Reducing Risk for Diabetes with Exercise

David Perlmutter M.D. – Empowering Neurologist: The food, the facts, the science to control your genetic destiny.

While there has been so much attention as of late focused on infectious diseases, there is another epidemic that may have even wider implications—type 2 diabetes. In and of itself, diabetes is a significant life-threatening condition. In addition, it is strongly associated with other important and potentially life-threatening diseases like Alzheimer’s, stroke, kidney disease, coronary artery disease, and even cancer.

According to CDC data from 2018, some 34.2 million Americans, or 10.5% of our population, have diabetes. The percentage of adults with this diagnosis increased with age, affecting more than 25% of those aged 65 years or older. And clearly, the data indicates that these numbers are progressively worsening with time.

Though it may be uncomfortable, it is important to embrace the notion that type 2 diabetes is generally considered a consequence of lifestyle choices. Diet certainly plays a very important role in regulating blood sugar, but other issues like sleep quality and quantity, and exercise, are also very important. Yes, there is a genetic component in terms of risk, but by and large this is a consequence of the various choices people make that have a bearing on their health.

So much has been written recently regarding diet and blood sugar control. A diet that is extremely low in refined carbohydrates and sugars, even to the extent of producing ketosis, is an extremely effective approach to lowering blood sugar, and has certainly been popularized.

But it’s also important to call out the relationship of a sedentary lifestyle to diabetes because this opens the door to understanding the relationship between exercise and healthy blood sugar levels.

In an article published In the European Journal of Epidemiology, British researchers performed a meta-analysis to try to determine how physical activity related to risk of developing diabetes. Their research included 81 studies and concluded that the relative risk for developing diabetes was powerfully associated with level of physical activity. In looking at all of the studies, comparing low versus high physical activity demonstrated a relative risk reduction for diabetes of 35% for the latter. As might be expected, more activity was associated with lower risk as was being involved in physical activity as part of one’s occupation. A risk reduction of an incredible 55% was associated with those involved in a cardiorespiratory fitness program.

In their conclusion, the authors of this report stated:

Our findings have important public health implications as lifestyles are becoming increasingly sedentary around the globe, and suggest a dose-dependent reduction of type 2 diabetes risk… Our finding that all types of activity including light, moderate, and vigorous activity, as well as resistance exercise, occupational activity and walking is associated with reduced type 2 diabetes risk has important public health implications as current guidelines for physical activity among adults recommend at least 150 min per week of moderate-intensity activity, or at least 75 min per week of vigorous-intensity activity, and for additional health benefits up to 300 min per week of moderate-intensity activity, or 150 min per week of vigorous-intensity activity… 

Typically, here in America, the approach to diabetes is to simply chase the blood sugar with medication. While controlling blood sugar is important, it does not absolve the diabetic’s risk for other conditions, described above. This is a disease that may very well be prevented in the first place, and this is a point that must absolutely be emphasized. As the authors quoted above made very clear, a lifestyle that includes regular exercise seems to go a long way towards reducing risk for this epidemic condition.

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