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DNA-puzzle

The Evolution of Truly Personalized Medicine: Epigenetics, Food, and Fitness

Most would not argue that there is ongoing transition in how our healthcare is being delivered. This article will examine some of these transitions as a result of breakthroughs in technology, as well as how genetic information, exercise, and diet will play an increasingly greater role.

When medical science was first getting its start, a more holistic philosophy was taken on how to treat illness and maintain health. Hippocrates is often deemed the father of modern medicine, and even today the allopathic physicians (M.D.s) take the Hippocratic Oath – to do no harm to their patients. Hippocrates knew, even in 400 B.C., that the best healer of the body is the body itself. For the most part, the best treatment is to create a strong body and get out of the way. Five guiding principles used in his philosophy for treatment include:

  1. Walking is man’s best medicine.
  2. Know what person the disease has, rather than what disease the person has.
  3. Let food be thy medicine.
  4. Everything in moderation.
  5. To do nothing is also a good remedy.

The second and fifth principles emphasize the power of knowing the individual and getting out of the way! The first and third principles show the power of exercise and food for healthy living. Even the genius, Thomas Edison, realized that a health maintenance organization (HMO) approach was the best method of healthcare both practically and financially. His quote, “The doctor of the future will give no medicine but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease,” is evidence that a holistic, preventative approach is what he advocated. He is also quoted, “…you can’t improve on nature.”

One size does not fit all

Personalized medicine is now on the forefront and it utilizes the genetic and epigenetic data of a person to guide medicines and treatment plans. Cancer drugs have probably harnessed this advantage to the greatest extent, thus far. Former President Jimmy Carter received Keytruda (pembrolizumab) for his brain cancer and it boosted his immune system and beat the cancer. While most of America (71%), still doesn’t even know about personalized medicine, those who were familiar with it did not know it would yield better results with fewer side effects. The different directions of personalized medicine are still being realized, but the field of pharmacogenetics is the first to really jump on the bandwagon of highly effective, precision-based treatment.

The reasons some drugs work for some people and not for others, or why side effects occur in some individuals and not others, is due to individual variability in metabolism. Why are some people lactose tolerant, or some can drink alcohol with no problem, and others have severe issues? It is usually because of enzyme differences, which are under the control of our genes. Interestingly, our enzyme genes can often be turned on or off by “inducible sequences” known as promoters or suppressors of operons, respectively. These “switches” can be repressed or induced depending on our environmental stimuli. Thus, we actually have some control over our gene expression, and this field is known as epigenetics.

Knowing what gene variants someone possess or not will guide the personalized medicine physician on which drug to use or not. By knowing allergic reactions in advance or which medicines may have side effects will help physicians to not make a bad situation worse. Unfortunately, the cost of personalized medicine drugs is much higher than alternative treatments. There is still a lot of exploration to be done on all the various applications of this technology, but the bottom line is that understanding individual variations and enabling the body to do what it is designed to do is a very good thing! Companies like Toolbox Genomics is one of many companies that use your genetic information to then tell you what foods and supplements to eat or avoid, and which exercises may help you the most, and ones that you may not respond to so well. The reason physicians do an intake on family history, or run various tests is to collect information that will guide their treatment. A genetic test on certain gene variants is simply taking this a step further.

How does exercise and diet apply to our epigenetics?

Did you know that exercise is highly beneficial to not only help with fighting cancer once it is already present, but also to never getting it? Physical exercise or movement in general will shift the epigenetics so that genes that suppress tumors are increased, and genes that cause cancer (oncogenes) are decreased. It does this by changing the amount of certain reactions called methylations. Things go wrong when there is too much or too few methylation reactions. Exercise has been shown to reduce or even reverse the epigenetic mutations that often result in tumorigenesis or tumor production. Exercise has also been shown to reduce genetic factors associated with aging like telomere length.

The fields of proteomics and metabolomics as well as pharmacogenomics, are all emerging because of the knowledge on how our genetics affects proteins, metabolism, and reactions to drugs, respectively. The field of nutrigenomics is rapidly expanding, and several companies are capitalizing on studying the relationship of how our genes affect how we process and utilize foods, as well as how food can affect our genes. Vitamins A and D, certain fatty acids, especially medium and short chain, some sterols (derived from cholesterol) and zinc have been shown to directly influence gene transcription. In direct effects include how diet affects gut bacteria, which in turn influences gene expression. Soon when nutritional recommendations are given, it will likely be “for this individual.”

The future of medicine will be taking our genetic information to a whole new level. Soon “smart” watches, clothes, hats, and other common devices will collect information that can benefit our health in many ways as the way healthcare is delivered continually evolves.

This article was featured in MedFit Professional Magazine. Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Mark P. Kelly has been involved with the health and fitness field for more than 30 years. He has been a research scientist for universities and many infomercial projects. He has spoken nationally and internationally on a wide variety of topics and currently speaks on the use of exercise for clinical purposes and exercise’s impact on the brain. Mark is a teacher in colleges and universities in Orange County, CA., where Principle-Centered Health- Corporate Wellness & Safety operates.

Senior-Weight-Training

Fitness: Programming Your Body to Become Strong & Resilient

In the early 90s I worked with a colleague who had a track background as a pole vaulter. Doug subsequently became a fitness professional and athletic coach. He had a philosophy about fitness that was characterized by a simple notion: “Weight training is the paycheck and cardio is the bonus”. I have thought about this issue continuously since I met Doug and as I have grown older, I believe he was right.

I am now training as hard – or harder – than I ever have before to ensure I enter my 70s with as little loss of lean muscle mass, and as much strength and power, as I can create. This article will highlight the importance of resistance training, give you some valuable ideas on how you might implement a program, and finally share ideas with you that can protect and preserve your body for the “long haul”.   

The Issue

Resistance training is characterized by working a muscle group to fatigue or failure under a prescribed “load”. This load can be an actual weight or body weight. Any “load-bearing” movement that includes multiple muscle groups is called a compound movement, such as a walking lunge with an overhead press with dumbbells, for example. Because we are sitting for the greatest portion of our days and not stressing our bones we are losing bone mass as well leading to osteopenia (the forerunner of osteoporosis) and then of course osteoporosis – serious bone density decline. The issue of frailty and imbalance is becoming more and more pronounced in our population and will only accelerate if we don’t change our sedentary behaviors.

Identifying the issues related to loss of muscle mass and bone mass is relatively simple and can be done through clinical testing. Women have the highest potential to start this chronic loss because they have different hormonal issues with aging – less testosterone and smaller bones for example – that creates an earlier onset of disease. Fractures and other related problems can happen in an instant if the loss is not addressed in a timely manner and medication can help along with changes in lifestyle and diet. However, the real solution lies in weight-bearing exercise where stresses are applied to the muscles and skeletal structure intentionally and safely. Men are not immune from developing these conditions – they just start later in life due to larger and heavier frames and greater weight.

Beginning a weight training program earlier in life is the best way to prevent the decline and decay of tissues and the easiest form of that training is in the form of weight training – free weights, machines, and other load-bearing exercises, such as bodyweight exercises. I will highlight my program for you as an example of types of exercises that help the most in preserving and protecting our muscles and bones from further loss or damage and injury.

Programming

The idea is to do a multiple set (8-12 repetitions/ 2-3 sets to start) program that targets all the major muscle groups: Back, chest, shoulders, arms, abdominals, and legs (calf, quad, hamstring) while “loading” the muscle and joint appropriately to stimulate fiber growth. Fiber growth occurs over time when a muscle is exposed to a load that forces a larger than normal contraction. One contraction is the shortening of the muscle (positive or concentric) and the other is the opposite force of lengthening the muscle (negative or eccentric). This movement is accomplished across a joint and creates the change we seek in terms of strength and size.

Each movement is done in a rhythmic and controlled manner that gives the muscle an opportunity to move through a “complete range of motion”. This constitutes “one rep” and applies the stimulus necessary for a muscle to be stimulated to grow following the session during what is called the “recovery phase”.  Each time we increase the load, we enable the muscle to grow and become stronger because the stimulus changes the nature of contractions making the movement more difficult but insuring that it becomes stronger in the process. 

We are not really sure about why this works the way it does but the theory is that by “tearing the muscle” microscopically we create a muscle that is stronger, more adaptable, and able to withstand greater loads going forward. This is referred to as “progressive resistance training” because it is designed as a controlled process with its defined purpose of increasing lean mass.

By programming more than one set we set up the muscle to have to deal with “variable loads” and have to adapt to these increased loads thereby making it able to withstand more of life’s rigors. The theory of doing 2-3 sets initially is that regardless of the weight used – light and smaller to heavier and larger – is that ALL muscles react in the same way to each stimulus – they grow in strength – but NOT necessarily in size. You don’t have to fear getting “muscle-bound” by lifting weights. That takes a concentrated and persistent effort, with a significant caloric intake to help repair the body, as all bodybuilders know. Most of us will never be in that category – and I am certainly not! 

Program Design: The Schedule

Designing a program that addresses the needs of the body as it ages is relatively simple and yet very challenging to implement. The reason is that you will experience some muscle soreness initially that you might find uncomfortable, but this is just the body’s way of recovering from the session (you should never experience pain as that is not normal – don’t believe in “the no pain, no gain” theory – that is just wrong!). 48-72 hours of recovery time is generally advised so that you can allow the muscle to heal itself. In between, you can then initiate a cardio program of swimming, cycling, walking or some other form of movement that allows you the opportunity to encourage this process to become more of a habit – and train your heart to support your effort (my favorite organ, other than the brain of course). 

I believe in a 3-5 day opening schedule of activity that encompasses some cardio and some weight training. Each session can be anywhere from 30 minutes to an hour depending upon your willingness to include a warm-up and cool-down phase, which I highly recommend. Cardio activities include an extended activity (continuous movement) over time and include a warm-up, training and then cool-down phase. You can include an abbreviated walk on the treadmill or outside and then engage your weight training program with a brief cool down to finish the session. 

Exercises & Muscle Groups

  1. Chest – (examples) chest press with dumbbells, barbell, wall pushups, modified floor pushups (knees on the floor) or wall pushups at an angle. 
  2. Back – (examples) seated row, pulldown – bar, low back extension, rubber tube chest extension, dumbbell reverse butterfly – standing with weights at chest level and extend backward.
  3. Arms – dumbbell curls, triceps extension with dumbbell, reverse pushup off bench.
  4. Legs – Wall slide, traditional standing squat, standing from seated position, leg press, calf extension (stairs), and standing lunges.
  5. Abdominal – crunches – lying on your back, knees bent – raise shoulders off the floor and repeat. Exhale on shortening and inhale on lengthening.
  6. Shoulders – shoulder press with dumbbells, front and side raise with dumbbells

I do 16 main exercises twice a week: Bench press (barbell), incline upright row (back), shoulder press, incline/decline press (chest), incline-lateral low row (back), seated triceps extension, arm curl, latissimus pull (back), pullover – chair (shoulder/back), seated leg press and calf extension, lateral raise (shoulder), low back extension, seated abdominal crunch with 65 pounds, hanging dips – upper body, and seated cable row.

Each of these exercises is performed in multiple sets with many repetitions and a variety of loads and at varying speeds to not only encourage growth of my muscles but also to help me maintain my speed and quickness as well. Each muscle group consists of type 1 and type 2 muscle fibers. Type 1 fibers are used for longer endurance activities while the type 2 fibers are for quick explosive movements such as sprinting and power activity (jumping out of the way of a car for instance). 

The reason I train my muscles against variable loads – climbing (the ladder) and descending – is to insure I give each fiber a chance to be engaged and give them the opportunity to become stronger. As I said earlier, I do my program twice a week – on Monday and Thursday – to ensure I recover sufficiently and allow the muscles time to repair themselves.

I am also cognizant of the reality that regardless of how hard – or well – I train, the odds are not in my favor for remaining this way due to the aging process. I am, however, “cutting the odds in my favor” by doing what I am to stay fast and strong.  I am convinced that weight training is the key to my future and that my potential for running fast will be able to be maintained through my continued commitment to remaining strong. It is as Doug said more than two decades ago – “weight training is the paycheck and cardio is the bonus” – but I am so glad I ran all these years as well! 

Nick’s Tips

  1. Do find the resolve to begin – and continue – a weight training program. Schedule at least three days a week for a concentrated effort at building and maintaining your lean muscle mass – and joint integrity. Remember, we start losing 2-5% of our lean muscle mass starting in our 20s – and bone mass as well – unless we do the work to prevent and slow the loss.
  2. Take time to build your cardio capacity through a commitment to your heart. I am able to do my weight training in just over an hour due to my overall cardiovascular fitness.
  3. Take your body seriously and examine how you feel about it. Getting mentally strong through accomplishing your goals is one very important way to stay on track and feel good about yourself. 
  4. Getting lean and being able to burn more calories every day requires only two things: Commitment and discipline founded on purposeful activity.
  5. Take your fitness needs very seriously and yet find ways to make them fun. “Every act we take is its own reward” – Earl Nightingale
  6. Finally, when you see how fast your body will change with weight training (within 30 days, you will see results) it will excite and encourage you to do more and finally realize the dream of a healthy, lean, strong, and fit body.

Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach and fitness professional with over 25 years of experience. His passion for health and fitness comes from his boyhood in Hawaii, where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

woman-weight-lifting

Why Women Need to Lift Weights

Traditionally speaking, when it comes to exercise, men have dominated the lifting weights world. This occurred mainly due to men being allowed to participate in sporting activities while women were not allowed to because it was not considered “lady like” and it was illegal. However, times have changed, as women are no longer looked at as being inferior to men; and it is safe, appropriate and very normal for them to exercise, particularly lift weights.

Here are a few reasons why women say they do not need to lift weights and my answer to their concern.

It Will Make Me Look Bulky

While this is a very legit concern, it is typically not true. In order for a woman (or man) to look “bulky”, they will have to do what is called a lot of “volume” in their workouts. Volume is the number of weight, repetitions, sets and exercises done in order to achieve mass or bulk.

If a woman follows the recommended numbers of days of weight lifting/week by ACSM (2-3 days/week, lifting weights for all the major muscles using 1-2 sets of 8-12 reps), they will not get bulky

Lifting Weights Does Not Help Me Burn Calories

Weight lifting has a high metabolic (ability to burn calories) rate. As a result, the more lean muscle a woman has, the less likely she is to gain weight and the easier it is to keep the weight off. Muscles are like the gas in our cars. The gas is used by the engine and keep the car moving.  Having muscle, by lifting weights, allows your body to keep moving and consistently fight off fat gains.

There is No Benefit For Me to Lift Weights

There are tons of benefits of women lifting weights! They include weight loss, improved mood and well-being, better posture and prevention of osteoporosis. These four are all major concerns for most women and lifting weights helps with all of them!

I Only Need to do Cardio to Be Healthy

While doing cardio activities (i.e. running, swimming, elliptical, spin class, etc.) is beneficial for the heart, it does not put the necessary stress on the bone and muscular system that our bodies crave. We were designed in a way that our muscles were meant to be moved beyond just walking and typing on a computer! While cardio is a great way to burn calories, oftentimes, it will burn away muscle because it is a catabolic activity. Lifting weights help to balance that out. 

Do I Really Need to Start Lifting Weights?

Yes, YOU do! I recommend that a woman looking to start lifting weights seek out professional help. A certified personal trainer is well qualified to provide safe and proper advice for her.

Also, I recommend home DVD workout programs such Power 90, Slim in 6 and Chalene Extreme that have all proven to help women strength train properly.

Weight training is important for everyone to do. It helps with posture, weight loss, prevention of osteoporosis and other metabolic diseases. It does not require a lot to do it, so why not incorporate two days/week for 30 minutes or less to lifting weights!


Maurice D. Williams is the owner of Move Well Fitness in Bethesda, MD, and Assistant Professor of Health & Human Performance at Freed-Hardeman University.  He is a NASM Master Instructor and Master Trainer,  and is also certified with NASM as a Corrective Exercise Specialist, Performance Enhancement Specialist, Senior Fitness Specialist & Weight Loss Specialist, and as a Certified Strength and Conditioning Specialist by NSCA.

weights-water

Taking it Slow. Not Every Fitness Goal Needs to Be Fast and Hard.

Senior Woman Holding Fitness Sign With Family In BackgroundGo big or go home? We all want to see fantastic results from our hard work and dedication to any fitness program. If we maintain nutrition, eat well and work as hard as we can, we are going to see results: that is inevitable. But, do we have to train as hard as possible each and every time we workout, each and every day? Sure, we fit in a rest day, but what else can we do to make sure we are restoring our bodies and minds?

Fitness goals are most easily reached when they are part of every aspect of our lifestyle and not compartmentalized into a few hours of the day. We have limited energy sources no matter how healthy we are, so it is important to maintain awareness about how each of our decisions and actions influence our wellness and choose accordingly.

From a physical aspect, we can slow down some of our workouts to build strength. This works in a variety of ways. By increasing resistance, continuing muscle exertion over a period of time and working muscles beyond the support of initial momentum, strength can be gained, even with relatively light weights or by using the weight of the body alone. This can be true of some weight training programs and is something you can discuss adding to your fitness routines with a certified personal trainer. It is also one of the key elements of building strength through yoga practice and asanas (yoga postures). An additional consideration from a holistic health perspective is the effects of the stress hormone cortisol on weight loss. By taking part in calming physical activities such as restorative, gentle, yin and meditative yoga practices, it is possible to reduce stress, allowing the body to shed weight, heal and be at top capacity for more intensive strength and cardio training when you are working with your personal trainer or in other group fitness programs. By taking time to slow down, you can actually optimize performance and fitness results.

Nourishing your mind can also come in handy, as a way to promote your health when you are not busy exercising or working. Take time to read, learn, talk with fitness experts, organize your time and plan your meals. A wealth of free information is available online to support you in your fitness goals. Blogs with entries from personal trainers and other fitness experts are a great place to start. Personal trainer certification organizations such as the National Council for Certified Personal Trainers (NCCPT), maintain blogs with a variety of advice for personal trainers and fitness enthusiasts. You may also get inspired and decide to take your fitness goals one step further. Once you get involved learning more about fitness, biomechanics and how amazingly capable your body is, you may even get inspired to become a personal trainer or group fitness instructor yourself!

If you find yourself interested in learning more about how to incorporate fitness into every aspect of your life, maybe even your work, you can find out more from the NCCPT.

No matter where you are at in your fitness journey, don’t forget to take some time for yourself. Slow down sometimes to speed up your progress!

Reprinted with permission from NCCPT.


John Platero is the founder and CEO of the National Council of Certified Personal Trainers (NCCPT) which has certified thousands of personal trainers both nationally and internationally.

Trainer helping senior woman exercising with a bosu balance

Core Strength is NOT Washboard Six Pack Abs: 4 Steps to Building Your Powerful Core Strength

Most people associate the core with the look of your abdominals. They believe that having a strong core is associated with the look of a washboard stomach or Six Pack Abs. In reality, there are 27 muscles that make up the core of your body. From pelvis and hip muscles on up, the core is an entire system. Only a few of the muscles are visible to the naked eye.

Back pain

Three Steps to Ease Back into Exercise After a Back Injury

According to studies, Low back pain affects nearly 80% of all adults.  Most low back injuries come from the following: wearing high heels (women), performing manual labor and people who sit for long periods of time (greater than 3 hrs.). Although these statistics are alarming, there are some simple steps one can take to make sure that they avoid current and future back pain or injury. These steps all involve simple exercises that can be performed from anywhere, including one’s office.

Step #1: In order to prevent further injury or a relapse, the 1st thing one should do is stretch common muscles that are tight and may have caused the lower back pain in the first place. Tight muscles are known to overwork and when this occurs, they become overactive and let us know through pain. These muscles include: erector spinae, hip flexors, calves and the lats (the big back muscles). For each stretch, you want to hold the stretch for 30-120 seconds and perform the movement for 1-2 repetitions 3-5x/week. (View Stretches: http://www.webmd.com/back-pain/living-with-low-back-pain-11/five-back-pain-stretches)

Step #2: After you have stretched the tight muscles, now it is time to focus on strengthening the muscles that are weak or underactive. Muscles become weak or underactive typically from lack of use or overuse by the muscles that assist or oppose the weak muscles. For example, if your hip flexor is tight, it could cause your glutes (butt) muscles to become weak.  The muscles that tend to weak with a lower back injury include: certain core muscles, the butt and hamstrings. For each strengthening exercise, you want to perform 1-2 sets of 10-15 repetitions 3-5x/week. (View core exercise: http://www.webmd.com/back-pain/living-with-low-back-pain-11/core-strength-for-back-pain; http://www.webmd.com/back-pain/lower-back-pain-10/slideshow-exercises)

Step #3: Now that you have isolated the lower back with stretching and strengthening exercises, now it is time to focus on integrating your entire body back into exercising. Integrated exercises involve using as many muscles as possible in one given exercise. By performing integrated exercises, you will ensure that the your hip joint (which can be misaligned with low back injuries) starts and remains in the right position and the proper muscles are working as they should be. For each integrates exercise, you want to perform 1-2 sets of 10-15 repetitions 3x/week. (View integrated exercises: http://www.allthingshealing.com/Chiropractic/Corrective-Exercise-for-Back-Pain/8558#.VIoTN74zf8E)

If you follow these three simple steps, you can avoid low back pain setbacks and ensure that your back is strong enough to handle your daily activities of life.


Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

sitting-sedentary

Is Sitting Really the New Smoking?

Make no mistake: sitting less time overall is a good idea for myriad health reasons, but is sitting as bad for you as some would suggest? Is it really the new smoking? In 2017 alone, a slew of new research studies has looked at various health detriments associated with prolonged sitting, even in adults who exercise regularly.

For adults with type 2 diabetes, bouts of either light walking or simple resistance activities benefit not only their glycemic responses to meals (4; 5), but also markers of cardiovascular risk. Both types of interrupting activities are associated with reductions in inflammatory lipids, increases in antioxidant capacity of other lipids, and changes in platelet activation (6).

What is good for one may not be as beneficial for all, though. For example, in adults with low levels of frailty, sedentary time is not predictive of mortality, regardless of physical activity level (1). Sitting more if you are already frail likely just increases frailty and mortality risk, which is not surprising. Along the same lines, being less fit matters in how you respond to breaking up sedentary time. Middle-aged adults with low levels of cardiorespiratory fitness gained the most metabolic benefit from breaking prolonged sitting with regular bouts of light walking, which included five minutes of light walking every 30 minutes over a 7-hour research period (2). If you’re already very fit, adding in some light walking breaks during the day is not going to have as much of an effect—again not surprising.

For in adolescents in school, reducing their sitting time (both in total time and length of bouts) has been shown to improve their blood lipid profiles and cognitive function. A “typical” day (65% of the time spent sitting with two sitting bouts >20 minutes) was compared with a simulated “reduced sitting” day (sitting 50% less with no bouts >20 minutes (3). Can teens stand to improve their health this week? Again, it cannot hurt to break up sedentary time, so why not do it? More recess breaks for teens would be good—and for everyone else for that matter.

All is not lost for people with limited mobility or no ability to engage in weight-bearing activities. Including short bouts of arm ergometry (five minutes of upper body work only every 30 minutes) during prolonged sitting attenuates postprandial glycemia (following two separate meals) when done by obese individuals at high risk of developing type 2 diabetes, even though they remain seated (7). People who cannot walk or stand can, therefore, break up their sedentary time in other ways that can also be metabolically beneficial.

As for other health benefits, breaking up sedentary time is associated with a lower risk of certain types of cancer. In a recent meta-analysis, prolonged television viewing, occupational sitting time, and total sitting time were all associated with increased risks of colorectal cancer in adults (8), which is the most common type after breast/prostate and lung cancers. That study reported a dose-response effect as well, suggesting that both prolonged total sitting time and greater total daily sitting time (2 hours) were associated with a significantly higher risk of colorectal cancer.

In summary, even just the most recent evidence is convincing enough that prolonged sitting is bad for you, and many more studies published similar results in prior years. Is sitting as bad as smoking, though? That remains to be proven. However, you really cannot argue with a recent international consensus statement on sedentary time in older people (9). It states, “Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle.” In fact, the best advice may simply be to consider the whole spectrum of physical activity, from sedentary behavior through to structured exercise (10). Putting yourself anywhere onto that spectrum is definitely better than sitting through the rest of your (shortened) life.

Reprinted with permission from Sheri Colberg.


Sheri R. Colberg, PhD, FACSM, is a Professor Emerita of Exercise Science at Old Dominion University and a former Adjunct Professor of Internal Medicine at Eastern Virginia Medical School. She is an internationally recognized authority on diabetes and exercise. As a leading expert on diabetes and exercise, Sheri has put her extensive knowledge to use in founding Diabetes Motion (diabetesmotion.com), a website providing practical guidance about being active with diabetes. She also founded Diabetes Motion Academy (dmacademy.com), offering training and continuing education to fitness professionals.

 

References cited:

  1. Theou O, Blodgett JM, Godin J, Rockwood K: Association between sedentary time and mortality across levels of frailty. CMAJ 2017;189:E1056-E1064. doi: 1010.1503/cmaj.161034.
  2. McCarthy M, Edwardson CL, Davies MJ, Henson J, Bodicoat DH, Khunti K, Dunstan DW, King JA, Yates T: Fitness Moderates Glycemic Responses to Sitting and Light Activity Breaks. Med Sci Sports Exerc 2017;8:0000000000001338
  3. Penning A, Okely AD, Trost SG, Salmon J, Cliff DP, Batterham M, Howard S, Parrish AM: Acute effects of reducing sitting time in adolescents: a randomized cross-over study. BMC Public Health 2017;17:657. doi: 610.1186/s12889-12017-14660-12886.
  4. Larsen RN, Dempsey PC, Dillon F, Grace M, Kingwell BA, Owen N, Dunstan DW: Does the type of activity “break” from prolonged sitting differentially impact on postprandial blood glucose reductions? An exploratory analysis. Appl Physiol Nutr Metab 2017;42:897-900. doi: 810.1139/apnm-2016-0642. Epub 2017 Mar 1124.
  5. Dempsey PC, Larsen RN, Sethi P, Sacre JW, Straznicky NE, Cohen ND, Cerin E, Lambert GW, Owen N, Kingwell BA, Dunstan DW: Benefits for type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities. Diabetes Care 2016;39:964-972
  6. Grace MS, Dempsey PC, Sethi P, Mundra PA, Mellett NA, Weir JM, Owen N, Dunstan DW, Meikle PJ, Kingwell BA: Breaking Up Prolonged Sitting Alters the Postprandial Plasma Lipidomic Profile of Adults With Type 2 Diabetes. J Clin Endocrinol Metab 2017;102:1991-1999. doi: 1910.1210/jc.2016-3926.
  7. McCarthy M, Edwardson CL, Davies MJ, Henson J, Rowlands A, King JA, Bodicoat DH, Khunti K, Yates T: Breaking up sedentary time with seated upper body activity can regulate metabolic health in obese high-risk adults: A randomized crossover trial. Diabetes Obes Metab 2017;23:13016
  8. Ma P, Yao Y, Sun W, Dai S, Zhou C: Daily sedentary time and its association with risk for colorectal cancer in adults: A dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2017;96:e7049. doi: 7010.1097/MD.0000000000007049.
  9. Dogra S, Ashe MC, Biddle SJH, Brown WJ, Buman MP, Chastin S, Gardiner PA, Inoue S, Jefferis BJ, Oka K, Owen N, Sardinha LB, Skelton DA, Sugiyama T, Copeland JL: Sedentary time in older men and women: an international consensus statement and research priorities. Br J Sports Med 2017;19:2016-097209
  10. Dempsey PC, Grace MS, Dunstan DW: Adding exercise or subtracting sitting time for glycaemic control: where do we stand? Diabetologia 2017;60:390-394. doi: 310.1007/s00125-00016-04180-00124. Epub 02016 Dec 00112.