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Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.

Saturday, April 30, 2016

GOT A MINUTE? GET FIT!

No more excuses about not having time to exercise.  New research finds that doing just one minute of high-intensity exercise can boost your metabolic health as much as doing 45-minute moderate intensity workout.

The study included 27 inactive men who were randomly assigned to do either short high exertion or longer moderate exertion workouts three times a week for 12 weeks, or to a control group that did not exercise.  The intense exercise included three 20-second “all out” sprints on exercise bikes. It also included a two-minute warm-up, a three-minute cool-down, and two minutes of easy cycling for recovery between sprints for a total workout time of 10 minutes.  The men in the moderate workout group did 45 minutes of continuous cycling at a moderate pace, plus the same warm-up and cool-down as those in the sprint interval group.  At the start and end of the 12-weeks, researchers assessed participant's aerobic fitness level as well as  their body’s ability to use insulin properly to regulate blood sugar levels. They also biopsied the men’s muscles to examine how well their muscles functioned at a cellular level. 

By the end of the study, the endurance group had ridden for a total of 27 hours, while the short interval group had ridden for a total of six hours, with only 36 minutes of that time being strenuous.  Despite the dramatic difference in how long each of the exercise groups had spent working out, by the end of the study, both exercise groups exhibited similar improvements in fitness and blood sugar regulation.   Both groups had nearly a 20% improvement in endurance, significant improvements in insulin sensitivity, and significant increases in microscopic structures in the men's muscles that are related to energy production and oxygen consumption . 

What to do: So, in this study, short intense activity and longer moderate intensity activity  were equally good at improving health and fitness.  But, the very brief, high intensity exercise was much, much shorter, so, if you are having difficulty making time for activity, doing short intense intervals may be an effective strategy to improve fitness.  Try powering up the stairwell at work or Google "high intensity interval training" for lots of ways to get in this type of exercise.  Certainly, high intensity exercise in not appropriate for all persons especially those with heart health problems. (Always talk to your provider before starting a new exercise program.)  If very vigorous activity is not for you, this study also illustrated that the more traditional workout format of sustained moderate intensity activity (such as brisk walking) remains an effective strategy to improve fitness.    

Source:
Gillen JB, Martin BJ, MacInnis MJ et al. Twelve weeks of sprint interval training improves indices of cardiometabolic health similar to traditional endurance training despite a five-fold lower exercise volume and time commitment. PLOS ONE, 2016; 11 (4): e0154075 DOI: 10.1371/journal.pone.0154075

Adapted from articles available at:
https://www.sciencedaily.com/releases/2016/04/160427095204.htm
https://consumer.healthday.com/fitness-information-14/misc-health-news-265/one-minute-is-all-you-need-for-a-good-workout-710408.html
http://well.blogs.nytimes.com/2014/12/10/one-minute-workout/?_r=0
http://www.theguardian.com/lifeandstyle/2015/aug/02/is-one-minute-of-high-intensity-exercise-really-enough-to-get-fit

Saturday, April 23, 2016

PRE-DIABETES CAUSES NERVE DAMAGE

It is well understood that, over time, diabetes causes nerve damage in the extremities, a condition known as peripheral neuropathy.  Damage to the nerves results in sensations of tingling, "pins & needles", and pain, especially in the hands, lower legs, and feet and eventually results in a deficit of sensations altogether, impairing balance and awareness of injuries.  While it has been appreciated that high blood sugar damages small nerves, it has not been well understood if the modest elevations in blood sugar characteristic of pre-diabetes also cause nerve damage.  A new study suggests that pre-diabetes does result in significant damage of peripheral nerves.   

This study included 52 participants with tingling and pain in their hands and feet as well as 10 individuals with no nerve pain (controls).  The participants were an equal mix of male and female and ranged in age from their mid-40s to late 60s. Of those with neuropathy, 13 participants had pre-diabetes, 14 had type 2 diabetes and 24 had no blood sugar related health problems.  To measure nerve damage progression, the research team compared the density of nerves in skin samples taken at the start of the study and 3-years later.   Unlike those with healthy blood sugar, those with pre-diabetes and diabetes saw similar declines, about 10% each year, in nerve density at all sites sampled.

What to do:  It is increasingly being recognized that the co-morbidities of diabetes including damage to the kidneys, cardiovascular system, and nervous system starts during pre-diabetes.  These findings illustrate the importance of catching pre-diabetes early and making lifestyle changes that can return blood sugar to healthy levels and prevent diabetes.  The American Diabetes Association defines pre-diabetes as having a fasting blood sugar of 100-125 mg/dL and/or a hemoglobin A1c of 5.7-6.4%.   Research shows that moderate cardiovascular exercise such as brisk walking for 30 minutes five times per week and a 5-7% reduction in bodyweight can prevent or delay diabetes in those with pre-diabetes.  If you have excess weight or other risk factors for diabetes, make sure your provider is checking your hemoglobin A1c blood level which often indicates pre-diabetes before fasting blood sugar levels become elevated.

Source:
Khoshnoodi MA, Truelove, S, Burakgazi A, et al.  Longitudinal assessment of small fiber neuropathy: Evidence of a non–length-dependent distal axonopathy. JAMA Neurology, April 2016 DOI:10.1001/jamaneurol.2016.0057

Adapted from articles available at:
http://www.hopkinsmedicine.org/news/media/releases/small_nerve_fibers_defy_neuropathy_conventions
http://www.sciencedaily.com/releases/2016/04/160411112554.htm>.
http://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/prediabetes-may-damage-nerves-more-than-believed-709885.html