Just like in our Diet Guide, we are setting forth Exercise Habits for our patients/clients to abide by. Steadfast rules for exercise are harder to make since there are many different variables according to goals. Since we really try to focus on improved body composition as well as increased cardiometabolic health (e.g insulin sensitivity), we can narrow our recommendations to fit our targeted population. We will use the FITT (Frequency, Intensity, Type, and Time) principle to show our recommendations. Each recommendation will be followed
Frequency – 5-7 days per week.
We use this term for prescribing the number of times per week of actual exercise sessions planned and followed through with. We strongly recommend setting a goal of at least 5 days per week with an optional day or two off. This will provide the body with the consistent insulin sensitizing mechanisms (Type 2 Diabetes lowering), calorie burning, and muscle building opportunities it is built for and expecting. With the resistance training, we feel it is necessary to allow at least one day (preferably two) between days which focus on the same muscle groups. This is required for time to recover, repair, and grow. For Type 2 Diabetes prevention / treatment some sort of exercise should be performed everyday since one exercise session can increase insulin sensitivity for up to 48 hours.1
Intensity -At least 1 day per week of high intensity exercise (intensity is relative to patient’s current state)
In simple terms, intensity represents the effort that goes into a given exercise. Examples include heavier weight requiring more effort to move through space, a faster paced run/swim, or a steeper climb. This component is also one which should be approached with caution. A highly trained athlete may exercise at a very high intensity involving heavy weights, maximal effort speed, and steep inclines. But a beginner who is overweight and has not ever played sports should start very slowly (e.g. walking at fast pace before trying to full out sprint). Click here to read more about Intensity Recommendations. Ask your doctor for a suggestion of how intense you may safely begin an exercise regimen. High and low intensity have been shown to increase insulin sensitivity and decrease predisposition to Type 2 Diabetes.2,3
Type -At LEAST 2 days of resistance training. The other days are according to preference.
This is the fun part. There are many different ways to get good exercise. Some important essential components are necessary to include for optimal results. First of all, an exercise which will burn an appropriate quantity of calories along with positive strain on the cardiovascular system should be implemented (aerobic). This includes the obvious modes including jogging, swimming, biking, and walking. Others which are just as good or better include sports like basketball, football, tennis, volleyball, soccer, etc. Secondly, and we consider most importantly, is resistance training. There are many muscles in the body which should be utilized for their calorie metabolizing and glucose sensitizing capabilities. The best way to take advantage of these benefits is to specifically use those major muscle groups by isolating them to a certain degree and force them to be metabolically active. See the Exercise Videos section of movements for demonstrations of exercises.
Time -At LEAST 5 hours per week or 45 minutes per day.
This term refers to the amount of time dedicated to the exercise session, a particular exercise modality, and even sets/reps for resistance training. We suggest approximating an hour to be set as the prescribed exercise session. Within that hour should consist of 5-20 minutes warming up in some low intensity cardiovascular/full-body exercise: jogging, elliptical machines, leg/arm bikes, calisthenics, etc. This should be followed by 40-50 minutes of the primary selected exercise type for that day. The last 5-10 minutes should be low intensity “cooling down” by walking or biking slowly and stretching. Reps/Sets: in reference to resistance training, patients must put together a program to exercise specific muscle groups accordingly with repetitions and whole sets. One repetition is constituted by one full range of movement from beginning to end. A number of repetitions constitute one set. For example: 4 sets of push-ups consisting of 15 repetitions (actual ups/downs) in each set. The sets should be separated by 30 seconds to one minute for proper recovery without compromising intensity of strain on the muscle. We recommend at least 12 sets per session and no more than 22 sets per session. The number of repetitions within each set is individually preferenced but generally 6-15 repetitions which are difficult to finish covers most beneficial targets of resistance training. This is adjustable within the program you design to fit in with your plan for warming up, cardiovascular focused exercises, and cool-down/stretching. Some studies show that regardless of intensity or type that it is the length of exercise per week that matters most for insulin sensitivity.4
References
1. Perseghin G, Price TB, Petersen KF, et al. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med. 1996;335:1357–62.
2. Borghouts LB, Backx K, Mensink MF, Keizer HA. Effect of training intensity on insulin sensitivity as evaluated by insulin tolerance test. Eur J Appl Physiol Occup Physiol. 1999;80:461–6
3. Kang J, Robertson RJ, Hagberg JM, et al. Effect of exercise intensity on glucose and insulin metabolism in obese individuals and obese NIDDM patients. Diabetes Care. 1996;19:341–9.
4. Houmard JA, Tanner CJ, Slentz CA, Duscha BD, McCartney JS, Kraus WE. Effect of the volume and intensity of exercise training on insulin sensitivity. J Appl Physiol. 2004;96:101–6.