Orginally published on the MedFitness Network
What is HIIT and Its Benefits for Those with Type 2 Diabetes?So, you’ve heard the buzz in the media about HIIT, its impact on weight loss and cardiovascular benefits and are wondering, could HIIT be for me? As a diabetic, someone with insulin resistance or one at high risk for either, you have likely heard the benefits of exercise, its impact on your blood sugar, and how your weight plays a role in all of it. However, you may be wondering is this safe? What should I do? How do I get started? What should I know?
There are four huge reasons to incorporate HIIT into your regimen (assuming you’re cleared by your physician).
Let’s Talk About IntensityIntensity refers to the level of exertion of the heart. Vigorous/High intensity can be defined as activity that is at 6 or more METs (metabolic equivalents).8 However, this definition is not practical for the everyday participant. A more practical way of identifying the level of intensity that you’re working at is illustrated below:
However, to be clear HIIT training is not appropriate for everyone, and if any doubts remain be sure to contact your physician. The American Diabetes Association recommends a 12-point electrocardiogram be performed on those with type II diabetes prior to beginning a vigorous training program, and while HIIT is not a prolonged vigorous training regimen, you should consult with your physician as a precaution.7
What Programs are Appropriate for You?While some critics of HIIT argue that the high intensity increases participant dropout rates, the truth is you won’t know if it’s enjoyable or even tolerable unless you give it a try. Additionally, you may not like one HIIT program, but may find you like another. In all cases, it is recommended that you start at either a moderate or light intensity gradually increasing to higher intensities over time.8
What should I be aware of when undergoing a HIIT programSpecific to type II diabetes, you should be aware of:
Jeremy Kring holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com
Originally published on the MedFitness Network
If you’re reading this you are likely interested in beginning or improving in a recreational activity or sport. You might want to train for stadium football, a rec team, fun runs, obstacle courses or something as major as a triathlon. While you may be anxious to jump right into a training program there are a few things you should consider such as your current activity level, current physical condition (i.e. chronic conditions, aches, past surgeries, injuries), and knowledge of physical fitness programming.
Who is the Aging Athlete?The aging athlete can be anyone who needs to rethink their recovery strategy as it relates to the rigors of the desired/continued activity due to the aging process. Likely this is any athlete or recreational athlete in their 30’s, 40’s and beyond. The National Strength and Conditioning Association (NSCA) states, that while the cardiovascular endurance and muscular strength of older competitors or athletes are truly exceptional, even the most highly trained athletes experience some decline in performance after the age 30. As such participating in recreational sports or activities fully depends on your health and preparation and the sport or activity you are pursuing.
Before you begin you should consult with your primary health care provider (PHCP). If you’ve been cleared but inactive for any period of time complete a physical activity readiness questionnaire (PAR-Q) to ensure nothing has changed. Additionally, if you have a chronic condition, chances are your PHCP has already discussed exercise with you, and most likely gave you some general guidelines. A chronic condition defined by the Center for Disease Control and Prevention (CDC) is a condition that lasts one year or more and requires ongoing medical attention or limits activities of daily living or both. This does not preclude you from participating in recreational sport or activity necessarily, but it is a factor to be taken into consideration. You may be asking yourself, is this something I can do? Is this something I can do on my own? Do I need a trainer? How do I know what trainer I should go to?
Is this something you can do on your own?The answer is yes, with this caveat. Unless you have a background in exercise, likely there will come a point when you will need someone to reach out to for advice. If that happens reach out to a professional with the appropriate qualifications. Frequently, I have heard gym members echo comments questioning the validity or worth of paying someone to do something they can do on their own. They often do not realize or recognize that hiring a professional who is educated and experienced in strength and conditioning is more than just programming exercise, it’s also injury prevention. Activities, movements, or lack of recovery may not have caused injury in the past, but as we age the dynamic changes, and to remain healthy and injury free, we must change. Commonly people just work around injuries, avoid certain exercises, or reduce intensity and accept that’s just part of aging, so they press forward. However, if they would have consulted with a fitness professional they may have found a better more comprehensive solution.
Working around past injuries is a useful and worthy approach, if done correctly. However, the truth is that most of those injuries are a result of their habits. Perhaps they have been predominantly inactive, spending much of the day sitting. Perhaps they were training hard without any or little variation in intensity, without any or little variation of joint movement, and without any or little variation in program design. These all add up to repetitive stress injuries. Common repetitive stress injuries often appear as bursitis, arthritis, tendonitis, and lower back pain/injuries.
That is not to say you cannot do this on your own nor that you need a trainer or will always need a trainer. It is to communicate the point that we do not inherently know how to exercise properly. Many in their youth have participated in sports, and the programs they were taught may be missing some crucial elements to keep them healthy and pain free. These elements are missing sometimes because years ago we did not have the information we have today. Sometimes it’s because we only remember some of what we were taught, and other times it’s because we have aged, or our physical needs have changed and require a change in programming.
If you’ve never exercised before, it’s recommended you either take a few classes (not a fitness class such as spin, but an instructional class offered at a gym, YMCA, or college) or hire a trainer for a short period of time. Perhaps you are on the fence on taking a class or seeing a trainer. If that is the case, ask yourself these questions:
Are you developing aches and pains that are lasting for longer periods of time?
Do you know what a plane of motion is, and how to exercise your joints in each plane of motion?
How often do you change your program? Do you have a chronic condition?
Are you developing lower back, knee, or hip pain?
The answers to these questions can give you a good sense of whether you may benefit from seeking professional assistance or instruction.
The Key is Individualized ProgrammingAssuming your destination is recreational sports and activities or even occupational activities the program should be appropriately progressed in intensity, duration, and specificity to get you to your desired destination. Repetitive stress injuries occur because one set of tissues in the body/muscle/joint continue to be challenged in the same way at the same spot over, and over again. By taking your occupation, past activities or recreational sports into account your program can be structured to bring the proper balance of strength, and flexibility to the areas that may be neglected or strained. Below is a list of general guidelines if you’re choosing to do this on your own:
What Should I look for in a Trainer?If you elect to see a trainer there’s a few things you want to look for. You want a trainer with verifiable experience, an accredited certification/college degree, and liability insurance. The fitness industry is largely unregulated and there is some debate among which certifications are the best. A good place to start is the MedFit Network as trainers have to meet professional criteria in order to be listed. Additionally, it is important that their experience and background suits them to your specific needs. If you have a chronic condition, dealing with pain or have past injuries these are areas you want to be confident they can serve. As you are either engaged in athletic activity or want to engage in athletic activity it is important that the trainer have a solid foundation of periodization, and athletic performance. Quack science and self-professed gurus have no place here. The trainer’s practices should be founded in the principles set forth by the American College of Sports Medicine (ACSM), and the National Strength and Conditioning Association (NSCA). Most trainers offer a free assessment, which gives them an opportunity to learn about you, and you to learn about them. Be sure to meet with several trainers and ask for client references. This is a reasonable request and a quality trainer will not take offense. Lastly, if something feels off, seek a second opinion.
When undertaking rigorous activity and sport, there are other services you may want to consider, or discuss with your PHCP such as massage therapy, nutritional counseling, or chiropractic care depending on your needs. Remember one size does not fit all and by keeping your health in balance now you will be able to continue to enjoy the activities and sports you love for years to come.
Jeremy Kring, holds a Master’s degree in Exercise Science from the California University of Pennsylvania, and a Bachelor’s degree from Duquesne University. He is a college instructor where he teaches the science of exercise and personal training. He is a certified and practicing personal/fitness trainer, and got his start in the field of fitness training in the United States Marine Corps in 1998. You can visit his website at jumping-jacs.com
Originally published at the Medical Fitness Network
There are many treatments for Type II Diabetes (which will be referred to simply as diabetes in this article) but none come with the level of benefits seen by the implementation of a proper exercise program. This is a tall order but exercise is effective for the treatment of insulin resistance and diabetes in three areas. These areas are inflammation, the cell mitochondria (where the cell generates power), and hyperinsulinemia (high blood insulin).2 Treating these areas with exercise goes beyond the benefits of treating just diabetes. In turn, you will be helping prevent other health issues associated with diabetes such as heart disease, stroke, and circulation issues. The questions is how does exercise do this and what kind of exercise is necessary?1
To understand how exercise treats diabetes, it is important to understand that diabetes is the end result of insulin resistance. Insulin resistance can be illustrated in that: when we eat something with carbohydrates or sugar, our body breaks it down into blood sugar known as glucose. This glucose triggers a response from our pancreas to produce the hormone insulin. Insulin in turn shuttles the blood sugar into the cells to be used as energy. However, when someone becomes insulin resistant the cells do not respond to the insulin’s attempt to shuttle the blood sugar into the cell, so the pancreas produces more insulin to get the same job done. In essence, the cells are developing a tolerance to the insulin and in order to get the blood sugar absorbed the cells begin to require more and more insulin to do the same job. This leads to the blood retaining the blood sugar for prolonged periods of time as well as an elevated presence of insulin. When someone has prolonged high blood sugar, we call this hyperglycemia and the person is said to be diabetic. Having high blood sugar is dangerous due to the stress it places on cells. It can cause many problems up to and including death.
In the area of inflammation, it is known that not all inflammation is the same. Inflammation can be acute — meaning it is brought on for a short period of time — which happens with activities such as exercise or when tissue undergoes some sort of trauma. Inflammation can also be chronic, meaning it is persistent and recurrent.
Acute inflammation is necessary, and healthy, because it begins the healing and repair process by bringing in white blood cells, and ridding the tissue of damaged cells. Inflammation is required otherwise the body would be unable to heal.
Chronic inflammation can be found in many conditions, such as autoimmune diseases, prolonged injury/infection, obesity, diabetes and other chronic diseases. When inflammation remains present, even at a low level, it begins to damage the body’s cells. Science now knows that:2
What is known is:
So you've decided to lose weight, but you find it's more difficult than just dieting? Here are five common causes of stalling weight loss:
1. Are you tracking your food?
-Simply put, those who track their food lose weight, those who don't, don't. Most times when a client I have trained is not tracking their food, it is because they believe they know what they're eating and/or believe they are eating well. So if you fall into this category, track your food and prepare to be surprised.
2. Are you drinking enough water?
-A rough estimate of the proper amount of water can be found by taking your body weight and dividing it by 2. This is the number of ounces you should consume per day.
3. Are you consuming enough protein?
-You need absolutely no less than .8-1.0 gram of protein per kilogram of body weight. However, your protein requirements may be higher. Depending on your physical activity you may require as much as 1.8-2.7 grams of protein per kilogram of body weight.
4. Are you getting enough iron and other vitamin and minerals?
-The body can not properly metabolize (burn) fat without them. Here's an analogy... if fats, and carbohydrates are the wood of a fire, vitamins and minerals are the oxygen. If you remove oxygen from a fire, the fire goes out. In an example, we know iron feeds the hemoglobin of the blood. Hemoglobin is what carries oxygen in the blood. Oxygen is required to burn fat.
However our body's metabolic needs go beyond that of just iron, many other minerals and vitamins also play a similar role. So moral of the story is vitamins and minerals are crucial to your weight loss. If you're taking a multi-vitamin, take it with a food that has at least a small amount of fat so your body can properly absorb them.
5. Are you getting enough resistance and cardio?
-You should be getting no less than 2 sessions of resistance/weight training, and no less than 150 minutes of cardio/week.
Resistance/weight training is important because this type of exercise prevents the loss of muscle during weight loss. It is important to maintain your muscle because your muscle in large part determines the speed of your metabolism.
Cardio training is important to weight loss for calorie burning purposes, and to strengthen the heart, and oxygen delivery system. While 150 minutes is the minimum it is generally held by organizations such as the Institute of Medicine (IOM), and the American College of Sports Medicine (ACSM) that more is better.
The last point here is that exercise increases the body's ability to utilize blood glucose and regulate insulin. When insulin stays high our body stays in a fat storing/shuttling mode. Exercise helps reduce periods of prolonged elevated insulin, and arguably increases the time the body is burning instead of storing fat.
As a trainer you come across many different people, and many different goals. The one thing I have heard numerous times was “Can you write me something I can do to keep me fit?”. To which my answer is, “certainly I can write something up and go over it with you, but there are a couple challenges”. The first challenge I explain to them is that there’s a good chance you’re not going to remember what I show you, so going over it once may not be your best option. The second challenge is that this workout will not be effective for more than a month or two. At this point I normally get a blank look, followed by the question “what do you mean?”. While there are inherent challenges with changing your workout routine every time you exercise, your program should be changed at minimum every 4-8 weeks (depending on the source your read).
So the three reasons to change your workout routine are:
Prevention of Overuse Injuries or RSI’s
The likelihood of developing RSI’s are repetitive stress injuries or overuse injury can be reduced by changing your program routinely. While many overuse injuries are caused from not enough rest between bouts of exercise, or form errors, some are caused by an imbalance of strength and flexibility surrounding a joint. Such imbalances are more likely or even inevitable when the same program is used indefinitely. Common overuse injuries associated with this imbalance are tendonitis, and bursitis. So new routines with variation in tempo, movement, and muscle group focus, as well as incorporating specific stretches to the routine can help ensure that the muscles and joints and connective tissue receives various forms of stress which helps maintain a balance of strength and flexibility throughout the body.
Prevention of Muscle Accommodation
Muscle accommodation refers to the nature of how muscles adapt. Muscles adapt to the stress placed on them, but they adapt only as far as is required. So when you begin a new routine your body will adapt best for the first 4-8 weeks. After that marginal increases may continue but they will begin to slow down. So a better approach than performing the same program until progress stops, is to start a new program when progress slows. This is why most exercise sources an studies indicate that ideally workout programs should be changed every 4-8 weeks.
This probably goes without saying. However, if you’re bored with a program you become less likely to perform it, or put your best effort into it, simple as that. The mind, body, and soul are hopelessly entwined. Study after study show the connection between the mind, emotional status, and performance. So having your “head in the game” is as much a reason for changing your program as is fostering physical progress. I’m not suggesting being bored is an appropriate excuse for not working out. I am suggesting however, that if you’re getting bored, changing it may help keep you engaged and prevent you from skipping workouts.