Benefits of Exercise
Exercise can help to help prevent Diabetes 2 and
cardiovascular disease. The major causes of the epidemic of
obesity and diabetes in all affluent countries are the wrong
diet and a low level of physical activity. High blood sugar
levels can be reduced by exercise and over time exercise and
proper diet can prevent the consequences of diabetes.
Paffenberger reported that of 50,000 former students at
Harvard and the University of Pennsylvania, physical activity
reduced the risk of both type II diabetes and coronary heart disease
and results in extended longevity. Ruderman praised the
remarkable ability of exercise to help prevent type II diabetes and
cardiovascular disease. He stressed that research shows that a
sedentary lifestyle is a major cause of diabetes 2 and coronary
heart disease. Exercise improves insulin action, lowers blood
pressure and corrects blood fat lipid abnormalities. The insulin
resistance syndrome can be corrected by low intensity, prolonged
exercise. The risk of type II diabetes is reduced by 25% and of
heart disease by 50% among people who are moderately active.
Kannel described a theoretical chain of events leading to
atherosclerosis: abdominal obesity promotes insulin resistance and
the pancreas increases insulin production which results in raised
triglyceride levels and reduced HDL cholesterol (the so-called
"good" cholesterol). This combination of lipid abnormalities is
often associated with small, dense particles of LDL (the "bad"
cholesterol), which is atherogenic. Insulin resistance leads to
glucose intolerance and diabetes, which further promote
Insulin resistance increases re-absorption of sodium by the
kidney, increasing blood volume and producing hypertension, which
also contributes to blood vessel disease. Insulin resistance is
caused by fat stored in the abdomen. Hip or thigh fat is not
associated with major health problems.
Men over age 40 tend to excess abdominal fat and insulin
resistance. Women are at greater risk of accumulating visceral fat
after menopause. Visceral obesity is associated with
elevations of a lipoprotein, apo-B. The combination of high insulin
levels and high apo-B, causes an eleven-fold increased risk of heart
The benefits of exercise are discussed in some detail in in the
book Managing Diabetes. Exercise programs are outlined with specific recommendations.