Many people want to know the best exercise to…fill in the blank. They would like to know the best exercise program to lose weight or prevent type 2 diabetes. Others want to keep their brains functioning. Sometimes people would also like to know the best time of day so that their physical activity has the most impact on their health. We’ll get to all that shortly, but first, just how important is physical activity to a healthy lifestyle?
Best Exercise to Prevent Diabetes:
A commentary in the journal Diabetes Care suggests that primary care providers should assess physical activity at every visit as a “lifestyle vital sign.” The authors are responding to a large, long-term study utilizing the UK Biobank data (Diabetes Care, May 23, 2023).
Early in the study, 90,000 participants wore a wrist accelerometer for seven days so that the investigators could evaluate their physical activity objectively. Over the next decade of follow-up, about 2,000 of the volunteers were diagnosed with type 2 diabetes. The relationship with physical activity was strong, but inverse. That is to say, people who were more active were less likely to develop this metabolic condition. People with the habit of spending 20 minutes a day on a brisk walk were 20 percent less likely than couch potatoes to develop diabetes. More moderate-to-vigorous exercise lowered the odds of developing type 2 diabetes even more.
As a result, the commenters conclude that
“when it comes to physical activity for T2D prevention, some is better than none, more is better, and earlier is best.”
Although an active lifestyle early in life offers good protection, it is never too late to reap the benefits of physical activity.
Does It Matter When You Exercise?
Scientists in the Netherlands wondered whether time of day made a difference for the effect of exercise (Diabetologia, Nov. 1, 2022). They recruited 775 overweight individuals who were part of the Netherlands Epidemiology of Obesity study. The participants tracked their breaks in sedentary activity and the amount and timing of moderate to vigorous physical activity they performed. Meanwhile, the researchers studied the volunteers’ insulin resistance and measured their liver fat through magnetic resonance spectroscopy.
The number of active breaks people took to interrupt their sedentary time made no difference for insulin resistance or liver fat accumulation. The amount of moderate to vigorous exercise and its timing mattered, but only for insulin resistance. Those who accomplished most of their exercise in the afternoon or evening reduced their insulin resistance by 18 and 25 percent respectively.
What Type of Exercise Is Best?
All the experts we have consulted insist that there is no one perfect activity for everyone. Just moving your body is the key to success. If you like to walk, great. If biking or swimming is your thing, great! Should you prefer tennis or dancing, double great!! You may wish to listen to our free podcast about best exercise here and find out about ballroom dancing vs. dementia.
Research also suggests that resistance exercise (RE) or resistance training (RT) to build muscular strength protects people from type 2 diabetes (T2D) (Mayo Clinic Proceedings, online, March, 2019). As a result, strength training might be just as important as aerobic activity in keeping blood sugar under control. You can learn more about this by listening to Brad Schoenfeld, PhD, and Katy Bowman in our recent podcast, Show 1342: Balancing Your Movement Diet for Good Health.
What Is Resistance Exercise or Resistance Training?
Muscular strength is a key factor in heart health. That is to say, people who are stronger are less likely to develop heart disease or die from heart trouble (Journal of Cardiopulmonary Rehabilitation and Prevention, Nov-Dec., 2012).
The authors of this paper report:
“To conclude, RT [resistance training] must be considered in addition to aerobic exercise in the prevention and treatment of CVD [cardiovascular disease], since both MusS [muscular strength] and CRF [cardiorespiratory fitness] may provide unique benefits. In fact, RT might be a more attractive type of exercise for overweight and obese individuals, who are at a higher risk of developing CVD and who may be averse to aerobic exercise.”
Resistance training, strength training or resistance exercise is a way to build muscular strength and endurance. It involves muscular contractions, usually against some sort of resistance. Imagine lifting a can of beans with your left hand 25 times. That is resistance exercise. Lifting a dumbbell does the same thing. Pulling on a strong rubber exercise band is also resistance training. So is using exercise equipment at a gym.
When you use exercise equipment (or lift a can of beans 25 times in a row), you challenge your muscle cells. Microscopic changes in those cells lead to repair and regrowth. That leads to enhanced strength. As we age, we naturally lose muscle. Resistance training can slow that process.
The Study in the Mayo Clinic Proceedings:
A rigorous study suggests that you can lower your risk for type 2 diabetes with resistance training. Over 4600 adults between the ages of 20 and 100 years were recruited from the Cooper Clinic in Dallas, Texas. None of them had type 2 diabetes at the beginning of the study.
Most prior research on the best exercise to protect against type 2 diabetes has relied upon “self-reported evaluation of resistance exercise.” This is an unreliable way to determine the impact of muscular strength on health outcomes.
The Results of Resistance Exercise:
These investigators had their volunteers actually perform leg presses and bench presses on resistance weight machines to measure muscular strength. During the eight-year follow-up period, approximately 5% of the volunteers were diagnosed with type 2 diabetes.
Those with lower muscle strength were more likely to develop this metabolic condition. People with middle level muscular strength were 32% less likely to be diagnosed with type 2 diabetes. Moderate resistance training may be an important addition to a regular exercise regimen. We can’t say it is the absolute best exercise program, but it’s an important adjunct to any well-designed personalized program. Learn why your doctor should write you a personalized exercise prescription by listening to our podcast with Dr. Jordan Metzl at this link.
Why Would Muscular Strength Be Protective?
The authors of the Mayo Clinic Proceedings study report:
“Because muscular strength is partially determined by RE [resistance exercise], the protective effect of moderate muscular strength against T2D [type 2 diabetes] may be due to the benefits of RE. In fact, RE helps maintain or increase lean body mass, which improves glycemic [blood glucose] control by augmenting skeletal muscle storage of glucose. Other effects reported for RE may include reducing visceral adiposity [belly fat], which has been associated with insulin resistance.”
Counterintuitively, people with most upper body strength did not get protection from type 2 diabetes. In other words, moderation may be the key to success.
The researchers report that:
“Emerging data suggest that greater amounts of aerobic exercise may not yield additional health benefits. Similar to aerobic exercise, long-term excessive RE may cause pathologic structural changes.”
Their conclusion:
“In this study, we found that moderate muscular strength, but not upper muscular strength, was associated with a reduced risk of development of T2D independent of estimated CRF [cardiorespiratory fitness]. These results indicate that very high levels of RE [resistance exercise] training may not be necessary to obtain the considerable health benefits on T2D [type 2 diabetes] prevention.”
What Exercise Do You Do?
Share your exercise experience in the comment section below. What do you stick with? Have you found that dancing helps your brain? What about strength training? Is that something you find helpful?
