In an earlier post I described how I discovered that walking normalized my fasting blood sugar. In a comment on that post, Phil wrote:
You could also have consulted a doctor, or a diabetes website, and probably found out about the benefits of walking for controlling blood glucose a lot sooner.
My initial reaction was that this was wrong–that a search on the web would find hundreds of suggestions for managing diabetes and walking would be just one of them. Diabetes, after all, is a huge problem. A doctor would probably prescribe something. But what if Phil were right?
What would I find if I looked? I didn’t actually know. So I looked. Under “diabetes”, the Mayo Clinic website has two sections about treatment. Under “ treatment and drugs” are six suggestions, such as “healthy eating”. The suggestion called “physical exercise” recommends aerobic exercise. “Get your doctor’s OK to exercise,” it says. “Aim for at least 30 minutes of aerobic exercise most days of the week,” it continues. My walking was not aerobic. Obviously one does not need a doctor’s approval to walk at a normal pace. In a second section called “ lifestyle and home remedies” were ten suggestions, such as “make a commitment to manage your diabetes”. No mention of walking.
What about the American Diabetes Association website? Their “ Treatment & Care” page says nothing about exercise. It mentions drugs and transplants (e.g., kidney transplants). There’s also a “ Food & Fitness” page. There are dozens of comments about what foods to eat. The “Fitness” section begins like this:
Exercise is part of a healthy lifestyle for everyone, and it’s especially important for people with diabetes. But exercise doesn’t necessarily mean running a marathon or bench-pressing 300 pounds. The goal is to get active and stay active by doing things you enjoy, from gardening to playing tennis to walking with friends. Here are some ideas for getting moving and making exercise part of your daily life.
The fitness section goes on and on about such topics as “What is Exercise?” and “Top 10 Benefits of Being Active”. Surely the ADA hired some hack to write it. It’s useless.
I conclude that if you already know that walking helps you can find evidence to support this. But searching the web will not lead you to try walking any time soon. You will be too busy changing your diet and trying all possible aerobic exercises. (And I did aerobic exercise several times a week and still had too-high blood sugar.) My initial reaction was wrong, it turned out: I found a large number of suggestions and my actual activity (walking 30-60 min/day) wasn’t one of them. No way could I “walk with friends” every day. (I’ve tried and failed miserably.) The next time I see my doctor I will find out what he would have recommended.
Agreed, basic exercise information was buried and took too many clicks to find on the ADA site, but eventually they defined “brisk walking” as aerobic exercise. Then you had to go somewhere else to read how much you should walk. Not well done, although I’m sure they expected doctor involvement due to the health risks and potentially, insulin adjustment.
When I had gestational diabetes, my nutritionist told me to walk briskly for at least 20 minutes, twice a day. That was over 20 years ago, so the glucose benefit was known, and quantified.
My pedometer defines aerobic steps as 10 minutes of continuous walking. That seems to be a common definition for exercise — brisk walking counts, but only if you do it at least 10 minutes. Unless you walk really slowly, there should be a change in breathing by then. On a long walk, my heartrate is about the same as for mowing the lawn, which isn’t vigorous exercise, but it is aerobic. Aerobic (Sally Edwards) defines the aerobic zone as 70-80% of maximum heartrate.
There’s one short (but not easy when done with proper form) T-Tapp move called Hoe Downs that lowers blood sugar. The move has been featured in books — Dr. Carolyn Dean (MD and ND) in “IBS for Dummies” and Dr. Nicholas Perricone’s “The 7 Secrets to Beauty, Health and Longevity – The Miracle of Cellular Rejuvenation.” From the article linked below, “Preliminary testing has also shown that Hoe Downs can effectively drop glucose levels quickly. Test results verified an average drop in glucose from 62 to 85 points upon completion and an average rate up to 100 points at 10 minutes post completion.”
https://www.t-tapp.com/articles/hoedowns/default.html
https://www.youtube.com/watch?v=lsURicKB_G8
Talking Rat, I found that ordinary walking — not brisk — worked fine. No mental effort required. In other words, my solution can be found nowhere on the ADA site, as far as I can tell. Judging by my experience, the “aerobic” restriction is just wrong.
Thats great! I’ll have to try your walking solution and see where it gets me. I’m in a similar boat to you (non diabetic, I track my fasting bg, and it’s been high lately (95+) even though I eat paleo/primal with a low carb emphasis.
I’ll report back later
But Seth, you don’t have diabetes, you have symptoms that arguably match “pre-diabetes”. When I look up “pre-diabetes treatment” on Google, the first website it recommends is WebMD, which has four recommendations. In order: (1) watch your weight, (2) make healthy food choices, (3) get active, (4) take medicine if you need to.
They elaborate on “Get active” : “Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It’s fine to be active in blocks of 10 minutes or more throughout your day and week.” The first item they suggest if you click on “moderate activity” is “brisk walking.” You might say that you don’t walk briskly, you just walk, but I think that’s splitting hairs. You mentioned that ambling through stores while shopping doesn’t seem to do it, after all.
The second site Google lists is the American Diabetes Association. I found this site even worse than you suggest, it’s really horrible. This association is, I suspect, essentially a front for the big drug companies. Absolutely appalling.
Let’s go to the third Google suggestion for “pre-diabetes treatment”. It’s something called “suite101.com”, which I’ve never heard of. Immediately below the headline (“Pre-diabetes treatment helps prevent diabetes”) is a photo of a couple strolling down a dirt road. The site lists diet, exercise, and medication as ways of controlling pre-diabetes, and says diet and exercise are most effective but some people need medication. As for exercise, the site says “Exercise plans do not need to be elaborate or expensive. Taking a walk for ten minutes each day can decrease your chances of developing diabetes, although experts advise being active for 30 minutes each day…”
So…two out of the top 3 sites recommended by Google recommend “brisk walking” or “walking” among their top few strategies for controlling pre-diabetes.
I also checked the Mayo Clinic site, since it’s one that you mentioned and since it is such a trusted brand. They list four treatments under “treatment and drugs”: (1) eat healthy foods, (2) get more physical activity, (3) lose excess pounds, (4) take medication as needed. (I’m guessing the webMD page borrowed from here, or vice versa). As for “get more physical activity”, “take a brisk daily walk” is the first of their examples.
So I think that although you have a valid point about walking not being adequately promoted by some sites, I think you are greatly exaggerating the difficulty of identifying moderate exercise in general, and walking in particular, as a treatment for pre-diabetes.
Phil, thanks for looking into this further. The WebMD advice is an example of what I’m talking about. I did standard amounts of aerobic exercise (walking fast uphill on a treadmill) about 1.5 hrs/week. It didn’t solve the problem. In China, I did lots of brief exercise, riding my bike here and there — maybe 5 min at a time. That didn’t solve the problem.
To say that distinguishing between “brisk walking” and “walking” is splitting hairs ignores the history of exercise physiology, where the term “aerobics” was invented to make just that distinction. Brisk walking is aerobic, non-brisk walking is not. The “aerobic exercise” concept was taken to explain a lot — to help distinguish helpful from unhelpful exercise. Years ago, to my dismay, I found that when I simply walked several hours/day (non-aerobic) my resting heart rate and blood pressure got worse. They got better when I resumed aerobic exercise. This supported what the exercise experts had concluded.
Aerobic exercise is also a lot more difficult than non-aerobic exercise. It is hard to do every day. Whereas non-aerobic walking is easy to do every day. This is another reason the suggestion of “brisk” (= aerobic) walking wouldn’t have led me to try non-aerobic (= ordinary) walking. The solution I found requires it be done every day.
I agree with you that the web advice is useful. It’s obviously better than nothing. But it wouldn’t have led me any time soon to the solution I found, which is a lot easier than “brisk walking”. Brisk walking requires mental effort, walking doesn’t.
Seth,
I agree with some aspects of what you’re saying, but not all of them. Many sites do recommend walking — either just “walking” or “brisk walking” — to treat pre-diabetes. The Mayo Clinic is one of them. What you seem to be saying is that that doesn’t count, because being told that brisk walking will help you would not lead you to think that normal walking would help you. For one thing, I don’t think that’s true for most people. For another, some sites do just recommend “walking,” without the “brisk.”
It’s funny that you say you “simply walked several hours/day” in order to improve, so such an activity level should be recommended instead of “brisk walking” for a shorter period because brisk walking takes more effort. Yeah, but Seth, there’s no way most people are going to walk “several hours per day!” I’m guessing you meant “several miles per day”? Even so, that takes a substantial amount of time, unless you walk briskly. More time than most people are willing to spend, I think. (And for what it’s worth, like most people I would consider a 4mph walk to be “brisk”, but I wouldn’t consider it “aerobic”, so to me a recommendation to walk briskly is not the same as a recommendation to get aerobic exercise).
I believe you when you say that you had to discover the benefits of walking (vis-a-vis pre-diabetes) on your own. All I’m saying is that walking is in fact widely recommended for pre-diabetics, so self-experimentation isn’t needed to come up with this.
I also agree with you that self-experimentation is good in many contexts, including things like improving blood sugar.
I’m curious whether consuming small amounts of cinnamon makes any difference in your blood sugar level.
In 1998, I walked on a treadmill without shoes. As a result, I got blisters on the bottoms of my big toes. and they wouldn’t heal. I went to my primary care doctor, and I was diagnosed with diabetes. I was told to protect my feet and to take oral pills for my diabetes.
In 2005, I had my right big toe amputated because of a diabetic ulcer that got an infection in the bone. I was told to protect my feet by not walking, and to take more diabetic pills.
IN 2009, I had my left big toe amputated because of another infected diabetic ulcer. Again, I was told to protect my feet by not walking, and to take more diabetic pills.
In March 2010, I developed really bad diabetic ulcers on my right foot, and surgeons said my right leg had to be amputated. I refused amputation, and I went home. I was told to be completely sedentary, and to let my feet heal by staying in a recliner all day with my legs elevated. I was told to not walk or stand, and to put no weight on my feet.
In June 2010, after years of being told to protect my feet by not walking, I was told that the blood vessels in my legs were badly blocked.. Even worse, I was told this month, July 2010, that my coronary arteries were severely blocked. I then was told that the blockages were too severe for stents, and later a planned quadruple bypass was cancelled because the surgeon didn’t want to create bypasses with a vein from one of my legs, because I might then need a leg amputation.
So, now, after years of being told to not walk, to stay off my feet, and after developing life-threatening heart disease, I have a new team of health care providers, including cardiologists, and I have some new and different advice,
The new advice?
Walk. Walk as much a possible.
Nathan, I haven’t tried small amounts of cinnamon but I will look into it.
Jim Purdy, did your doctors explain why the great change in their advice?
https://www.ncbi.nlm.nih.gov/pubmed/20029518
Appl Physiol Nutr Metab. 2009 Dec;34(6):1087-92.
Slow postmeal walking reduces postprandial glycemia in middle-aged women.
Nygaard H, Tomten SE, Høstmark AT.
Lillehammer University College, PB 952 2604 Lillehammer, Norway. havard.nygaard@hil.no
Jallen, thanks for bringing that paper to our attention. That sort of makes my point: the way the authors emphasize “slow” walking. Because it is so different than “brisk” walking. Given that a research paper has just been published about this, it is highly unlikely that this is something everybody in the field of diabetes knows and had I merely searched the web or asked my doctor it would have been obvious.
Seth, the doctors didn’t change their advice. I changed doctors.
I think you should ask your doctor about this and please let us all know what you find out. Walking does improve blood sugar levels because it is exercise. When a patient asks me what they should do to help their blood sugar I reply, “anything”. Simply do anything you want three times per week: run, walk, swim, hike, ride a horse, play rugby anything. Just start making time to do something that is active and you will see your blood sugar come down. Then and only then we can talk about diet, nutrition and other alternative treatments that can help you deal with this disease.
Take charge of your health as doctors we work for you!
My findings do not agree with your advice. “Do anything you want three times per week” — I found that I need to walk every day, which is seven times per week. 3 vs 7: big difference.