Exercise isn’t an option when it comes to helping improve your insulin sensitivity. It’s mandatory. That it also helps you lose weight and improves your health in other ways is just another huge bonus.
THE EXERCISE ADVANTAGE
Exercise doesn’t just reduce body fat; it increases the amount of muscle you have. Here’s something we bet you didn’t know: More muscle mass helps reshape your body, preserve your strength, and turbo- charge your metabolism. The more muscle you have relative to your body weight, the more insulin sensitive you are. And because muscles burn glucose faster than fat can, the more muscle you have, the more energy you’re able to expend. That’s why exercise and controlling carb intake are the two integral components of the Atkins Blood Sugar Control Program (ABSCP).
Loss of muscle mass is an inevitable part of aging, especially in the absence of regular exercise. That’s one reason your metabolic rate slows down, making it far easier to gain weight. But vast societal changes in the last century have conspired to make even young people fatter as we exercise less and eat more empty calories. The reliance on machinery, particularly the automobile and household appliances such as vacuum cleaners and washing machines, has significantly diminished the amount of physical activity in most people’s lives. To compound our increasingly inactive lifestyles over the past few decades, many people now spend work hours staring at a computer screen or standing in one spot on an assembly line, only to go home, where they crash in front of the “tube.” Combine this couch-potato mentality with a diet heavy in carbohydrates and relatively low in protein (the recommendations of the USDA as expressed in the food guide pyramid), which signals your body to store fat instead of burning it, and you have a recipe for the current health crisis.
ELEVEN REASONS TO WORK OUT
If exercise were a drug,factories wouldn’t be able to make it fast enough. Here are 11 reasons to step it up:
To buck the trend and avoid becoming a statistic in the epidemic of “diabesity,” you should follow the blood sugar control program outlined in previous chapters and begin an exercise program. In tandem, they will shift into high gear those hormonal signals to burn fat.
EXERCISE HELPS PREVENT DIABETES
The protective effect of exercise against diabetes is powerful—and it’s strongest in the people who are most at risk. Let’s look at a very interesting study.Researchers reviewed the patterns of physical activity and other personal characteristics of nearly 6,000 male graduates of a major university over a 15-year period. Among the men who had several risk factors for diabetes at the start of the study—including a family history, being overweight, and high blood pressure—the ones who actually went on to develop diabetes by the end of the study were the ones who were the least physically active. The at-risk men who were the most physically active were far less likely to develop diabetes. In other words, the protective benefit of increased physical activity was strongest for the men who were at highest risk of diabetes.1
Similar results were found in a long-term study of more than 110,000 men and women in China. When the members of the group were screened for diabetes in 1986, the researchers found nearly 600 who already had impaired glucose tolerance, or prediabetes. The participants were randomly divided into four groups. One group was the control group, who made no dietary or exercise changes. Of the others, one group made only dietary changes based on the standard diabetes recommendations; one group made no dietary changes but added exercise; and one group added exercise and made dietary changes.After six years, nearly 68 percent of the control group had developed diabetes.In the diet-alone group,nearly 44 percent had developed diabetes; in the exercise-alone group, 41 percent had developed diabetes; and in the diet-and-exercise group, 46 percent had developed diabetes. Exercise alone was actually more helpful in preventing diabetes than the standard diabetes diet alone or the diet in combination with exercise.2 This is no surprise. The standard carb-filled diet didn’t allow people to do as well, even when they exercised to overcome the effects of all those carbohydrates.
EXERCISE AND YOUR BLOOD SUGAR
Researchers have known for decades that exercise helps to improve insulin resistance by making your muscles more responsive to the effects of insulin. So, if you have signs of the metabolic syndrome, prediabetes, or diabetes, your primary motivation for exercising is crystal clear. But exactly how much improvement can you expect? In an attempt to answer that question, researchers recently conducted a meta- analysis of clinical trials on the effect of exercise in patients with Type 2 diabetes. They looked at the results of 14 different studies using moderate exercise alone—the patients in the study didn’t take any drugs to treat diabetes and they didn’t change their way of eating. The result? Not a lot of weight loss, but significant improvement in blood sugar control as measured by the glycated hemoglobin (A1C) test. In fact, the improvement was enough to make a dent in the risk of diabetic complications.3 And that was just with exercise alone! Just imagine what can happen when you combine the Atkins controlled- carbohydrate program with exercise.
THE RIGHT PROGRAM FOR YOU
Almost everyone can find an exercise plan that is safe and achievable, but we strongly advise you to consult your doctor before you begin. If you have been completely inactive or have a heart condition, it is absolutely essential to do this. You may need a stress test to check if you can exercise safely. These tests are usually easy to do, so don’t hesitate to ask for one. You may be asked to exercise by walking on a treadmill or riding a stationary bike while hooked up to a heart monitor. Sometimes a doctor may also use a medication or a sound wave test (echocardiogram) to provide additional information about your heart function while exercising.
GETTING GOING
Once your physician has given you the green light,how should you begin?
First, before making any fitness changes, you may want to wait until you’ve established your new controlled-carbohydrate dietary program for at least two weeks.Allow your body time to adapt to your new way of eating. Then it will be ready to move on to the next component of your new lifestyle. Of course, those of you who are eager to step up your fitness level can certainly begin to be more active in general to prepare for the official start of your exercise regimen.
SPECIAL EXERCISE CONCERNS FOR PEOPLE WITH DIABETES
Some common complications of diabetes may impact your fitness choices. If you have diabetes, discuss your exercise plans with your doctor before you start.
Diabetic Retinopathy. If you have this eye condition, you may need to avoid activities that raise your blood pressure sharply,such as strenuous weight training,or those that involve a lot of pounding and jarring,such as jogging, running, and racquet sports. Brisk walking and working out on exercise machines such as the elliptical trainer and exercise bike are almost always acceptable.
Peripheral Neuropathy. A common complication of diabetes,peripheral neuropathy often causes a reduction or loss of sensation in the feet. Repetitive exercise involving the legs, such as long walks, jogging, running, using a treadmill, or doing step exercise, could cause hard-to-heal foot ulcerations and even bone fractures.You may have to stick to non- weight-bearing or nonconcussive exercise,such as swimming,water aerobics, riding a stationary bike, or using a rowing machine. Be sure to inspect your feet carefully on a regular basis for evidence of redness, blisters,or skin changes.
TWO TYPES OF EXERCISE
The kinds of exercise we are talking about can be divided into two basic types: one that improves cardiovascular fitness (aerobic) and one that builds and maintains muscle (resistance). Running, jogging, brisk walking, bicycling, in-line skating, and swimming are all aerobic exercise. Resistance exercise may raise your heart rate and respiration somewhat, but it mostly builds muscles. Weight training falls in this category, as do isometrics and the kind of circuit training that is popular at many health clubs and gyms.A good fitness plan includes both types of exercise. In the next chapter, we’ll tell you about ways to incorporate both types to get the most out of your exercise program, both enhancing your cardiovascular health and preserving or gaining strength.
TAKE IT EASY
If you are heavy and not used to moving much,or if you’re simply very out of condition, begin slowly, proceeding step-by-step to a more active lifestyle. This will reduce the likelihood of joint problems. Even if you are eager to see results, it is essential that you gradually increase activity to allow your muscles, joints, ligaments, and tendons time to adjust to a new level of use. Otherwise, you may injure yourself, sabotage your grand plan, and send yourself back onto the couch.
SETTING YOUR EXERCISE GOALS
Once you have made a firm commitment to exercise,the next step is to figure out how much is enough. A lot of researchers have looked at that question, and the answers pretty much come down to this:
1.At least half an hour of aerobic activity, such as brisk walking, at least three days a week.Four to six days is even better—as is longer duration. In fact, in recommendations made in 2002, the Surgeon General of the United States called for an hour of moderate-intensity physical activity every day. An alternative goal recommended by the Centers for Disease Control in conjunction with the American College of Sports Medicine is 30 minutes of “at least”moderate activity all or most days of the week.4 You may not be able to start out at such a level, but it should be your goal, since research suggests a relationship between increased exercise and improved health benefits.5 Whatever activity you choose, it should raise your heart rate.
2. Do additional strength-training exercise at least twice a week. A good whole-body strengthening workout takes only about half an hour, although you may not have the stamina for this duration initially. On the days you do this type of workout, you can reduce the amount of aerobic activity proportionately. Do not work the same muscle groups two days in a row.
3.Give yourself a day off from exercise once a week,although if you grow to enjoy exercise, as many people do, it would be fine to take a walk on your “day off.”
Do understand that you may not be able to achieve these goals initially—but that’s not a reason to skip exercising altogether. Even a small amount of exercise is better than none at all, and most people can gradually increase their exercise level.
FIND YOUR TARGET HEART RATE
Just like any other muscle in your body, the heart gets stronger when it is worked. When you do aerobic exercise, you make your heart beat faster and harder. You don’t want to overdo that, of course, so you need a way to determine just how much faster your heartbeat should get. There’s a simple formula you can use to figure that out.
1. Begin by finding your resting heart rate. This is your heart rate when you are relaxing. Sit quietly for 15 minutes (read or watch television), then locate your pulse either on the thumb side of either wrist or on either side of your neck under the angle of your jaw. Using a watch or clock that counts seconds, count your heartbeat for ten seconds. Multiply that number by six to get the number of beats in a minute. For most people, the resting heartbeat is between 60 and 80 beats per minute. (In general, the fitter you are, the more slowly your heart beats when you’re at rest.) Write the number down and label it “resting heart rate.”As you get fitter,you’ll see two things happen:Your heart will return to its resting rate more quickly after exercise, and your resting heart rate may slow down a little.
2. Next, subtract your age from 220. Write the number down and label it “maximum heart rate.” This step compensates for your age. If you’re 50, for instance, your maximum heart rate would be 170 beats per minute (220 – 50 = 170).
Important note: You do not want to push yourself to your maximum heart rate.
3.Your starting heart rate goal during exercise is 60 percent of your maximum heart rate. So, take your maximum heart rate, as determined in step 2, and multiply it by 0.60. If your maximum heart rate is 170 beats a minute, then your exercise goal, which is called your target heart rate, is 102 beats a minute (170 × 0.60 = 102). But bear in mind that everyone’s heart rate is different, and your personal maximum heart rate could vary as much as 15 beats higher or lower than the formula. Use the numbers you get from the formula just as a guideline, not a firm target.
4. When you first start exercising, you should aim for a heart rate that is 60 percent of your maximum rate. As your fitness level increases,challenge yourself to gradually raise your exercise heart rate to 65 percent, then 70 percent or even more (up to 80 percent) of your maximum heart rate. Since your primary goal is to achieve fitness, not compete in the Olympics, the key is to build to a level that you can maintain comfortably while gaining optimum cardiovascular benefit for your time exercising.A reasonable long-range goal is a target heart rate of 70 to 80 percent of your maximum heart rate. Building to this slowly will prevent injury as well as burnout from exercising at a level that is “too hard.” Some medications, such as beta-blockers for lowering high blood pressure,can limit how quickly your heart beats.Again, if you take any prescription medications, be sure to discuss your exercise plans with your doctor first.
5.Always remember that some exercise is better than no exercise,so don’t feel discouraged if you can’t exercise for long or can’t comfortably raise your heart rate to the recommended level. Congratulate yourself for doing what you can!
Use the chart below to estimate your heart rate during exercise at the level that is right for your age and level of fitness.
TARGET HEART RATES FOR EXERCISE
AGE | ||||||
PERCENT OF | 20 | 30 | 40 | 50 | 60 | 70 |
50% | 100 | 95 | 90 | 85 | 80 | 75 |
60% | 120 | 114 | 108 | 102 | 96 | 90 |
70% | 140 | 133 | 126 | 119 | 112 | 105 |
80% | 160 | 152 | 144 | 136 | 128 | 120 |
Your goal is to start your exercise program and work up to the point where your heart rate reaches your target minimum and stays there for 30 minutes three times a week. Eventually, you’ll be able to exercise at your target maximum every day if you wish—you may also be able to stay at that level beyond 30 minutes.
CHOOSE ACTIVITIES YOU ENJOY
Exercise may be mandatory, but it should also be fun. Find an activity you like and can do without strain, a lot of advance planning, or a lot of expense. For many people, walking fills the bill, but there are plenty of other ways to get your exercise. All you have to do is find one—or more—you enjoy and do it. Dr. Atkins loved to play tennis, for instance, so he played as often as he could.
For those of you who are hard-core exercise haters, find the activity you hate the least. Give yourself rewards for small improvements. For instance, buy a book you’ve been wanting and read it while you walk on the treadmill. Treat yourself to a new CD with energetic music to keep you motivated while working out. Check out an exercise video from the library.
Some of the activities you used to enjoy—running or basketball, for instance—may now be off-limits to you because of excess weight or joint problems, such as arthritis of the knee. That’s no excuse for not exercising. Swimming, water exercises, riding a stationary bike, using an elliptical training machine, and low-impact aerobics are generally easy on your joints. And as you lose weight and strengthen your body, you may well find that your aching joints improve and let you exercise in more varied ways. If you have inflammation in your joints, after following the ABSCP and taking supplemental essential fatty acids, you should find inflammation and aching is decreased, which will allow you to exercise more.
DRINK BEFOREYOU’RE THIRSTY
The very first thing you should do at the start of any exercise session is fill up your 1-liter water bottle, drink about a quarter of it, and keep it close by.When you’re sweating and breathing hard, you lose fluid rapidly. By the time you get thirsty, you may already be a little dehydrated—even in cold weather, when you’re not sweating that much. Drinking water before, during, and after your workout keeps you properly hydrated. The payoff is that you will be able to get through your workout more comfortably. When you have adequate hydration, your body can more quickly clear away lactic acid, the by-product of exercise metabolism that causes that aching sensation in your muscles. Becoming dehydrated makes it harder to exercise and produces no long-term benefit. This isn’t about sweating off water, it is about safely burning fat, increasing muscle mass, and developing cardiovascular fitness so that you can live longer.
EXCUSES, EXCUSES
For every antiexercise excuse, there is a rebuttal:
“I hate to exercise.” I can’t tell you how often we’ve had a patient tell us,“I can’t stand exercising.It’s so boring.”Our usual reply: Unless you get moving, life as an invalid, barely able to leave the house, will be a lot more boring.Besides,exercise can be fun if you make it fun.Instead of walking alone, for instance, use that time to walk with family members and friends. Your walk stops being a chore and turns into family quality time or a pleasant visit with a friend—and everyone benefits from the exercise.
“I don’t have time to exercise.” Really? The average American watches four hours of television every day. You can easily manage to do a home aerobics workout or your weight-training routine while watching just one half-hour sitcom episode. It’s certainly better than sitting there passively.
“I really don’t have time to exercise.” If you are truly overburdened with things that must be done, it may be time to reconsider your priorities, because your exercise must be done as well. If you have to cut back on something else to be able to exercise, then do so—your health should be up there on your list of top priorities. And don’t forget that with a little imagination, you can almost always manage to work more exercise into your day (see Staying Motivated on page 283).
STAYING MOTIVATED
There are some days when the very idea of exercising seems overwhelm- ing.How can you overcome this and stay motivated? We suggest that you:
“I’m so heavy that I’m embarrassed to go to a gym.” If you are uncomfortable exercising in public you can do so quite effectively in the privacy of your own home. Moreover, exercise programs (including water aerobics) designed especially for overweight people are now available in many communities, often through local hospitals, community centers, and health clubs. Look for such a program; you’ll probably find one nearby. Instead of being embarrassed, you may end up finding yourself an exercise buddy with the same goals as yours.
TEN WAYS TO SNEAK IN SOME EXERCISE
Anything that gets you moving—even housework—counts as exercise. Studies have also shown that three 10-minute sessions of exercise per day are almost as effective as one 30-minute session.6 Especially on days when you just can’t work in an exercise session, try these simple ways to add some movement to your daily life:
WHAT’S YOUR EXERCISE IQ?
1. Which forms of exercise below are aerobic?
2. Your goal is to exercise how often?
3. Your goal when you exercise is to raise your heart rate to:
4. Bonus question for women:
Which of the following statements are true about exercise for women?
Answers
e,true.d,true;c,true;b,false;1.b,d,e,f.2.a.3.c.4.a,false;