary job that involves car driving and computer work. Diabetes, dementia, heart disease and some cancers become more common.
Some may think that fitness in old age is down to genes and luck but social strata differences exist with good nutrition and exercise as major factors in enhancing health and fitness into old age.
Apart from getting older, environment and lifestyle affect disease onset. At the age of 40, some forty percent of people have at least one long term condition and the rate goes up by ten percent each decade. As environmental and behavioural factors stack up over time, more people develop an increasing number of diagnoses. Yet, small habits such as cycling to work, can mitigate the effects of a sedentary job.
As time goes on, a person’s independence can be compromised by well -meaning carers and relatives doing more for their charges rather than letting them do things for themselves.
Genetics are thought to play only 20% of the part in the development of modern diseases. Lack of fitness has more of a part to play than disease and multiple morbidity.
Pain can lead people to limit their activity because they think it could make their illness worse, but strength, stamina, suppleness and balance training are usually needed more rather than less as you get older and accumulate illnesses.
These factors improve cognitive ability in midlife through to a person’s 80s. They can reduce the onset of dementia. Increasing independence results.
The Academy of Medical Royal Colleges go as far as describing exercise as “the miracle cure”. Improving the time to stand from sitting down, walking, and resistance training exercise all produce a dose response effect with the most frail benefitting the most. Any exercise or activity such as gardening that gets you slightly breathless and is done in ten minute bursts or longer counts as the 150 minutes minimum as recommended in the UK.
Stopping smoking and limiting alcohol are also worthwhile interventions. Gyms, walking groups, gardening, cooking clubs and volunteering have all been shown to improve the health and well- being of people of all ages with long term conditions.
When people are admitted to hospital they often experience a rapid decline in function. Patients are not allowed to move about or go to the toilet themselves in case they fall. The numbers of these are considered adverse incidents and are strongly discouraged. Thus the ambulant end up chair or bedbound. Most inpatients spend 80% of the time in bed and more than 60% come out with reduced mobility.
All patients should be encouraged to start an activity programme and gradually increase the frequency, intensity, and time that they do it.
The outdoor environment can be improved by even pavements, open spaces, tables and seating in public areas, safe cycle lanes and restriction in car use.
Money may need to be shifted from passive care and polypharmacy to activity and rehabilitation services.
People need to concentrate on being active every day. A quarter of women and a fifth of men do no activity whatsoever in a week never mind the minimum recommended 150 minutes a week.
In the UK the total social care bill is over £ 100 billion which is virtually the same as spent in the NHS.
The cost of care doubles between the ages of 65 and 75 and triples between 65 and 85. If everyone was just a bit fitter, the savings would add up.
Individuals need to see it as their responsibility to stay fit or improve their fitness. There needs to be more national coordination regarding the environment, transport and our working schedules so that we can all stay that bit functionally younger into old age. We could be making the difference between staying at home or depending on social and residential care.
One piece of news I spotted recently that has implications for all of us (and is relatively easy to do) was research that has shown that people with type 1 diabetes who are more active have a lower risk of premature death than those who don’t exercise.
Diabetes.co.uk reported that the Helsinki study. It followed 2,639 people with type 1 diabetes, 310 of them had diabetic kidney disease. They were followed up eleven years later. During the course of the research, some 270 people diets. In the least active group, the death rate was 14.4 percent. Only 4.8 percent died in the group who performed more exercise. Activity seemed to benefit patients who had kidney disease and those who didn’t.
The lead study author, Der Heidi Tikkanen-Dolenc from the University of Helsinki and Helsinki University Hospital, said: “Doctors have always prescribed physical activity for their patients with type 1 diabetes without strong evidence. Now we can say that in patients with type 1 diabetes, physical activity not only reduces the risk of diabetic nephropathy and cardiovascular disease events but also premature mortality.”
Keeping active is a challenge in this day and age. Our governments and big business have unwittingly conspired to create a world where the default way to live is a sedentary one where cheap, nasty junk food is all-too-readily available. Being active and exercising often takes a lot of effort, unlike populations who lived years ago who were active because they had to be.
But the message that exercise can help prevent premature death IS a powerful one. Let’s celebrate World Diabetes Day with a walk!