Walking metabolism benefits diabetes & prediabetes

The benefits of walking exercise for general metabolism support and blood sugar control are important whether you are trying to stop prediabetes, help type 2 diabetes, or not.

walking for diabetesA walking exercise routine can play a part in the prevention and treatment of many medical conditions including prediabetes-metabolic syndrome and diabetes. In this post, I am going to write about the benefits of walking exercise for controlling blood sugar in an effort to promote a healthy metabolism in the presence of prediabetes or full type 2 diabetes.

One reason why walking can be effective for supporting and promoting a healthy metabolism is because walking-exercise involves the larger muscles of the legs. Contractions of these large muscle groups burn a lot of fuel for energy and that fuel is glucose (sugar).

Muscles have a storage supply of glucose known as glycogen. If you walk far enough, or with enough intensity, you will tap into this storage source of glucose-sugar to keep your leg muscles moving.  As you use up the stored sugar in your muscles, they begin to “pull” glucose-sugar out of your blood to keep the energy flowing and to replenish their glycogen reserves.

The liver is also a storage depot for glucose-sugar, so as your muscles use up what they have stored, they call on the liver to start releasing some of its saved-up glucose into the blood so they can use it to keep you moving throughout your walking exercise activity.

This burning of stored glucose is part of the normal process of metabolism. It is this part of the process that is often “bogged down” in many people simply because they do not move enough. Humans are designed for movement, and when we are stationary, ill health quickly ensues.

walking exercise to help stop prediabetes and prevent type 2 diabetes metabolic syndrome xAn analysis of 14 studies looking at the benefits of exercise for blood sugar control and weight loss in people with type 2 diabetes has been done. Researchers found,

Exercise training reduces HbA1c by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.”

The lack of change in body mass should not surprise you if you read my post about walking and weight loss. Walking is not the foundation for weight loss, food is. In addition, body mass index (BMI) is not the best measure to evaluate the effects of exercise in that it does not necessarily relate well to body composition. While some of the exercisers may have had an unchanged BMI, this may have come about from their body fat being reduced while their muscle mass was increased, thus keeping their BMI the same.

This is actually what you want – if your BMI goes up as a result of exercising, while your body fat goes down, it is a cause for celebration. More muscle mass encourages a healthier metabolism and a more functional life. Do more than walking as part of your exercise routine, add some resistance exercises to the mix. You’ll be glad you did.

Actually, scientists have examined identical twins who have lived different physical activity lifestyles to study how the degree of each twin’s physical activity level may be associated with their body composition, blood sugar control, and even their brain size and shape.

Compared to their inactive co-twins, the active twins had:

  • Lower % body fat
  • Better blood sugar control and insulin sensitivity
  • Larger parts of their brains in the non-dominant hemisphere

The researchers concluded,

…a greater level of physical activity is associated with improved glucose homeostasis and modulation of striatum and prefrontal cortex gray matter volume independent of genetic background. The findings may contribute to later reduced risk of type 2 diabetes and mobility limitations.”  (source)

Not all forms of walking exercise equally benefit diabetes

Despite the fact that exercise is positive for blood sugar control and for support of a healthy metabolism, you should know there is a little catch for using walking for your best health – you must walk with sufficient intensity in order for walking exercise to have a meaningful impact. Because walking is something most people do naturally, your body can perform walking movements very efficiently.

stopping prediabetes with pedometer walking robert creightonIn order to achieve the needed metabolic conditioning from walking, or any exercise for that matter, you need to ramp up the intensity. I suspect this is one of the reasons why studies looking at walking for weight loss do not show stellar results. Most people simply to not apply the necessary intensity to affect meaningful change.

Interval walking exercise is a great way to use increased intensity for improving blood sugar control in Type 2 diabetes (T2DM). Using an “interval” approach to walking exercise refers to walking at a higher intensity followed by a period of reduced intensity, then repeating.

A just published study (August 2014) bears this out:

Researchers compared walking exercise programs in patients with T2DM:

1. A Continuous-Walking Group. Continuous walkers stayed at the same speed throughout each session.

2. An Interval-Walking Group. These interval-walkers repeated a cycle of walking fast for 3 minutes, then slower for 3 minutes.

They were instructed to walk for 1 hour, 5 times a week for four months.

The results of this comparison only showed improvements in blood sugar control in the Interval Walking Group  due to increased insulin sensitivity.

Improved insulin sensitivity refers to your insulin hormone becoming more effective at moving glucose out of your blood and into your muscles and liver. When your muscles have been “pushed,” or are being subject to increased walking intensity, insulin becomes a more “cooperative” hormone and works with your muscles to get them the glucose they need.

walking hand weights for prediabetes exerciseSo, in order to really benefit from walking exercise to support your best metabolism, you have to dial up the intensity of your effort, but only for a short period of time. In general, exercise intensity rather than duration is what matters to support your best health with better blood sugar levels, and hopefully a resultant lower body weight, in conjunction with proper food, of course. Food is the foundation, walking is supportive.

Walking is the most wide-spread form of physical activity so there are a lot of walkers who would benefit from knowing this. And many non-exercisers would begin a walking routine if they knew they could spend less time walking while getting more benefit by simply “pushing it” a moderate amount.

Here is another reference supporting walking intensity (speed) in people 21 to 98 years of age who were followed for up to 10 years showing higher walking speeds were associated with a reduced risk of a heart condition.

Hardcore readers can get an in depth discussion of the mechanisms behind the superior effects of interval vs continuous training on blood sugar control in type 2 diabetics by clicking here for a full .pdf of a randomized controlled trial with 50 references.

Is Interval training a more enjoyable form of physical activity?

You guessed it…Most people seem to enjoy an interval form of walking exercise more, especially when done in a functional manner. What I mean by “functional” is performing exercises that mimic movements you may do throughout the day. When done through a fitness center in a group setting, these exercise workouts tend to be different each time you show up. When you combine variability with higher intensity, exercisers spend significantly less time exercising per week while getting results. When your level of exercise enjoyment goes up, you are more likely to keep at it and get better results.

If you are going to walk for exercise, whether you are diabetic or not, speak to your doctors to make sure you are medically capable to begin an exercise lifestyle. Begin slowly. If you are overweight start with a non-weight bearing physical activity like a bike or do weight machines at a fitness center with lighter weight and higher repetitions. Many overweight people become injured when they begin an aerobic endurance-type exercise activity because of the repetitive overloading stresses on the feet and knees. Do not start out with an interval approach. Low intensity is best to start. Actually doing primarily balance type exercises is the best place to start. Your progression should concentrate on stability first, then mobility, then increased strength and aerobic capacity.

So, how do you know if you are walking with enough intensity?

There are heart rate monitors available and they can be a great asset for many people, but a simpler way for many people as they start out is to simply use the “talk test.” This involves gauging your walking exercise intensity by tracking how difficult it is for you to walk and talk at the same time. The talk test has been shown to be beneficial for different types of exercise, i.e., walking, jogging, cycling, elliptical trainer and stair stepper. You want to walk with an intensity that prevents you from easily carrying on a conversation. You should have to stop talking to catch your breath.

If you exercise at an intensity level that still enables you to carry on a conversation, but you are slightly winded, it is a good and safe intensity for you. If you can’t carry on a conversation, and you find yourself very short of breath, you may be overdoing it. One thing is for sure, if you are walking and are able to chat away with your partner, stop moving your lips and start moving your hips.

heart rate monitor for pre diabetes walkingThe test is great for beginning or noncompetitive exercisers, rather than those who are training toward specific fitness goals. Once you become more experienced, you will be able to “listen” to your body better, and understand how it responds to intensity. A simple heart rate monitor can also be a great tool.

How to know if you are walking enough during the day to promote health?

pedometerObservation of pedometer use suggests a pedometer helps adults exercise more, but sedentary adults sometimes need a kick in the behind and some instruction to motivate them to use one.

People at high risk of type 2 diabetes who started using a pedometer found:

Pedometers were useful tools for:

  • observing levels of exercise
  • setting personal goals for walking
  • helping evaluate whether daily goals were met

Negative experiences were associated with:

  • functional failures
  • pedometers’ unsuitability for exercise other than walking
  • the health goal of 10,000 steps being too high.

You can go here to pick up a good inexpensive pedometer.

Also, as I am sure most readers know, many phones can be used as a pedometers these days.

In my last post about some of the benefits of walking exercise, I wrote about walking as a means to maintain and improve cardiovascular health, particularly in reference to blood circulation to the feet and legs. Check it out here.

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About Robert Creighton

Dr. Creighton is a podiatrist and foot surgeon with over 26 years in podiatric practice treating thousands of patients afflicted with the physiological, physical, and psychological side effects and complications of diabetes and pre-diabetes metabolic syndrome. He believes these disorders present a pressing public health concern that need to be more actively addressed in a multidisciplinary way. Dr. Creighton graduated from what is now the Temple University School of Podiatric Medicine after receiving his undergraduate degree in Biology. He is certified by the American Board of Foot and Ankle Surgery, a member of the American Public Health Association, an American College of Sports Medicine certified personal trainer and a Member of the American Nutrition Association.

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