Friday, September 9, 2011

Diabetes Prevention-Earning Your Calories

Michael Phelps at work
It should be pretty clear from the last two posts that sugar in the blood stream leads to the dangerous complications of diabetes.  Just as important as what is delivered to the blood vessels is how it leaves. The greatest source of energy demand is from the muscles.  If we don't use our muscles, they won't use up the sugar.  It is that plain and simple.  Conversely, when we actively use our muscles we turn into a blood sugar burning machine.  Well conditioned athletes use up a huge amount of sugar.  In the last Olympics, it was well documented that Michael Phelps, our gold medal, world record breaking swimmer, consumed around 9000 calories a day.  Most of those were in the form of carbohydrates.  That would put many of my diabetic patients in the hospital in a diabetic coma.  He had to consume that much to keep up with the amount of calories that his muscles were consuming due to his intense training.  However, I have witnessed many swim coaches who are over weight and at risk for diabetes.  The reason?  While they were actively training they developed a habit of heavy caloric intake which was not adequately scaled back when their training decreased.  The point is that exercise allows us to be able to eat more food.

One need not be an olympic swimmer to increase his ability to burn sugar.  Intensity matters but consistency is the key.  In the days when most of our population worked on farms, type II diabetes was not very common.  Today, where many of us work at computer screens or sitting down, the incidence is sky rocketing.  That is not a coincidence.  If you are not a construction worker or a farmer, you likely need more exercise.  I've discussed this in previous posts, but it does not matter what sort of activity you engage in as long as you are moving your muscles and getting your heart rate up.  The heart rate is an indicator that the muscles have used up their store of fuel and are calling out for a new delivery.  Whatever you choose to participate in, do it regularly.  It would be nice to be able to exercise just once a week for three hours and call it quits.  If we just ate once a week, I suppose that would work, but as long as we are putting fuel in the body, we need to keep the engine running.  I recently saw a patient in the office and I told him, "I'll make you a deal...you only have to exercise on the days that you eat."  The glimmer of hope that shone in his eyes as I started my sentence quickly turned to despair as he realized the point I was making.


I enjoy eating as much as anyone else.  I love ice cream.  I have been known to have a certain fondness for M&M's.  I realize that eating such items on a regular basis is a recipe for disaster.  Some years back to curb a nearly nightly habit of having ice cream, I put together my rules for eating.  I have followed these rules now for 15 years and I'll have to say that it has worked well for me.  During the week, I make sure and eat my five servings of fruits and vegetables a day.  I avoid all sweets, junk food, and yes, even ice cream.  On the weekends, I can eat anything I want, if and only if, I have exercised at least four days during the week.  I'll admit that in the beginning, I over did it on the weekends.  By Sunday, I would often feel bloated, lethargic and I often battled headaches.  Monday would be a relief.  I now no longer go crazy and feel much better for it.  It is nice to be able to sit down and have a milkshake without guilt.  I view it as a reward rather than a transgression.  Since I have burned it, I earned it!

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