s we try to connect with our patients and encourage movement, we have dropped the term “exercise” and replaced it with “physical activity.” There is evidence that acts of daily living, such as gardening and walking further from the car to the store, have a positive impact on our health. The concept is that recommending this type of movement may be more achievable to some patients than asking them to walk for 30 minutes per day, 5 days per week.
Now we take one more step backwards, so to speak, and recognize that we need to explore another dimension of lack of activity: sedentariness. The evidence is in—when individuals sit for long periods of time with minimal movement, blood glucose values rise contributing to the overall state of hyperglycemia in persons with diabetes. Even for individuals who achieve the national guidelines of a minimum of 150 minutes of activity per week, sitting for long periods of time can increase the risk of overall mortality.
There is some evidence that rising to a standing position and light intensity movement throughout the day may result in favorable changes to physically inactive patients with type 2 diabetes. Active workstations and half hour to hourly interruptions from sitting have been studied and demonstrated positive metabolic outcomes.
Studies suggest that moderate to vigorous physical activity has a stronger influence on positive metabolic outcomes than limiting sedentary time to short bouts of light physical activity.
So as diabetes educators, how can we coach patients to reduce time in long bouts of “sedentariness” at work and at home?
- Walk messages to colleagues in lieu of emails
- Set an alarm clock for every hour and stand up and walk around for a few minutes
- Get a drink of water every hour
- Create a standing station as an option at work
- Use a mobile headset if phone conversations can occur while walking
- Do not use a remote control for the television
Studies suggest that moderate to vigorous physical activity has a stronger influence on positive metabolic outcomes than limiting sedentary time to short bouts of light physical activity. I do worry that the message of optimal metabolic health with regular moderate to vigorous physical activity may be lost as we work to try to find some way to engage our patients in some form of movement. But with a society that relies on computers and cell phones, long commutes—often in cars—and remote controls for television watching, promoting short bouts of activity throughout the day is another challenge.
However, it may prove to be an avenue for reducing the risk of diabetes and certainly, the amount of time spent in hyperglycemia. We, as diabetes educators, can perhaps set the stage for more movement is better
, while starting the physical activity conversation with let's start here
with some of our most sedentary patients.
About the Author:
Carla Cox is a registered dietitian and certified diabetes educator. She has been a certified diabetes educator for over 15 years, and has served as an assistant adjunct professor for 14 years, teaching in areas of sports nutrition and exercise physiology.