Exercise-not just about the weight loss

How many people do you know who’ve given up an exercise program when the weight doesn’t come off immediately? Too many, I’m sure.

Now, there’s yet another study showing that there are benefits to exercise, even when the stones aren’t dropping.

The Journal of the American Medical association (JAMA) published a piece this week extolling the benefits of exercise for diabetes patients. The opinion,  released to coincide with the 72nd annual Scientific Sessions of the American Diabetes Association,  suggests that even moderate exercise can help treat diabetes caused by obesity. Here’s a portion of that report:

“There’s long-standing evidence that physical fitness can help people live longer, even those who carry too many pounds. Seminal research by Steven Blair, PED (then at the CooperInstitute of Aerobics Research in Dallas, Texas) and colleagues found that cardiovascular fitness is strongly associated with improved survival and is independent of body weight (Blair SN et al. JAMA. 1989;262[17]:2395-2401). Further studies have extended these findings, showing that physical fitness is closely associated with diabetes, also independent of body fatness.

There is a dramatic, steep increase in mortality among patients with very low fitness scores. “Actually, it is not fitness we are concerned about but rather low fitness,” said Carl Lavie, MD, of the John Ochsner Heart and Vascular Institute in New Orleans, who spoke at a symposium on the importance of fitness on the pathophysiology and treatment of diabetes. Although both fitness and fatness are important, cardiorespiratory fitness greatly modifies the association of obesity with death due to cardiovascular disease, he said.

The underlying mechanism, explained John Thyfault, PhD, an exercise physiologist at the University of Missouri, appears to be the key role that that muscle plays in how the body processes glucose. The best indicator for the risk of developing diabetes or cardiovascular disease is the glucose response when food is consumed. The release of insulin following food ingestion facilitates glucose transport into muscle and fat and inhibits a mechanism the body uses to keep blood glucose levels from dropping too low, hepatic gluconeogenesis (the generation of glucose in the liver from substances other than carbohydrates, such as lactate). About 80% of circulating glucose is transported into muscle, making it the most important organ in maintaining proper glucose levels.”

The researchers conclude that some of the benefit of exercise in patients with diabetes comes from NOT being sedentary, and not necessarily from being superfit. They also suggest that resistance and strength training are also important in improving the health of diabetics.

Could exercise be bad for you?

A bit of a disturbing study – and it’s just one study- from the States, suggesting that for some healthy people exercise could be bad for the heart.  Gina Kolata writes about it on the NY Times Health blog. Here’s a portion:

“Could exercise actually be bad for some healthy people? A well-known group of researchers, including one who helped write the scientific paper justifying national guidelines that promote exercise for all, say the answer may be a qualified yes.

By analyzing data from six rigorous exercise studies involving 1,687 people, the group found that about 10 percent actually got worse on at least one of the measures related to heart disease:blood pressure and levels of insulin, HDL cholesterol or triglycerides. About 7 percent got worse on at least two measures. And the researchers say they do not know why.”

The study suggests that an equal percentage of people showed very good changes to those key measures.  One of the mysteries is that there doesn’t seem to be a significant correlate to age, gender, race, or previous level of fitness.  The study was not long-term, so failed to measure the actual impact on heart disease and mortality.

In contrast to this study, shows like the Biggest Loser are showing that exercise is a significant part of the treatment for unhealthy people with conditions like diabetes and cardiovascular disease. See this Medscape article.

So what is a jogger to do? Or a swimmer? Or cyclist? I would never suggest anyone ignore the results of good science, but in this case there is so much data supporting regular exercise — from weight loss to improved psychological outlook – that I would file this study under “lets check again about this later, when more research backs it up and spells out the significance.”

My suspicion is that many who start a new exercise program do so too vigorously, and that might have a negative impact on parts of the body.

From losing weight to one of the world’s fittest

Rich Roll is considered one of the world’s fittest people.

Rich Roll says he “unlocked a more authentic version of” himself by training for and competing in endurance events. It started with trying to get in shape by paying attention to his diet and his weight, and morphed into a love of the endurance world. He’s a top ironman triathlete, competes in ultraman events, and is the author of several books, including Finding Ultra: Rejecting Middle Age. You can hear a brief interview he did with NPR’s Weekend Edition by clicking here.

He describes his journey as a spiritual one, but are the incredibly long hours of training the best way to achieve internal transformation? Critics of endurance events and training claim that the activities are self-centered and potentially damaging. It’s not uncommon for ultra endurance athletes to be told by some friends and families that they’ve lost their  minds. Yet, the athletes themselves feel fulfilled in a way that they never have before.

I’ve competed in some endurance events (not ultras) and spoken to many, many athletes who are totally committed to the endeavor. There’s not a single, unifying reason why they do it. However, increasingly, people are looking for ways to distinguish themselves from the “average” person – as Roll says in his interview, to line-up next to some of the top elite athletes in the world.