الله بسمالرحیم الرحمن
Role of Physical Activity on Diabetes and Cardiovascular
diseases
Isfahan University of Medical Sciences
Faculty of Rehabilitation SciencesDr Javid Mostamand
Physical Activity Is Like Magic for Type 2 Diabetes and Cardiovascular Diseases
Physical Activity Is Like Magic for Type 2 Diabetes and Cardiovascular Diseases
سالمت ورزشو جامعه سالمت ورزشبر تاثير
فيزيولوژيك ورزشنياز ورزش كردن همگاني تالشبراي
..... جنيني دوره سالمتي رمز تحرك ورزشوجراحي
ميشود 5هر مبتال ديابت به نفر يك ثانيه افزايشوزن گرم كيلو افزايش% 5هر
خطرديابتقلبيعروقي هاي ورزشوبيماري
Proportion of disease prevalence attributable to obesity
Type 2 diabetes
Hypertension
Coronary heart disease
Gallbladder disease
Osteoarthritis
Breast cancer
Uterine cancer
Colon cancer
57%17%
17%
30%
14%
11%
11%
11%
WWBCopyright © Allyn & Bacon
2006
What Can Physical Activity Do For Us?
Give us more energy
What Can Physical Activity Do For Us?
Help us lose weight and keep it off
What Can Physical Activity Do For Us?
Increase flexibility and strength
Slow bone lossProvide better
quality of life
What Can Physical Activity Do For Us?
Build muscle
What Can Physical Activity Do For Us?
Lift our moodTreat
depressionReduce stress
and anxiety
What Can Physical Activity Do For Us?
In Diabetes type 2 Improve blood
glucose control
(lowers Hemoglobin A1C)
Physical activity lowers blood glucose in type 2 diabetes by helping: muscle cells become more
sensitive to insulin keep the liver from producing too
much glucose build more muscle We lose weight and keep it off
What Can Physical Activity Do For Us?
Keep our heart healthy
Physical activity helps our heart by:
Strengthening heart muscle Lowering resting heart rate Lowering blood pressure Improving cholesterol Reducing risk of heart attack
and stroke
“Sitting” through life increases our risk of:
heart disease high blood
pressure high cholesterol overweight type 2 diabetes
We now must plan physical activity into our schedule
We now must plan physical activity into our schedule
Getting Started Check with our doctor
if we:Are over age 35Have had diabetes
more than 10 yearsHave high blood
pressure, heart disease, poor circulation, or other diabetes complications
Aerobic Activity
Walking briskly Bicycling Hiking Jogging/running Skating Stair climbing Swimming Water exercise
Health Benefits of Physical Activity: Strong Evidence
Lower risk of:Early deathCoronary heart disease, strokeHigh blood pressure Type 2 diabetesCancers: Colon and Breast
Prevention of weight gain Weight loss (with reduction of caloric intake) Prevention of falls Depression, cognitive function (older adults)
20
Children and AdolescentsAges 6-17
22
Children and Adolescents (ages 6-17) 60 or more minutes of physical activity daily
Aerobic: Most of the 60 or more minutes per day should be either moderate- or vigorous-intensity aerobic physical activity. Include vigorous-intensity physical activity at least 3 days per week.
Muscle-strengthening: Include muscle-strengthening physical activity on at least 3 days of the week, as part of the 60 or more minutes.
Bone-strengthening: Include bone-strengthening physical activity on at least 3 days of the week, as part of the 60 or more minutes.
Encourage participation in physical activities that are: Age appropriate, enjoyable, and offer variety
AdultsAges 18-64
4 Key Adult Guidelines Avoid inactivity Substantial health benefits from medium
amounts of aerobic activity More health benefits from high amounts of
aerobic activity Muscle-strengthening activities provide
additional health benefits
Inactivity?
“All adults should avoid inactivity. Some physical activity is better than none, and adults who participate in any amount of physical activity gain some health benefits.”
Substantial Health Benefits Guideline “For substantial health benefits, adults should do:
at least 150 minutes (2.5 hours) a week of moderate-intensity aerobic activityOR
75 minutes (1.25 hours) a week of vigorous-intensity aerobic physical activityOR
an equivalent combination of moderate- and vigorous-intensity aerobic activity.”
“Aerobic activity should be performed in episodes of at least 10 minutes, And preferably, it should be spread throughout the week.”
Additional & More ExtensiveHealth Benefits Guideline
““For additional and more extensive health benefits, For additional and more extensive health benefits, adults should increase their aerobic physical activity adults should increase their aerobic physical activity to:to:
300 minutes (5 hours) a week of moderate-intensity,300 minutes (5 hours) a week of moderate-intensity,OROR150 minutes a week of vigorous-intensity aerobic 150 minutes a week of vigorous-intensity aerobic
physical activityphysical activityOR OR an equivalent combination of moderate- and an equivalent combination of moderate- and
vigorous-intensity activity.”vigorous-intensity activity.”
Muscle-Strengthening Guideline “Adults should also do muscle-strengthening
activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.”
Comments onMuscle-Strengthening Guideline
Requires moderate to high level of intensity or effort:Relatively few repetitions (e.g. 8-12)If do resistance training, 1 set sufficient
At least 2 days a week Major muscle groups:
legs, hips, back, chest, abdomen, shoulders, arms
Knee Strengthening Exercises
Hip Strengthening Exercises
Back Strengthening Exercises Birddog (Opposite Arm and Leg Extension), Bridge,
One-Leg Bridge, Plank
What about Flexibility Activities?
Flexibility activities are acceptable
Flexibility activities are usually part of exercise programs
Flexibility is a component of fitnessPeople need sufficient flexibility to be activeFlexibility activities, like stretching, do
increase flexibility
Back Stretching Exercises
Older AdultsAges 65+
Key Older Adult GuidelinesKey Older Adult Guidelines
The 4 key guidelines for adults apply to older adults, but there are 4 additional qualifying guidelinesGuideline for adults who cannot do 150
minutes/weekBalance exerciseOnly use relative intensity to determine the level of
effortChronic conditions and injury risk
Guideline for Older AdultsWho Cannot Do 150 Minutes/Week
“When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.”
Comment:For example, physical activity has a
beneficial effect on functional limitations in older adults, meaning adults with limitations should be active as their abilities allow
Balance Exercise Guideline
“Older adults should do exercises that maintain or improve balance if they are at risk of falling.”
Comment: Insufficient evidence to make this a general guideline
for all older adults Research has studied mainly exercise programs, and
hence guideline uses “exercise.”
Resistance Activities (for diabetes)
“Push, Pull, and Lift” Activities increase muscle
strengthprevent falls increase mobility improve blood glucose
control
Stretching
Improves our balance and coordination
Make us more flexible Reduces stiffness Reduce our risk of
injury
How Can we Begin?
Choose activity (example: brisk walking)
Set a long-term goal - at least 30 minutes a day, 3-5 days a week
Buy comfortable walking shoes
Gradually Increase Activity
Beginning Exercisers:
First Week - 3 times a week Morning: Walk 5-10 minutes Lunch: Walk 5-10 minutes After dinner: Walk 5-10
minutes
Keep track of how long and how far you walk each day
Keep Track of Our Steps
Use a pedometer Keep track of how many steps you
normally take in a day for one week Gradually add 500-1,000 steps a
day Set a goal of at least 3,000 to
4,000 steps more than your baseline
Vary Your Activities
Monday Tuesday Wed Thursday Friday
Walk Swim/
Water Aerobics
Walk Swim/
Water Aerobics
Walk
Monday Tuesday Wed Thursday Friday
Exercise bike
Aerobic class
Exercise Bike
Aerobic Class
Exercise Bike
Effect of Physical Activity on Blood Glucose Depends on:
our blood glucose level before we exercise
diabetes medicationwhen and how much we ate last our physical fitnesstype of activity
Effect of Physical Activity on Blood Glucose
Blood glucose checks before and after exercise are the key
Effect of Physical Activity on Blood Glucose
Physical activity usually lowers blood glucose
Physical activity can raise our blood glucose if:our BG is >250 mg/dl before our exercise and
we have ketones we’re starting a new vigorous exercise
program
Exercising With Heart Disease
Caution: Very strenuous
activity Heavy lifting or
straining Exercise in extreme
cold or heat
Choose: Moderate activity
such as walking, swimming, biking, gardening
Moderate lifting, stretching
Exercising with Hypertension (high blood pressure)
Caution Very strenuous
activity Heavy lifting or
straining
Choose Moderate activity
like: walking weight lifting with
light weights stretching
Make sure your blood pressure is in control first
Exercising with Neuropathy (nerve disease)
Caution Weight-bearing, high
impact, strenuous, or prolonged exercise: jogging/running step exercise jumping exercise in heat/cold
Choose Low impact,
moderate activities: biking swimming chair exercises stretching light to moderate
daily activities
Check feet after exercise
Exercise Safely (Diabetes)
Check your blood glucose before and after exercise
Don’t exercise if your blood glucose is too high or too low
Carry carbohydrate to treat low blood glucose if you are at risk
Exercise Safely (Diabetes)
Stop exercising if you feel pain, lightheaded, or short of breath
Avoid strenuous activity in extremely hot, humid, or cold weather
Wear proper shoes for the activity to reduce the risk of injury
Exercise Safely (Diabetes)
Wear diabetes identification Drink plenty of fluid
WWBCopyright © Allyn & Bacon
2006