Stumble It!
You Dissin’ Exercise?
A couple of weeks ago, Time magazine published an issue with an attention-grabbing headline: Why Exercise Won’t Make You Thin.
Won’t make me thin? you ask. Then what the heck am I bothering huffing and puffing and sweating like mad on the treadmill?
Good question, says the author, John Cloud. The theory, he writes, is that exercise makes people hungry. And because people eat when they are hungry, they gain weight (duh). People also tend to think they burn more calories than they actually do when they work out, so they “treat” themselves with a Starbucks frappuccino or a dessert, effectively rendering their caloric burn-off null and void or adding on top of what they already eat. Of course, exercise has its benefits, Cloud states, helping with heart disease and overall fitness. But despite the fact that, reported by the Minnesota Heart Survey, that there are more people exercising today than in 1980, yet obesity has risen. What gives?
Well, according to some leading experts, that hypothesis may not be entirely true – or at least true up to a point. James Pivarnik, not an expert in diabetes but the President of American College of Sports Medicine in Indianapolis, wrote a rebuttle in the following [Aug. 17] issue, stating:
“I must take issue with some of the points portrayed as fact. Numerous studies have shown that exercise is indeed central to an effective weight-loss program. The key concept is a simple equation of energy balance: calories expended throughout the day must exceed calories consumed as food. And contrary to the data selected for your article, studies have shown that most exercisers are not uncontrollably hungry after a workout. We strongly encourage reporting that portrays both sides of an issue so readers can decide for themselves–instead of being led down a potentially harmful path.”
The LA Times also has great counterpoints, with one expert, American College of Sports Medicine member Dr. Janet Rankin, stating, “A practical response to the claim that exercise makes you eat more and gain weight is to look around. If this were the case, wouldn’t those who regularly exercise be the fattest? Obviously, that isn’t the case.”
It’s true that many different factors go into whether or not someone is successful at losing weight. There’s commitment, there’s the right type of exercise, there’s intensity level and length of time, and there’s what you do when you’re not exercising (like eating). Dieting and exercise are important for weight loss, and exercise is certainly important for weight maintenance. But for people with diabetes, who are so consumed with balancing food, medication, exercise and, well… life, things are not nearly as simple as it is for our non-PWD counterparts. So I thought I’d ask some leading experts in the field of diabetes and exercise to weigh in on what they think of these claims and what we can do about it:
Sheri Colberg-Ochs, a specialist in diabetes and exercise physiology and author of The Diabetic Athlete, says, “It’s common sense that you can easily overeat and overbalance the calories you expend during exercise IF you pay no attention to your diet at all.”
Cloud theorizes that many people aren’t able to lose weight because exercise makes them ravenous afterwards. But it’s more likely that for most people, it’s not an overwhelming sense of hunger that drives people to eat, but this “reward” concept — that people feel entitled to eat whatever they want since they worked out. Sheri says most people generally expend about 300-600 calories per hour of aerobic work. “You can eat more than that in a peanut butter sandwich or a small order of French fries,” she says. So the idea of rewarding workouts with a post-meal “snack” has got to go, folks.
For people with type 1, we sometimes have to eat before/during/after a workout to keep our blood sugar stable, which can sometimes effectively kill off the exercise calorie burn, for example when we’re forced to gulp down a juice box.
“For type 1s, you have to cut back on your insulin if you don’t want to chase lows all the time,” Sheri says, adding that you may indeed need to eat carbs and protein after exercise to prevent later-onset lows. Not a treat, but a necessity. She adds that there are lower calorie ways of treating a hypo, by using glucose tablets, gels or liquids instead of something like juice. Treating with glucose tablets or boxed juice can also prevent accidental over-treating, which piles on the calories from the uncontrollable urge to eat out your refrigerator!
Gary Scheiner, CDE, author of Think Like a Pancreas, and a board member of the Diabetes Exercise and Sports Association, adds: “Cut the insulin that is active during, and potentially for a while after, the workout. This is easier and more effective when exercise is performed soon after a meal. Exercise before a meal usually requires extra carbohydrate consumption, which contributes to weight gain, while exercise after meals allows a substantial insulin dose reduction, which contributes to weight loss.”
There’s the trick: It’s all about balance. According to Sheri, research shows that you can lose weight through exercise alone, but it may take more like an hour each day, as well as monitoring your food intake. Losing weight through dieting alone is tough, though. “You end up losing a lot of muscle mass and not just fat, which leaves you with less muscle and a lower metabolic rate when you’re done,” Sheri says.
A lower metabolic rate means you’re burning fat much slower — not something you want to encourage if you’re trying to lose weight! The key is to exercise regularly AND watch your diet. No extra snacks, and monitor your blood sugar and make adjustments with your doctor to work on low blood sugars.
Gary, a PWD for 24 years himself, adds this final note: “I think that there is too much obsession with the scale. ‘Fitness’ is what we’re striving for, and that is not always reflected when weighing ourselves. Many forms of exercise will increase muscle mass, bone density and blood volume — all of which may hinder weight loss, but they all reflect improved fitness. Loss of body fat (the ‘bad stuff’) with a concurrent gain in the ‘good stuff’ usually shows up in things like how your clothes fit, waist-hip ratio, and body fat percentage… but not on a simple weigh-in.”
It might be easy to blame exercise for the fact that you’re not losing weight, and therefore think that you shouldn’t exercise at all. But this is just plain nonsense; exercise has myriad positive benefits on your health, helping to prevent dozens of diseases and health conditions, like high blood pressure and heart disease. Let’s get sensible here, Mr. Cloud: Exercise should be done IN ADDITION to healthy eating (in moderation), not as a substitute.
Explore posts in the same categories: D-News Examined, Diabetes Essentials
Thank you for this article Amy. I have, for the first time in my life, been struggling with weight gain and never realized what a struggle it is to balance food, exercise and bg at the same time. I won’t however be giving up my exercise even though I’m not seeing any kind of weight loss because it does make me feel good and I know it’s good for my insides
Posted by: Stacey Divone | September 3rd, 2009 at 7:59 amI loved how Sheri pointed out that it can get tricky for Type 1’s to exercise. This year was my first time ever working out. I really have no excuse now because my apartment complex has a great gym that has 24 hour access. Once I started working out I noticed that I was always going low during or after a workout. I would eat before and would check my BG afterwards. Always low I would chug a juice drink. This became my new excuse on why I can’t exercise. I never thought about the glucose tabs. Thanks for that idea.
Healthy eating and exercise is something that should be done by most not just diabetics and people who are overweight. The benefits are there.
Andrea a.k.a. Sticky Sweet Mom
Posted by: Andrea B. | September 3rd, 2009 at 8:06 amMost of all, I feel better when I exercise. That’s enough proof that it’s good for me!
Posted by: Rachel | September 3rd, 2009 at 8:18 amI think the Time article misrepresented the original study, from what I have heard. Of note, all people in the study who exercised saw a reduction in waist circumference. I don’t know if they measured body fat %-age in the original study but I agree–it is not all about the scale (although it cannot be ignored either).
I have found more success exercising before meals, rather than after, actually, because I am generally further away from my last bolus. If I exercise right after my meal, I am walking a very fine line between overdoing the bolus and battling lows during my workout, or bolusing too little and battling highs. With consistent exercise in the morning, for example, I might reduce my basal a little or none at all and get through a workout without any lows. Before I start, I might eat a banana or something equivalent if my workout is >1 hr long. Usually I don’t even need to bolus for this (or might bolus like 30% of normal) if I eat right before starting.
I have found an effective method for me is to use appropriate nutrition during a workout, eat a meal right after (breakfast or dinner, usually), and then treat the rest of the day as if I hadn’t exercised (ie, do not treat myself).
Posted by: Anne | September 3rd, 2009 at 9:58 amAmy, thanks for being the voice of reason (again!). People lose sight of the simple equation noted in your blog – to lose weight you need to expend more calories than you consume. Another associated key that helped me manage both my weight and my diabetes is portion control. Are you really drinking 8 oz of juice, or have you just grabbed a 12, 16, 18 oz bottle from the health club juice bar?
Fair Winds,
Posted by: Michael Ratrie | September 3rd, 2009 at 10:01 amMike
And this is yet another reason why I have cancelled my subscription to this magazine. To even have this on the front cover of such a high level publication is ludicrous. Isn’t one of the main reasons today that there are so many more type 2’s being diagnosed is because they are not exercising? This just drives me insane how this makes front cover. Thank you Amy for calling this article out. Like the post states, even if you don’t lose weight according to your scale, you will at least be somewhat healthier and feel better about yourself. What a bad decision on the part of TIME to release such nonsense.
Posted by: Chris Stocker | September 3rd, 2009 at 7:49 pmexercise benefits are not simple the calories that we spend but more important – the energy efficiency balance that they exert.
Posted by: Dr. Dina Ralt | September 3rd, 2009 at 10:27 pmThat’s why we need to do it daily or we lose the better efficiency balance. Think of our body as the car gear box …exercise requires a shift…and the body will keep on with this shift for about 24hr.
If you care to read more :
http://nettingno.blogspot.com/2008/03/two-urges-to-eat.html
Like Anne, I don’t go low if I exercise in the morning before eating (and bolusing) — something about mornings (not just dawn phenom) and it works. If planning to exercise after afternoon or evenings meals, I often take a minimal bolus but leave the basal alone.
I agree that it’s all about fitness/wellness – not about the scale/pounds. My endo always says to keep exercising, even though the days when I don’t exercise at all (end up sitting at my desk all day, like a rainy day) are often the most stable Bg days – very little Bg fluctuation. But who wants to live in a body that hasn’t moved all day? Not me. I try to keep moving. I also think it’s good for my heart and overall metabolism.
ps it’s “rebuttal” – sorry, Amy.
Great post.
Posted by: T1 in Boston | September 3rd, 2009 at 11:56 pmLet’s also keep in mind thin doesn’t equal fit. To get fit you need to exercise
Rick
Posted by: How to Exercise Throughout Your Day | September 4th, 2009 at 9:54 amSensei J. Richard Kikrham B.Sc.
I think that the exercise may prevent the fat cells from accumulating and by prompting the body to burn calories from fat before burning calories from carbohydrates and it reducing feelings of hunger.
Posted by: Edwin | September 5th, 2009 at 1:18 amI personally don’t have a problem with my weight (5′8″, 150 lbs), but I have had problems when I do anything strenuous (I like to hike/geocache). I have to disagree with Gary Scheiner, CDE. I’ve often run into high blood sugar because I assumed that I would burn off a good portion of my carb intake while hiking. Turns out that I can have higher blood sugars (I believe) because there wasn’t enough insulin to allow my body to use the sugar that was available to me. Remember, insulin is what ALLOWS your body to USE that sugar to fuel your muscles during exercise. Hard lesson learned a few years ago: wound up with severe hyperglycemia…yet I wasn’t eating, or taking insulin. Liver delivered stored sugar to my body, but because I wasn’t taking insulin (because, I figured I wasn’t eating, I didn’t need it), I still wound up with 1500 blood glucose. To take less insulin is insane, because, although you might avoid an extreme low, you can also risk an extreme high, because you will have nowhere for your sugar to be used…that’s why we have insulin. It should be a balance. I’ve learned to be prepared for a low during a hike. But at least my body can use the sugar I’ve ingested, because I took a reasonable amount of insulin. Another diabetic balancing act!
Posted by: xim1970 | September 5th, 2009 at 11:14 pmI wonder who wrote this. My exercise has helped me lose 38 lbs in 3 months. Ride a bike, qit reading the drivel put forth by modern media!
Posted by: Kirby | September 11th, 2009 at 10:04 pmThere is a health benefit for exercise (such as decreasing insulin resistance) that occurs even if there is no weight loss.
Posted by: Diabetes and Exercise | September 16th, 2009 at 8:02 pmLike Kirby I wonder the same thing. I have always been able to lose weight easily with exercise. However, I don’t walk…I run and do intense yoga and in conjunction with proper eating the weight always comes off. I just give less insulin and try to exercise at the same time every day and for about the same amount of time. If someone is fit rather than fat, they don’t feel hungry after working out. So I suppose getting fit first is important so the feelings of hunger subside.
Posted by: Sysy Morales | September 19th, 2009 at 8:42 pm