Pumping Up With Protein: Does This Work for Exercise and Health?

Protein is never a key exercise fuel, but it’s critical for other reasons. During most exercise, protein contributes less than 5 percent of the total energy, although it may rise to 10 to 15 percent during a prolonged event like a marathon or Ironman triathlon. Taking in enough dietary protein is important because dietary protein allows your muscles to be repaired after exercise and promotes the synthesis of hormones, enzymes, and other body tissues formed from amino acids, the building blocks of protein.

You should consume at least 12 to 35 percent of your daily calories as protein. For most people this means taking in at least 60 grams of protein daily.

About half of the 20 amino acids are considered essential in your diet, meaning that you must consume them or your body will suffer from protein malnutrition, which causes the breakdown of muscles and organs. Essential amino acids are found in meats, poultry, fish, dairy, eggs, and soy products; all plant-based foods besides soy are lacking one or more essential ones, but taking in combinations of plant sources (like rice and beans) can supply what you need.

Your body can make the rest of the amino acids itself (they are the nonessential ones). But you need to have enough protein in your diet overall to synthesize body proteins after workouts, which is a critical time for increases in strength, aerobic capacity, or muscle size.

Because protein is important to overall health but isn’t a major exercise fuel, you do need to worry about consuming enough, although it doesn’t have to happen right before or during an activity. You’ll get most effective restoration of liver glycogen if you keep your blood glucose levels in tight control after exercise. Consuming a small amount of protein along with carbohydrate (in a ratio of 1:4, or one gram of protein to every four grams of carbohydrate) after an activity may help you repair your muscles and get stronger more quickly.

Typically, an ounce of chicken, cheese, or meat has about 7 grams of protein.

Taking in more protein and slightly less carbohydrate after exercise can help keep your blood glucose more stable over time because protein takes three to four hours to be fully digested, and some protein is converted into blood glucose. You can eat protein strategically to prevent later-onset hypoglycemia, which insulin users are more likely to get. Have some in your bedtime snack (along with fat and carbohydrate) to prevent nighttime lows after a day of strenuous or prolonged activity, if you use insulin.

Taking in some protein along with carbohydrate right after hard or long workouts may ­help ­your body ­replenish ­its ­glycogen ­stores ­more ­effectively. Though­ anyone ­who ­is ­getting ­older—­and ­that ­includes ­all ­of ­us—­can­ benefit from taking in enough protein, supplements are usually not the optimal way to get enough. Let me explain why.

As you get older, your body may need a more protein compared to when you were younger ­to form, maintain, ­and­ repair ­muscles­ and­ other ­body ­structures. Anyone who is doing regular exercise training also needs more protein to repair and build muscle, but you can usually get this amount (and more) when you’re eating ­a­­ balanced ­meal ­plan ­with ­adequate ­calories. To­ figure out ­how­ much ­you need, ­find ­the ­category ­that ­fits ­your ­age ­and ­training, ­and ­multiply ­your body weight­ (in pounds­ or­ kilograms)­ by­ the­ grams­ found­ in­ the­ corresponding table ­column.

TABLE           Recommended Protein Intake by Training Status and Age

Per Pound Body Weight         Per Kilogram Body Weight

Adults 19 to 50 years (inactive)          0.36 grams                              0.8 grams

Adults over 50 years (inactive)           0.5 grams                                1.1 grams

Endurance training                              0.55–0.64 grams                     1.2–1.4 grams

Strength training                                 0.68–0.77 grams                     1.5–1.7 grams

Calorie deprived (diets)                      0.73–0.82 grams                     1.6–1.8 grams

The biggest myth about amino acid supplements, and protein in general, is that you must load up on them to gain muscle. That’s just not true. The protein requirement for strength-training athletes may be about twice as high as normal, but most people in the United States already consume more than these higher amounts of protein in their daily diets.

To put it in perspective, to gain one pound of muscle mass a week (a realistic maximum), a strength-training athlete needs no more than 14 extra grams of quality protein per day. You can easily get this amount from these sources:

» About two 8-ounce glasses of milk

» 2 ounces of lean meat, chicken, fish, or cheese (which isn’t much)

» Slightly more than 2 eggs (only the whites contain protein)

Adequate intake of protein also helps to maintain lean body mass when you lose weight on a diet and can help you gain more muscle mass from exercise training.

Reference:  Excerpted from Colberg, SR, “Chapter 7: Eating Right for Exercise,” Diabetes & Keeping Fit for Dummies, Wiley, 2019.

Regaining Fitness in a Post-Pandemic World

Yes, I know we’re still dealing with a life-changing pandemic around the world and especially in most areas of the United States, but it is still worth thinking ahead to what comes next. Despite our discussion last month on non-gym fitness trends (focused around an article in Time [1]), it is more than likely that many of us have experienced a change (most often a decrease) in our daily physical activities and, subsequently, in our aerobic and muscular fitness levels.

A recent study conducted in Washington state (the state first impacted by curtailed daily activities) showed that strategies to mitigate the COVID-19 pandemic may be impacting physical activity and mental health, with those experiencing a decrease in physical activity also having higher levels of stress and anxiety (2). While a few of us may have gotten more active while working from home or having an altered daily life, the rest of us have had to curtail our activities—if not our workouts in public spaces like gyms and pools, at least our daily movement. When confined to our homes for working and learning, the lack of a daily commute to arrive at work or school by itself can remove a lot of daily steps that people would otherwise be taking, and mental stress and anxiety may be leading people to engage in other less healthy behaviors like stress eating.

Past research has demonstrated greater strength gains and blood glucose improvements from doing resistance training using harder weights or resistance than most people have access to at home, and regular participation is reinforced by supervision during training sessions and/or by social support arising from group exercise (2,3) What does that say about the future of working out at home, seldom if ever supervised and often alone? It may be hard to predict, but it is undeniable that doing any activity is better than none at all. Nonetheless, it is entirely likely that we will have lost some aerobic capability and muscular strength by the time we are able to restart our pre-pandemic activities.

So, what can we do to prepare to fully reenter the fitness world after it is finally considered safe to resume our pre-pandemic lifestyles? The best way to be ready is to stay as active as possible by doing anything you can from home or other safe venues now. That includes getting involved in virtual fitness classes, dusting off and using any exercise equipment you have at home, doing exercises using your body weight as resistance, and breaking up your sedentary time frequently, regardless of where you are working or learning.

Here are some other tips to keep in mind:

  • Find some time every day to be active, even if you only stand up during meetings instead of sitting or do easy exercises next to your desk.
  • Do more spontaneous activity, including getting up to break up sitting time for a few minutes every 20 to 30 minutes.
  • Use whatever equipment or household items you have access to in order to add a little resistance training to your day (aim for two to three days per week).
  • Use the latest technology or other tracking device to make sure you are getting in a minimum of activity every day (set daily and weekly goals for yourself).
  • Start out slowly and progress slowly over time once you can get back into doing more and harder activities as your top priority should be gaining fitness without injuring yourself.

Remember, when you’re starting out all over again, the same principles apply as when you began getting physically fit in the first place. Avoid the pitfalls that can lead to injury and demotivation, such as starting back at too high of an intensity. Hopefully, if nothing else, this pandemic will have lead people to become more creative with their workouts and help everyone find ways to fit in more activity into their daily lives, during and after we’re through this rough patch.

References:

  1. Time magazine, July 15, 2020: https://time.com/5867166/covid-19-gyms-exercise/?fbclid=IwAR1DVNQEd03PaHdwZXSKlRNhYvlMosxVYg_Gfy5weAyk89Q5NTt82DRY8og
  2. Duncan GE, Avery AR, Seto E, Tsang S. Perceived change in physical activity levels and mental health during COVID-19: Findings among adult twin pairs. PLoS One. 2020;15(8):e0237695. Published 2020 Aug 13. doi:10.1371/journal.pone.0237695
  3. Dunstan DW, Daly RM, Owen N, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care. 2002;25(10):1729-1736. doi:10.2337/diacare.25.10.1729
  4. Dunstan DW, Daly RM, Owen N, et al. Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care. 2005;28(1):3-9. doi:10.2337/diacare.28.1.3
  5. Dempsey PC, Larsen RN, Sethi P, et al. Benefits for Type 2 Diabetes of Interrupting Prolonged Sitting With Brief Bouts of Light Walking or Simple Resistance Activities. Diabetes Care. 2016;39(6):964-972. doi:10.2337/dc15-2336

Working Out at Home: Is This the Wave of the Future?

The current pandemic has hit most traditional gyms and fitness centers hard, especially once more has been learned about the likely spread of the virus through respiratory droplets. There are admittedly few places with more collective heavy breathing than you’ll find in indoor workout venues!

After reading a recent article in Time on non-gym fitness trends in a COVID-19 world, I started asking others how they have been coping with transitioning to home-based workout routines. I asked, “So what’s your new favorite, home-based physical activity?” Most of the people who voluntarily answered my queries were coping quite well actually. Here are some examples:

  • Virtual fitness classes, Zumba, Pilates, Yoga and free weights on my own. I also teach virtual classes these formats.
  • Garage workouts and family bike rides
  • My total gym machine and I have made up and are a thing again. Hand weights with my favorite TV shows work well.
  • I love riding my bike ❤️
  • I have enjoyed TRX, kettlebell, and resistance band workouts.
  • Rediscovered exercise bands which I use with my home weights, coupled with daily walks. I’ve enjoyed training differently to going back to the gym. Will I go back to the gym? I think so when the old flexibility of going when I want rather than booking time in around new hours.
  • LOVE using the @Ergatta program with my indoor WaterRower rowing machine!
  • Not at home but, a very socially distant sport is Disc Golf. A nice walk in a park, but also focuses on eye hand coordination. Throwing skills can also be learned.
  • Living in a province with an awesome chief public health officer, Dr. Bonnie Henry, who has encouraged people to exercise outside, while observing physical distancing precautions.
  • Dance warm ups and indoor rowing, oh and chasing baby rabbits round the garden.
  • I’ve finally started my power walks right here in the neighborhood or on the beach. Fringe benefit: I know my way around the community now!

And my personal favorite:

  • Do beach walks count?

Yes, absolutely they do! (Just remember to social distance and wear a face covering when you can’t stay at least six feet apart from others on the beach.) Actually, all of the activities listed can work for you, as can many others. (Please feel free to access and download some of the anywhere, anytime exercises I recommend through the Resources page on Diabetes Motion Academy at https://www.dmacademy.com/resources.)

Later in the July 2020 Time article, it states, “Only 20% of Americans said they’d feel comfortable going to a gym as of July 13, according to a Morning Consult poll. Another survey, conducted by market-research firm OnePoll and commissioned by LIFEAID Beverage Co., found that 25% of Americans never plan to go back.” I have heard similar comments from family members and friends who were, up until a few months ago, consistent gym-goers, as I was myself.

What does that say about the future of working out at home versus returning to the gym once this pandemic is under control? I think that remains to be seen. However, if we can all figure out ways to be more physically active around our homes and neighborhoods without needing to shoulder the cost of joining a gym or the inconvenience of getting there, that may lead to all of us become and remain more active and improve our collective health far more than we have been able to do with gym memberships and lapsed attendance.

Gyms will still exist after this pandemic ends—at least some of them—and many people will enjoy going back to them and restarting their old workout routines. However, with the pervasive availability of the internet nowadays, the potential for use of Zoom and other virtual interactions, and additional innovative means of connecting to exercise and active communities remotely, I personally look forward to seeing what new and creative avenues this pandemic ends up leading us to in the fitness world!

Reference: Time magazine, July 15, 2020: https://time.com/5867166/covid-19-gyms-exercise/?fbclid=IwAR1DVNQEd03PaHdwZXSKlRNhYvlMosxVYg_Gfy5weAyk89Q5NTt82DRY8og

Exercising with Type 1 Diabetes: The Insulin-Food Balance Challenge

Addressing how to balance blood glucose levels during (and after) exercise with type 1 diabetes is not new. In fact, it is likely the KEY topic to address to be successful at being physically active if you take exogenous insulin and want to prevent hypoglycemia or hyperglycemia during exercise. Strategies include changing in insulin doses and/or supplementing with food, either of which can be done in myriad ways depending on the activity, timing, and more.

A recent 2020 study revisited whether it works better to supplement with carbohydrates or lower bolus (meal-time) insulin doses before exercise to prevent lows (1). Its conclusion—for this particular group of subjects doing continuous, moderate-intensity cycle ergometer exercise for ∼45 minutes—was that taking in 15 to 30 grams of carbohydrate when blood glucose levels decreased to 7.0 mmol/L (126 mg/dL) prevented hypoglycemia better. Okay, but….

My issue with these types of studies is not that they don’t prove a point—they do—but it’s that they prove a very, very narrow point. The results can only be generalized to people with the same physical fitness level, age, sex, and diet undertaking a specific type, intensity, duration, and timing of activity. Exercising with type 1 diabetes is so much broader than that. Moreover, it’s not just short-term insulin dosing or immediate carbohydrate intake that have an impact on balancing blood glucose and affecting how successful you are at being active.

Whether participating in sports or physical activity on a recreational basis or striving to be a professional or Olympic athlete, anyone who takes insulin must pay attention to his or her unique nutritional and dietary patterns, including intake of macronutrients (carbohydrate, protein, and fat), micronutrients (vitamins and minerals), fluids, and supplements like caffeine to maintain metabolic and glycemic balance (2). Athletic performance aside, nutritional recommendations may also differ on an individual basis relative to exercise, glycemic management, and body weight goals. Balancing all these dietary factors can be challenging for individuals with type 1 diabetes, and many related aspects have yet to be fully researched in this population.

Carbohydrates undeniably have the most immediate impact on blood glucose and must be matched with adequate insulin doses to manage blood glucose peaks after eating (3), but protein and fat intake can impact insulin needs as well (4). When you’re an active individual with type 1 diabetes, you must balance all your dietary choices before, during, and after exercise to manage blood glucose levels not to just prevent lows or highs, but also for optimal performance and recovery from working out or competing. It’s possible to eat many different ways including low-carbohydrate (5), and the best nutritional practices to optimize performance may or may not be best for blood glucose management, optimal health, and body weight simultaneously, potentially making achievement of athletic and health goals difficult at times.

As for insulin dosing, people vary so much with regard to their usual doses, insulin sensitivity, types of insulin used (basal and bolus choices), delivery (that is, insulin pump use vs. injections or inhalation), and more. It makes the whole balancing act that much more difficult, especially when blood glucose responses vary with the type of activity being done, including how long, how hard, how often, and under which environmental conditions. Even hydration status matters! Given how limited studies by nature must be to limit all these conditions, it takes individual trial-and-error to figure out what works best to maintain blood glucose levels in a fairly tight (and hopefully normal) range for each and every unique activity bout.

Many insulin users have still managed to figure out how to compete athletically at the highest levels, although it is far from simple when balancing blood glucose levels with these many confounding variables (6). It’s certainly still worth it to be physically active with type 1 diabetes, just a challenge!

References:

  1. Eckstein ML, McCarthy O, Tripolt NJ, et al. Efficacy of carbohydrate supplementation compared with bolus insulin dose reduction around exercise in adults with type 1 diabetes: A retrospective, controlled analysis. Can J Diabetes, 2020 (in press), https://doi.org/10.1016/j.jcjd.2020.03.003.
  2. Colberg SR, Nutrition and exercise performance in individuals with type 1 diabetes. Can J Diabetes, 2020 (in press), https://doi.org/10.1016/j.jcjd.2020.05.014.
  3. Bell KJ, King BR, Shafat A, Smart CE. The relationship between carbohydrate and the mealtime insulin dose in type 1 diabetes. J Diabetes Complications. 2015;29(8):1323-9, https://doi.org/10.1016/j.jdiacomp.2015.08.014.
  4. Bell KJ, Smart CE, Steil GM, Brand-Miller JC, King B, Wolpert HA. Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes: implications for intensive diabetes management in the continuous glucose monitoring era. Diabetes Care. 2015;38(6):1008-15, https://doi.org/10.2337/dc15-0100.
  5. Scott SN, Anderson L, Morton JP, Wagenmakers AJM, Riddell MC. Carbohydrate restriction in type 1 diabetes: A realistic therapy for improved glycaemic control and athletic performance? Nutrients. 2019;11(5):1022, https://doi.org/10.3390/nu11051022.
  6. Riddell MC, Scott SN, Fournier PA, et al. The competitive athlete with type 1 diabetes [published online ahead of print, 2020 Jun 12]. Diabetologia. 2020;10.1007/s00125-020-05183-8, https://doi.org/10.1007/s00125-020-05183-8.

5 Key Strengthening Exercises for People with Diabetes

Although stay-at-home restrictions are loosening around the USA and summer is coming, you may still need to get some of your activities indoors at home for a variety of reasons. If you aren’t doing resistance workouts already, you should really consider adding some resistance exercises to your normal regimens.

In fact, if you do nothing else, doing these 5 key exercises is critical for people with diabetes who may have weak core muscles, altered gait and balance, and central and peripheral nerve damage.  If you lose your core strength, it will affect your ability to do all activities of daily living, including walking and living independently.

Do at least one set of 8-15 reps of each one, but work up to doing 2-3 sets of each one per workout.  For best results, do these exercises at least 2 or 3 nonconsecutive days per week — muscles need a day or two off to fully recover and get stronger — but just don’t do them right before you go do another physical activity (as a fatigued core increases your risk of injury). 

These and many more exercises are available on Diabetes Motion Academy for free download. You will find all the illustrations for the following exercises here as well.

Exercise 1: Crunches with waist worker

Exercise 2: Chair sit-ups OR Low back strengthener

Exercise 3: Modified push-ups

Exercise 4: Squats OR Suitcase lifts

Exercise 5: Sit-to-Stand exercise

#1: Crunches with waist worker

Crunches:

Directions:

•     Lie down on your back with your knees bent.

•     Place your hands on your head right behind your ears.

•     While breathing out, contract your abdominal muscles to lift your head, neck, and shoulders off the floor and curl forward no more than 45 degrees.

•     Hold for a moment before returning to the starting position, then repeat.

Waist worker:

Directions:

•     Lie on your back on the mat with your legs bent, your feet flat on the floor, and your left hand behind your head.

•     Stretch your right hand across your body toward your opposite (left) knee and circle your hand three times around your knee in a counterclockwise direction; your right shoulder blade will lift off the mat.

•     Repeat the circular movement around the right knee using your left arm, but in a clockwise motion.

•     Keep your head in a neutral position and relax your neck to ensure that the contraction is in your abdomen area only.

#2: Chair sit-ups OR Low back strengthener

Chair sit-ups:

Directions:

•     Sit up straight in a chair with your feet on the floor, hands to your sides for support.

•     Bend forward, keeping your lower back as straight as possible, moving your chest down toward your thighs.

•     Slowly straighten back up, using your lower back muscles to raise your torso.

•     For added resistance, put a resistance band under both feet before you start and hold one end in each hand during the movement.

            OR

Low back strengthener (Superman exercise):

Directions:

•     Lie on your stomach with your arms straight over your head, your chin resting on the floor between your arms.

•     Keeping your arms and legs straight, simultaneously lift your feet and your hands as high off the floor as you can (aim for at least three inches off the floor).

•     Hold that position (sort of a Superman flying position) for 10 seconds if possible, and then relax your arms and legs back onto the floor.

•     If this exercise is too difficult to start, try lifting just your legs or arms off the floor separately–or even just one limb at a time.

#3: Modified push-ups

Directions:

•     Get on your hands and knees on the floor or mat.

•     If using a band for extra resistance, position it across your back and hold one end of it in each hand so that it is somewhat tight when your elbows are straight.

•     Place your hands shoulder-width apart on the mat.

•     Tighten your abdominal muscles to straighten your lower back and lower yourself (from your knees, not your feet) down toward the mat as far as you can without touching it.

•     Push yourself back up until your arms are extended, but without locking your elbows.

•     If this exercise is too hard, stand facing a wall and place your arms on it at shoulder height and your feet about a foot away; then, do your push-ups off the wall (with or without a resistance band).

#4: Squats OR Suitcase Lifts

Squats:

Directions:

•     Stand with a dumbbell (or household item, like water bottles) in each hand and your feet shoulder-width apart, with your toes pointing slightly out to the side.

•     If you’re using a resistance band, tie both ends of your band onto a straight bar or broom handle, which is placed squarely across your shoulders with the loop of the tied band placed under your feet.

•     Keep your body weight over the back portion of your foot rather than your toes; if needed, lift your arms out in front of you to shoulder height to balance yourself.

•     Begin squatting down but stop before your thighs are parallel to the floor (at about a 70-degree bend), keeping your back flat and your abdominal muscles firm at all times.

•     Hold that position for a few seconds before pushing up from your legs until your body is upright in the starting position.

•     Do squats with your back against a smooth wall if needed to maintain your balance.

OR

Suitcase lift:

Directions:

•     After placing dumbbells (or household items) slightly forward and between your feet on the floor, stand in an upright position with your back straight.

•     Keep your arms straight, with your hands in front of your abdomen.

•     With your back straight, bend only your knees and reach down to pick up the dumbbells.

•     Pick up the dumbbells or items in both hands, then push up with your legs and stand upright, keeping your back straight.

#5: Sit-to-Stand exercise

Directions:

•     Sit toward the front of a sturdy chair and fold your arms across your chest.

•     Keep your back and shoulders straight while you lean forward slightly and practice using only your legs to stand up slowly and to sit back down.

•     To assist you initially, place pillows on the chair behind your low back.

From Diabetes Motion Academy Resources, Sheri R. Colberg © 2020.

Manage Your Stress with Some At-Home Flexibility Exercises

Hamstring stretch illustratedFeeling stressed out by the pandemic or by being trapped at home with no end in sight? If you’re a regular exerciser like me, the closure of gyms and fitness centers in most parts of the country may be limiting your options to de-stress by being active. Take a few minutes each day and work on your flexibility with these simple exercises you can do at home. These and many more illustrated exercises are available on Diabetes Motion Academy for free download.

Flexibility exercises in their simplest form stretch and elongate muscles. Good flexibility is as important a part of fitness as stamina. Muscles must be strong, but they also have to be long (as opposed to contracted) to work optimally. In fact, stretching can do a lot more for your figure than aerobic exercise because flexibility work results in a supple, toned, and streamlined body. Moreover, the benefits of greater flexibility may go beyond the physical to include stress reduction and promotion of a greater sense of well-being. Exercise disciplines which incorporate stretching with breath control and meditation include yoga, tai chi, and Pilates.

In creating your flexibility workouts and completing them a minimum of 2-3 times a week, it’s again important to include stretches for all of the major muscle groups in your body. You will regain some of your flexibility by stretching regularly, although your gains may be ultimately limited by your genetic makeup, arthritis, metabolic control, and other variables. Nonetheless, even people with type 2 diabetes experience flexibility gains by doing just eight weeks of stretching of their major upper- and lower-body muscles thrice weekly in conjunction with a moderate resistance training program, so likely everyone will benefit to some degree from regular flexibility training and from moving their joints through their full range of motion.

Flexibility Training “Do’s” and “Don’ts”

Do:

  • Use a full range of motion around joints when stretching
  • Complete at least one stretch per major muscle group, optimally holding each stretch for 15 to 30 seconds
  • Stretch all parts of your body two to three days per week
  • Complete equal stretching exercises on both sides of your body or a joint
  • Breathe deeply during all stretches to relax your muscles more

Don’t:

  • Bounce during stretches, as doing so can cause muscle tears and joint injuries
  • Forget to stretch opposing muscle groups equally (e.g., quads and hamstrings)
  • Stretch to the point of causing sharp pain or intense discomfort
  • Continue with a stretch if you feel a sharp or immediate pain in any joint or muscle
  • Hold your breath or strain while stretching

To get the maximum benefit from static stretching, perform each stretch slowly. Doing the exercises correctly, with good form, is much more important than doing them quickly. To have any lasting effect on the muscle being stretched, you need to hold the stretch for at least 10 seconds to start. The more regularly you stretch, the better you become at judging how far to take your body. Aim to increase the duration of your stretches, so that you are eventually able to hold them for up to 30 seconds, the point at which muscles optimally start to lengthen. Also, be sure to stretch both sides of your body equally, as well as opposing muscles on both sides of a joint (such as biceps and triceps on the upper arm).

Download the free, printable PDF for illustrations and instructions of these flexibility exercises:

 

Upper-Body Stretches

#1: Neck stretch

#2: Shoulder/upper back stretch

#3: Chest/shoulder stretch

#4: Shoulder/biceps stretch

#5: Upper back/triceps stretch

#6: Wrist stretch

 

Lower-Body Stretches

#1: Quad (front of thigh) stretch

#2: Hamstring (back of thigh) stretch

#3: Alternate hamstring (back of thigh) stretch

#4: Gluteal (bottom) stretch

#5: Calf stretch

#6: Ankle stretch

 

Other Stretches

#1: Abdominal stretch

#2: Back/gluteal stretch

#3: Complete back (cat) stretch

#4: Total body stretch

                                                                                                                                               

From Diabetes Motion Academy Resources, “Flexibility Exercises,” Sheri R. Colberg © 2017.

Exercising in a Pandemic: 10 Easy Exercises to Build a Strong Core Without Leaving the House

Pelvic tilt

Just in time for the novel coronavirus (COVID-19) social distancing and closures of gyms and fitness centers in many areas, here’s a revisit of many important core exercises you can do at home to keep yourself strong and healthy. Download the free illustrated PDF (Chapter 21) for illustrations. You can also find a variety of other at-home exercises on Diabetes Motion Academy Resources for free download.

Many people are stuck at home for one reason or another think they can’t work on staying fit, but the truth is that you can get a stronger core and stay fitter without leaving home. You’d be amazed at how easy it is to get your fit on.

Remember: Your body core — the muscles around your trunk and pelvis — is particularly important to keep strong so that you can go about your normal daily activities and prevent falls and injuries, particularly as you age. Having a strong body core makes you better able to handle your daily life, even if that’s just doing grocery shopping or playing a round of golf.

Core exercises are an important part of a well-rounded fitness program, and they’re easy to do at home on your own. To get started on your body core workout, you don’t need to purchase anything. (Some of the advanced variations do call for equipment like a gym ball or dumbbells.)

Tip: Include all 10 of these easy core exercises in your workouts, doing at least one set of 15 repetitions of each one to start (where appropriate). Work up to doing two to three sets of each per workout, or even more repetitions if you can. For best results, do these exercises at least two or three nonconsecutive days per week; muscles need a day or two off to fully recover and get stronger. Just don’t do them right before you do another physical activity (because a fatigued core increases your risk of injury).

#1: Abdominal Squeezes

This exercise (Figure 21-1) is great for working your abdominals and getting your body core as strong as possible. If you’re female and have had gone through a pregnancy at some point, getting these muscles in shape doing these squeezes is a must.

  1. Put one of your hands against your upper stomach and the other facing the other direction below your belly button.
  2. Inhale to expand your stomach.
  3. Exhale and try to pull your abdominal muscles halfway toward your spine.

This is your starting position.

  1. Contract your abdominal muscles more deeply in toward your spine while counting to two.
  2. Return to the starting position from Step 3 for another count of two.

Work up to doing 100 repetitions per workout session.

#2: Planks or Modified Planks

Nobody likes doing planks, but they get the job done when it comes to boosting the strength of your core. Both planks and modified planks (Figure 21-2) work multiple areas, including your abdominals, lower back, and shoulders.

  1. Start on the floor on your stomach and bend your elbows 90 degrees, resting your weight on your forearms.
  2. Place your elbows directly beneath your shoulders and form a straight line from your head to your feet.
  3. Hold this position as long as you can.

Repeat this exercise as many times as possible during each workout.

#3: Side Planks

A modification of regular planks, this side plank exercise (Figure 21-3) works some of the same and some slightly different muscles that include your abdominals, oblique abdominal muscles, sides of hips, gluteals, and shoulders. Try doing some of both types for the best results.

  1. Start out on the floor on your side with your feet together and one forearm directly below your shoulder.
  2. Contract your core muscles and raise your hips until your body is in a straight line from head to feet.
  3. Hold this position without letting your hips drop for as long as you can.
  4. Repeat Steps 1 through 3 on the other side.

Switch back and forth between sides as many times as you can.

Tip: Try these plank variations to mix things up a bit:

* Raised side plank: Lifting both your top arm and your leg upward brings other muscles into play and makes your core work harder to maintain balance, but don’t let your hips sag.

* Gym ball side plank: Resting your supporting arm on a gym ball, use your core muscles to control the wobble to further strengthen your side muscles.

* Side plank with lateral raise: While holding the side plank position, slowly raise and lower a light dumbbell or other weight with your top arm to improve your coordination and strength.

* Side plank pulse: From the side plank position, add a vertical hip drive by lowering your hips until they’re just off the floor and then driving them up as far as you can with each repetition of this move.

#4: Bridging

If you work on your abdominal strength, you also need to build the strength in your lower back to keep things balanced. Bridging (Figure 21-4) is a good exercise to do that as it works your buttocks (including gluteals), low back, and hip extensors. Remember to breathe in and out throughout this exercise.

  1. Slowly raise your buttocks from the floor, keeping your stomach tight.
  2. Gently lower your back to the ground.
  3. Repeat Steps 1 and 2.

Tip: Try the bridging with straight leg raise variation: With your legs bent, lift your buttocks up off the floor. Slowly extend your left knee, keeping your stomach tight. Repeat with the other leg. Do as many repetitions as possible.

#5: Pelvic Tilt

An easy exercise to do, the pelvic tilt (Figure 21-5) works your lower back and
lower part of your abdominals.

  1. Lie on your back on the floor with your knees bent and feet flat on the floor.
  2. Place your hands either by your sides or supporting your head.
  3. Tighten your bottom, forcing your lower back flat against the floor, and then relax.
  4. Repeat Steps 2 and 3 as many times as you can.

#6: Superhero Pose

Whether you want to leap a tall building with a single bound or not, try doing this superhero pose exercise (Figure 21-6) to get a stronger core. It works many areas, including your lower back, upper back, back of shoulders, and gluteals.

  1. Lie on your stomach with your arms straight over your head.
  2. Rest your chin on the floor between your arms.
  3. Keeping your arms and legs straight, simultaneously lift your feet and your hands as high off the floor as you can.

Aim for at least three inches.

  1. Hold that position (sort of a superhero flying position) for 10 seconds if possible, and then relax your arms and legs back onto the floor.

Tip: If this exercise is too difficult, try lifting just your legs or arms off the floor separately — or even just one limb at a time.

#7: Knee Push-Ups

Push-ups are hard to do if you haven’t built up the strength in your shoulders yet, so this knee version (Figure (21-7) is an easier way to start for most people. This exercise works your chest, front of shoulders, and back of upper arms.

  1. Get on your hands and knees on the floor or a mat.
  2. Place your hands shoulder-width apart on the floor.
  3. Tighten your abdominal muscles to straighten your lower back and lower yourself down toward the floor as far as you can without touching.
  4. Push yourself back up until your arms are extended, but don’t lock your elbows.

Tip: If knee push-ups are too hard for you, try doing wall push-ups to start instead. Stand facing a wall at an arm’s length and place your palms against it at shoulder height and with your feet about a foot apart. Do your push-ups off the wall.

#8: Suitcase Lift

This exercise (Figure 21-8) is the proper way to lift items from the floor. Before you begin, place dumbbells or household items slightly forward and between your feet on the floor. You work the same muscles used in doing squats (lower back and lower body) with this activity.

  1. Stand in an upright position with your back and arms straight, with your hands in front of your abdomen.
  2. Bending only your knees, reach down to pick up the dumbbells.
  3. Grab the dumbbells or items in both hands and then push up with your legs and stand upright, keeping your back straight.

#9: Squats with Knee Squeezes

These squats (Figure 21-9) are not your normal squats. They’re more like a combination of squatting and wall sitting with a twist. You work the front and back of thighs, inner thighs (adductors), hip flexors and extensors all with this one exercise.

  1. Stand with your back against the wall, with your feet aligned with your knees and straight out in front of you.
  2. Place a ball or pillow between your knees and hold it there with your legs.
  3. Inhale to expand your stomach and then exhale and contract your abdominal muscles.
  4. Bend your knees and lower yourself into a squat.

Warning: To avoid injuring your knees, don’t bend them more than 90 degrees.

  1. Squeeze the ball with your thighs, drawing your stomach muscles more deeply toward your spine.
  2. Do as many squeezes as you can up to 20 and then return to the starting position.

#10: Lunges

Lunges (Figure 21-10) are a common activity to work on the front and back of thighs, hip flexors and extensors, abdominals, and lower back all with one exercise. Do them with proper form to avoid aggravating your knees, though.

  1. Keep your upper body straight, with your shoulders back and relaxed and chin up.
  2. Pick a point to stare at in front of you so you don’t keep looking down, and engage your core.
  3. Step forward with one leg, lowering your hips until both knees are bent at about a 90-degree angle.

Make sure your front knee is directly above your ankle, not pushed out too far, and don’t let your back knee touch the floor.

  1. Focus on keeping your weight on your heels as you push back up to the starting position.

Tip: To prevent injuries, if you feel any pain in your knees or hips when you do a lunge, do the following instead:

  • Take smaller steps out with your front leg.
  • Slowly increase your lunge distance as your pain gets better.
  • Try doing a reverse lunge (stepping backward rather than forward) to help reduce knee strain.

                                                                                                                                               

Excerpted from Colberg, Sheri R., Chapter 21, “Ten Easy Exercises to Build a Strong Core Without Leaving the House” in Diabetes & Keeping Fit for Dummies. Wiley, 2018.

10 Ways to Get Motivated to Exercise (When You’re Not)—Part 2 of 2

Unmotivated gal lying down

Last time we covered the first five ways to get motivated to exercise, and we’re back this month to give you the next five to keep your motivation going strong. Check out the following sections for more ideas for those days where you just can’t seem to get moving.

#6: Get an Exercise Buddy (or Several)

You don’t need to go it alone when being active. Having a regular (and reliable) exercise buddy increases your likelihood of participating, and it also makes your activities more social and fun. Get your spouse, family members, friends, and co-workers to join in your physical activities, especially during your leisure time. Having a good social network to support your new or renewed exercise habit helps you adhere to it over the long run.

Remember: Oftentimes your community is a good place to look for other exercise options. To become more involved in structured exercise programs, find out what exercise programs are in your workplace or community. You can often find groups of health-conscious people walking together during lunch breaks, or you may be able to join a low-impact aerobics or other exercise class offered at your workplace or a nearby recreation center.

Take the time to find out what’s available in your area. The more you can get involved in making your lifestyle changes as part of a larger community, the more likely you are to be successful in making them a lifelong habit.

Tip: If you can’t find a human exercise buddy, borrow or adopt a dog that needs to be walked regularly.

#7: Schedule It

Put your planned exercise down on your calendar or to-do list like you would other appointments. You show up for your doctor appointments, so why should scheduling your physical activity be any different? Never make the mistake of assuming it’ll happen just because you claim that you want to do it a certain number of days per week or month. It takes some planning ahead and the commitment to make it a priority.

#8: Set Goals and Reward Yourself

Setting goals helps keep your interest up. For instance, if you walk for exercise, you may want to get a pedometer and set a goal of adding in 2,000 more steps each day. Break your larger goals into smaller, realistic stepping-stones (such as daily and weekly physical activity goals) for all your active lifestyle changes, and use SMART goals. Trackers, activity logs, and other motivational tools are also widely available online.

Tip: Reward yourself when you reach your exercise goals (but preferably not with food). Who says that sticker charts and non-caloric treats are just for kids? Maybe you can promise yourself an outing to somewhere special, the purchase of a coveted item, or anything else that is reasonable and effectively motivates you to exercise.

If you miss one of your goals, try to make the rest of them happen anyway. Then reward yourself when you meet any of your goals, even if you don’t make them all happen.

#9: Take Advantage of Opportunities for Spontaneous Physical Activity

You don’t have to do activities at a high intensity for them to be effective for diabetes and weight management. You can also add physical movement all day long doing anything you want to, including gardening, housework, and many other spontaneous physical activities.

For instance, if you have a sedentary desk job take the stairs rather than the elevator whenever you can. Walk to someone else’s office or the neighbor’s house to deliver a message instead of relying on the phone or email. Or park your car at the far end of the parking lot and walk the extra distance. Guess what? You’ve just gotten yourself more active without giving it much thought.

#10: Take Small Steps

If you get out of your normal activity routine and are having trouble getting restarted, simply take small steps in that direction. You may need to start back at a lower intensity by using lighter weights, less resistance, or a slower walking speed. Starting out slowly with small steps helps you avoid burnout, muscle soreness, and injury.

For example, if you don’t want to exercise on a given day, make a deal with yourself that you’ll do it for a short time to get started (which is often the hardest part). Even doing only 5 to 10 minutes at a time (rather than 30 or more) is fine. After you’re up and moving, you may feel good enough to exceed the time you planned on doing in the first place. The key is to begin through any means possible.

Remember: You’re in this for the long term, so even taking just small steps in the right direction will eventually allow you to reach your fitness goals and reclaim your good health.

By way of reminder, the first five tips from last month follow:

#1: Check Your Blood Glucose

#2: Start with Easier Activities

#3: Pick Activities You Enjoy

#4: Spice It Up

#5: Have a Plan B

                                                                                                                                               

From Colberg, Sheri R., Chapter 22, “Ten Ways to Get Motivated to Exercise (When You’re Not)” in Diabetes & Keeping Fit for Dummies. Wiley, 2018.

10 Ways to Get Motivated to Exercise (When You’re Not)—Part 1 of 2

Unmotived guy lying downDiabetes is a complex metabolic condition, and your blood glucose levels can impact you not only physically but also emotionally and mentally. Often, feeling depressed or anxious about diabetes management can be demotivating for taking better care of yourself. Whether that care involves getting more physically active or making more healthful food choices, getting and staying more motivated can only benefit you and your blood glucose.

Remember: Exercise can lessen your feelings of stress, anxiety, and depression, among other mental benefits. In many cases, treating anxiety or mild to moderate depression with regular exercise is at least as effective as, if not more effective than, using medications to treat these symptoms; even just five minutes of aerobic exercise can stimulate anti-anxiety effects. And the side effects from being regularly active are much more positive. Being active can also positively affect your self-confidence, body image, and self-esteem.

But some days knowing all those benefits may not be enough to get you going. We’ve got you covered. Check out the following sections for ideas for those days where you just can’t seem to get moving.

#1: Check Your Blood Glucose

When you start a new exercise, checking your blood glucose before, during (if you’re active more than an hour), and after your workout pays off. A reading that changes — especially in the direction that you want it to — can be very rewarding and motivating. If you don’t check, you may never realize what a positive impact you can have on your diabetes simply by being active.

For example, say your blood glucose is a little high after you eat a meal, and you want it to go lower without taking (or releasing) any more insulin. You can exercise after your meal and bring your blood glucose down within two hours after eating and taking insulin, or you can avoid or lower post-meal spikes in your blood glucose. You wouldn’t know the extent of the effect you can have without using your blood glucose meter to check.

#2: Start with Easier Activities

Start slowly with easier activities and progress cautiously to working out harder. Exercising too hard right out of the gate is likely to make you end up discouraged or injured, especially if you haven’t exercised in a while.

Remember: If you often complain about being too tired to exercise, your lack of physical activity is likely what’s making you feel sluggish. After you begin doing even light or moderate activities, your energy levels rise along with your fitness, and your physical (and mental) health improves.

#3: Pick Activities You Enjoy

Most adults need exercise to be fun, or they lose their motivation to do it over time. It’s human nature to avoid doing the things you really don’t like to do, so try to pick activities you truly enjoy, such as salsa dancing or golfing (as long as you walk and carry your own clubs). Having fun with your activities lets you more easily make them a permanent and integral part of your diabetes management. If you haven’t found any that you enjoy much yet, choose some new ones to take out for a test run (so to speak).

Tip: Choose an exercise that suits your physical condition and overcomes or works around your limitations.

#4: Spice It Up

An essential motivator involves mixing your workouts up with different activities. People commonly complain about exercise being boring. Feelings of boredom with your program can be the result of repeating the same exercises each day. To make it more exciting, try frequently doing different physical activities for different durations and at different intensities. Knowing that you don’t have to do the same workout day after day is motivating by itself.

#5: Have a Plan B

Always have a backup plan that includes other activities you can do in case of inclement weather or other barriers to your planned exercise. For example, if a sudden snowstorm traps you at home on a day you planned to swim laps at the pool, be ready to walk on the treadmill or substitute some resistance activities. You can always distract yourself during your second-choice exercise to make the time pass more pleasantly. Read a book or magazine, watch your favorite TV program, listen to music or a book on tape, or talk with a friend on the phone while you’re working out.

Check back soon for the final five ways to get motivated to exercise—when you’re not!

                                                                                                                                               

Excerpted from Colberg, Sheri R., Chapter 22, “Ten Ways to Get Motivated to Exercise (When You’re Not)” in Diabetes & Keeping Fit for Dummies. Wiley, 2018.

Getting and Staying Motivated to Be Physically Active

Walking a dog in snowThis time of year, all of the fitness clubs and gyms run specials to bring in new members, and they know—and even count on the fact that—most of those people will no longer be regularly attending classes or doing workouts by the time spring hits. How do you avoid becoming one of those exercise dropouts?

Even elite athletes have some days when they are not as motivated to exercise. You know those days—the ones when you have trouble putting on your exercise gear, let alone finishing your planned workout. For the sake of your blood glucose and your health, do not use one or two bad days as an excuse to discontinue an otherwise important and relevant exercise or training routine.

Here is a list of motivating behaviors and ideas for regular exercisers and anyone else who may not always feel motivated to work out:

  • Identify any barriers or obstacles keeping you from being active, such as the fear of getting low during exercise, and come up with ways to overcome them.
  • Get yourself an exercise buddy (or a dog that needs to be walked).
  • Use sticker charts or other motivational tools to track your progress.
  • Schedule structured exercise into your day on your calendar or to-do list.
  • Break your larger goals into smaller, realistic stepping stones (e.g., daily and weekly physical activity goals).
  • Reward yourself for meeting your goals with noncaloric treats or outings.
  • Plan to do physical activities that you really enjoy as often as possible.
  • Wear a pedometer (at least occasionally) as a reminder to take more daily steps.
  • Have a backup plan that includes alternative activities in case of inclement weather or other barriers to your planned exercise.
  • Distract yourself while you exercise by reading a book or magazine, watching TV, listening to music or a book on tape, or talking with a friend.
  • Simply move more all day long to maximize your unstructured activity time, and break up sitting with frequent activity breaks.
  • Do not start out exercising too intensely or you may become discouraged or injured.
  • If you get out of your normal routine and are having trouble getting restarted, simply take small steps in that direction.

As for other tricks that you can use, start with reminding yourself that regular exercise can lessen the potential effect of most of your cardiovascular risk factors, including elevated cholesterol levels, insulin resistance, obesity, and hypertension. Even just walking regularly can lengthen your life, and if you keep your blood glucose better managed with the help of physical activity, you may be able to prevent or delay almost all the potential long-term health complications associated with diabetes.

                                                                                                                                               

From Colberg, Sheri R., Chapter 6, “Thinking and Acting Like an Athlete” in The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities. Champaign, IL: Human Kinetics, 2019.