A recent study in the UK found that a range of efforts to get people at risk of type 2 diabetes to increase their physical activity were ineffective.
The year-long study conducted by ProActive UK and published in The Lancet, found that face-to-face and phone intervention programs were no better at increasing any measure of overall health than leaflets in the mail.
This study, involving 365 sedentary adults, raised a red flag about the best way to help people at risk for type 2 diabetes. Other studies done in the U.S. have found more success with higher levels of intervention that include diet plans and specific exercise regimens, but not everyone agrees those drastic measures are needed for people to being reducing their risk of type 2 diabetes and heart disease.
Exercise regimens can be difficult to stick with, and experts agree the government could clarify the message that physical activity is more about small lifestyle alterations than an extreme makeover — and provide more suggestions to make those alterations.
“There is one message that really needs to be made stronger in public health,” said Steve McKenzie an administrator of the A. H. Ismail Center for Health, Exercise and Nutrition at Purdue University. “That is physical activity, regardless of your size, is going to make you a healthier person.”
A large U.S. government study from 2002 found that even moderate exercise and a healthy diet that resulted in a 5 to 7 percent weight loss could delay and even prevent type 2 diabetes.
The need for an approach that anyone can stick to is needed now more than ever. More than 20 million Americans live with diabetes, and one-third of the population is obese, according to the National Institute of Health.
Yet a study by the NIH in 2007 found Americans are a stagnant, sloth-like population. Not only did it report that activity is flat-lined, it also found the only increase in behavior was the amount of time spent sitting.
“Preventive health-care systems that aim to reverse the trend towards sedentary living in populations and deﬁned, at-risk groups should consider the need for wider public-health strategies,” authors of the ProActive UK study concluded.
The goal should be “not so much increasing the exercise but decreasing the sedentary behaviors,” said Norma Olvera, an associate professor of health and human performance at the University of Houston.
McKenzie recommends the National Institute of Diabetes and Digestive and Kidney Diseases’ program called Active at Any Size, which emphasizes activities such as taking short walks or gardening. The current recommendation is that any activity only needs to be done for 10 minutes at a time, adding up to at least 30 minutes a day, to help regulate glucose levels and lower “bad” cholesterol.
Those 10-minute intervals are not a slacker definition of exercise, but rather the key to basic physical fitness, according to McKenzie.
“We have all this focus on obesity,” he explained, “but if we take people in the upper overweight or the mild obesity, if they’re physical activity, they’ll be healthier and have lower healthcare costs.”
Shorter, more manageable intervals should be emphasized for completely sedentary individuals. “Even people who are trying to lose weight, they think the only way to exercise is to go to the health club and then they don’t move the rest of the day,” Olvera said.
She said she tells people to put on some music while doing housecleaning, or park at the opposite end of the parking lot when grocery shopping or going to the mall. Olvera said shifting the focus to just sitting less, rather than weight loss, makes it easier for people to stick with physical activity.
“It’s not just about obesity,” McKenzie said. “We got to get people moving.”