As a parent, you obviously want what’s best for your child – but what is really best when it comes to exercise and children with diabetes? Riekie Human tells us what you need to know (adults can learn a little something, too!).
Although experts agree that it’s crucial for kids with diabetes to exercise, you need to make sure they’re doing it safely. Thankfully, it’s easier than you think… We got all the answers from experts in the field.
What kind of exercise should my child do?
“The most helpful exercises encourage muscle contraction and increase the effect of insulin.” What does that mean? The exercise helps more glucose to be transported out of the blood stream and into the cells to be used: body weight exercise and resistance training are particularly good at this. However, young children should take part in all kinds of exercise, particularly cardiovascular for the development and health of the heart, lungs and lipid profiles (cholesterol), and team sports to encourage skills and develop confidence. Sarah Hall, Biokineticist at Wellness in Motion, Morningside
Ball sports are especially good for children with diabetes. “They involve a combination of exercises like jogging and sprinting, and research has found that this is best for stability in blood sugar levels.” Contact sports like karate can be tricky, especially for children with insulin pumps, as the pump could get damaged – and the same applies to horse riding. Andrew Heilbrunn, Head Biokineticist at the Centre for Diabetes and Endocrinology (CDE) in Houghton
What time of day should my child exercise?
The best time for kids with diabetes to exercise is before breakfast and before supper. “They’re less likely to hit lows at those times. Before breakfast, they’ll be quite insulin-resistant and are unlikely to experience a drop in blood sugar.” The worst time to exercise? An hour or two after meals, when insulin in the system can cause more frequent lows.
How long should my child exercise for?
That depends on the child: what they’re capable of and how fit they are. “The general recommendation is 1 to 2 hours, but take into account the type of exercise, your child’s age and their fitness level. And remember to limit exercise to 30 to 45 minutes if it’s a new sport or type of exercise – and then closely monitor their blood sugar levels, before and after exercising.”
What else do I need to know about exercise and diabetes?
It’s important to give the coach a list of symptoms of high and low blood sugar, as well as detailed instructions of what to do if your child goes low. “A child with low blood sugar will be irritable, have a headache and blurry vision, and generally feel horrible.” If your child’s blood sugar is too high, they will feel tired and thirsty.
Dr Claudine Lee, GP
If your child exercises for more than one hour, any time of the day, they should have a protein snack, like full-cream yoghurt or small yoghurt-coated rice cakes, before going to bed. “Sustained energy overnight is crucial, as it prevents hypos between 2 and 4am. “Also, always have a quick-acting sugar snack on hand (fruit juice, sweets or honey) to treat low blood sugar, and make sure the coach knows how to use a glucagon pen in case of emergency.
Ask the expert: Sarah Hall, Biokineticist Studies have shown that children with Type 1 or Type 2 diabetes are generally less physically active than those without: the exact opposite of what the situation should be!
Some advantages of increased physical activity for children with diabetes:
- Better health
- More confidence
- An improved response to insulin and blood sugar control
- A greater awareness of diabetes and their bodies
- The prevention of conditions associated with diabetes, like obesity and heart disease
- Improved weight management
- Don’t let your child exercise if their blood sugar is too high: over 16mmol/l or too low: under 4mmol/l, or if ketones are present.
- Make sure your child’s blood sugar is in the target range before exercise, in order to avoid low blood sugar.
- Talk with your doctor about lowering your child’s insulin dose before exercise, if necessary.
- Inject insulin before exercise in a site other than the body parts about to be used. For example, if your child will be running, don’t inject in the legs.
- Watch for symptoms of low blood sugar for 12 hours after exercise, especially if it’s a new kind of exercise.
- Make sure your child drinks water so they don’t get dehydrated.
- Choose something fun for you and your child to do together and they’ll learn that getting active is just as enjoyable as relaxing. You could go to dance classes, swim, learn to surf, take up yoga, go on hikes, play tennis or even join a soccer team. There’s even something called laughter yoga if you really want to have a good time.
Are you looking for a fun way to get fit? Here are a few exercise classes specifically for people with diabetes – we’ll add to this list as we find more! Please email us with details of other fun fitness classes for diabetics.
Latha Singh: Chatsworth, Durban
I’ve been an exercise instructor for the past 28 years. I teach exercise classes for women and senior citizen groups in and around Chatsworth.
I would love to spread my knowledge and literally hold exercise classes at hospitals (like Chatsmed Garden Life Hospital) and other venues to make people aware of the importance of exercise, especially people with diabetes.
My classes are currently at:
- Malvern Library (Queensburgh): Monday and Wednesday from 8am to 9am
- Shallcross Heidi School Hall: Tuesday and Thursday mornings from 8am to 9am
- Woodhurst Library, Chatsworth: Tuesday and Thursday from 6pm to 7pm
- Mobeni Heights Temple Hall: Wednesdays from 10am to 11am
- Woodhurst Library: Thursdays from 11am to 11.30am
Kayla Murphy: Randburg, Johannesburg
We are a private biokinetics practice in Randburg, Johannesburg. We specialise in youth and adult diabetic exercise classes: Fit for Diabetes (see below PDF for more info).
We are happy to do any free classes or participate in educational talks to get more involved and contribute to the diabetic community of South Africa.
The millenary practice of yoga is fast gaining ground on a worldwide scale; known as an efficient stress buster that brings practitioners greater vitality and a better mood, it also helps prevent heart disease, which is good news for people with diabetes.
Heart disease a risk for people with diabetes
Adults with diabetes have a higher likelihood of heart disease for various reasons. Those with Type 2 diabetes, in particular, may have conditions that can increase this risk, including high blood pressure, high cholesterol and triglyceride levels, and obesity. Leading a sedentary lifestyle is another modifiable major risk factor for both cardiovascular disease and insulin resistance, so one way to reduce the risk for heart attack or stroke is to keep physically active through aerobic activity and, new studies indicate, yoga.
Yoga as a means to reduce cardiovascular disease risk
In a review of 37 randomized controlled trials, researchers from the Netherlands and the USA found that yoga can provide the same benefits in risk factor reduction as commonly recommended activities such as cycling or fast walking. These two forms of exercise could have comparable working mechanisms; that is, yoga could have more physiological benefits, and exercise more relaxing effects than was originally thought.
As a deeply spiritual practice affecting physical and mental health positively, yoga is being embraced in a plethora of mental health settings, including rehabilitation centres for substance abuse. Science is more accepting than in the past of so-called ‘alternative therapies’ like yoga since numerous studies have shown that spirituality is linked to greater happiness and reduced anxiety and depression – key factors in managing diabetes from an integrated perspective.
In the studies, yoga practice was associated with significant improvement in Body Mass Index (BMI), blood pressure, and lipid levels, particularly when patients also took medication.
Yoga and aerobic activity a winning combination
Another, more recent study, presented at the American College of Cardiology in 2017, found that those who already have heart disease but practiced yoga in addition to aerobics, saw twice the reduction in BMI, blood pressure, and cholesterol levels, as those who practiced either of these activities exclusively. Combining these activities could also increase exercise capacity and improve heart function.
Of course, even if you only have time for yoga, you will still be doing yourself plenty of good, since heart rate variability (an indicator of optimal heart health) is higher in yoga practitioners. Yet another study showed that yoga can reduce atrial fibrillation (‘heart quivering’) while improving heart rate, blood pressure, and general quality of life.
If you have diabetes, it is important to lower your likelihood of heart disease by staying active, keeping to a healthy weight, and tapping into the potential of combining yoga and aerobic activities, making time for each throughout the week. By boosting physiological changes and lower stress levels, you can kill two birds with one stone, finding greater enjoyment and vitality as an added bonus.
A weekend hike is not just a fun, affordable activity for the whole family, it’s also one of the best ways to enjoy South Africa’s natural beauty. And a great way to get fit! What more could you ask for? Nicole McCreedy leads the way.
Hiking is good for the heart and the soul. Being in nature can help you to de-stress and reduce anxiety levels after a busy week, and when you hike you get all the same benefits of walking – and a few more. Hiking is a powerful cardiovascular workout that is known to reduce cholesterol, which means less risk of heart disease, and it can improve blood pressure. Keeping your heart fit and healthy is important for all diabetics.
So what’s in a hike? The following ingredients:
1 x beautiful trail
1 x pair of shoes
1 x backpack to carry all the essentials
1 x spirit of adventure
What to bring on your hike:
Luckily, you don’t need much equipment to hike. It’s important to research the route beforehand, though, especially if you’re going seriously off-road. Make sure you always hike with other people and pack these essentials:
- A cellphone in case you need to make an emergency call
- A GPS or map so that you don’t get lost.
- Enough water. It’s easy to become dehydrated, especially in warm weather.
- A low blood sugar snack (like dried fruit or juice).
- A mid-hike snack (like fresh fruit, crackers or nuts) to help you maintain your blood sugar levels.
- Your glucometer, strips and insulin, if necessary.
- A hat and sunblock to shield you from the sun.
- Rain gear if it looks like rain!
How to prepare for a hike
Ask the expert: Sarah Hall, Biokineticist
The nature of hiking means that your terrain is unstable and unpredictable. Each step is different from the one before and requires a combination of balance, strength and stability, using one leg at a time. Here’s how to prepare for a hike:
- Start by doing exercises with one leg at a time to isolate muscle groups and encourage improved balance and joint stability. This is called unilateral training.
- Strengthen your glutes and calves to help with climbing and hiking for a longer period of time. Choose exercises like step-ups, standing side leg raises, static lunges and single leg balancing. Try to do 3 sets of 20 of each.
- Alignment is key. Your spine will be taking the load with each step, so be sure to keep your hip, knee and ankle in one straight line for all exercises.
- Always include core exercises that strengthen your abdominals and try to keep your posture upright during the hike.
- To prevent injury during the hike, ensure that you take regular breaks and stretch.
Taking care of your feet
Ask the expert: Anette Thompson, Podiatrist
Here are 5 tips to take care of your feet while out and about hiking:
- Condition your feet It is important to train the muscles, tendons, and ligaments of your ankles and feet for hiking with a backpack.
- Get good footwear and socks Shoes that fit correctly are the most important way to keep your feet happy. When choosing socks, avoid moisture-retaining cotton: instead choose wool or synthetic socks.
- 3. Manage your toenails and skin Socks will catch on nails that are too long or that have rough edges, putting pressure on the nail bed. Take special care of the skin on your heels.
- Learn how to prevent blisters Experiment with different blister patching products and different taping techniques. Find what works for your feet and then perfect the method.
- Carry a small foot care kit A small foot care kit carried in a ziplock bag is easy to carry with your backpack. Include either Vaseline or talcum powder, a few alcohol wipes to clean the skin, some blister plasters and a safety pin to drain blisters (if necessary!).
Struggling to get started on a fitness routine? Maybe you need to try exercising in a group. It’s far more fun, and just as good for you!
There’s something about pounding the pavement on your own that is just no fun. Swimming lengths can also be lonely, and so can going to the gym. But who said getting fit had to be a solo exercise? Here are some of our favourite ways to get active with your friends and family members.
All you need is a pair of walking shoes and an adventurous spirit and you can start a walking group. Decide on a route that you want to follow, and start slowly – just a kilometre or two will do. It’s a good idea to have a goal in mind so that you can work up to longer distances. How about 10km by the end of the year?
Finding enough people for a full soccer team might be a challenge, but 5-a-side soccer only needs ten people to play the whole game, and ensures that everyone gets a real work-out. You can play on any field or in a garden (because there are fewer players, you need less space) and the game doesn’t last as long – generally an hour in total.
While you can pay a lot to attend official boot camp classes, you can also set up your own boot camp with a few friends. Decide what areas of the body you specifically want to work and set out a four-week exercise programme. You might want to include things like sit-ups, push-ups, jogging around a track or on the spot, doing star jumps, short sprints, skipping and lifting weights. Just make sure everyone is in agreement with what the session looks like – and don’t leave anyone behind!
Ask the expert: Ilona Padayachee, Biokineticist
The FITT principle is very helpful to keep in mind with walking.
F – Frequency
I – Intensity
T – Time
T – Type
Frequency: Aim to exercise for 3 to 5 days a week.
If you are a beginner try not to overdo it, start off slowly and progress to longer and faster walks.
Intensity: This is very important in any exercise programme.
Walking at the correct speed can make a huge difference to how effective the exercise is.
Time: Start slow and build up your time.
A beginner walker should start out at 10 to 12 minutes, including 5 minutes warm-up. Then increase it to 20 minutes by adding 2 minutes to the walk every week.
Type: Choose the type or kind of activity that you enjoy.
It’s always easier to stick to something you like doing!
Diabetic foot care tips:
No matter how much fun you’re having getting fit, don’t forget to look after your feet! As a diabetic, foot care is really important. Bad circulation in the feet and legs, often noticed as leg pain and leg cramps, is one of the problems facing diabetics, and can lead to chronic ulcers, numbness and even gangrene. Daily care for the feet is essential.
Here are some great tips:
- Exercise and regular movement is good for circulation.
- If possible, raise your feet when you’re sitting down.
- Check your feet every day for swelling, marks and red spots.
- Check your feet for ‘cold areas’ (a sign of poor circulation).
- Check your feet for ‘hot areas’ (a sign of infection).
- Dry your feet well after bathing, showering or swimming.
- Apply a good natural cream to the feet every day.
- Wear comfortable shoes that do not pinch the feet or toes.
- Keep toenails trimmed and file sharp edges.
Tired of pounding the pavement or looking for a fun way to get active? Trail running may be the sport for you. More and more people are heading to the mountains, the veld and the forests to get away from the city, spend time in nature and run free.
More than just a work-out
Trail running is good for the body, mind and soul. It’s also good for the wallet – except for the price of running shoes, it doesn’t cost a thing. Trail running is different to road running because the ground you’re running on changes all the time and isn’t flat and hard like a road. It helps “proprioception”, our sense of balance and body awareness. It also develops strength in muscles and joints, and gives you stronger ankles and hip joints. Softer surfaces like grass, sand, and gravel are easier on the joints than tar. Trail running will help you burn more calories and shed fat faster as your body uses a greater amount of energy to use more muscles to move on the uneven surface. Paying attention to each step you take will also distract your mind from your everyday To Do list (always a good thing!) Don’t forget to stop for a moment, breathe in the fresh air, and give thanks for where you are.
Although there is less risk of injury with trail running than road running, it’s a good idea in the beginning to include some exercises in your routine to strengthen your core, pelvic muscles, legs, knees and ankles to cope with the impact to these parts of the body. Follow a careful training programme where you can gradually build up your distance and speed. It’s important to be aware of your diabetic needs while you’re trail running, too. Don’t push yourself too hard in the beginning, and make sure you snack before you start running so that your blood sugar doesn’t go low while you’re on the trail.
When you’re trail running, it’s important to look where you’re going – vehicle tracks, puddles, logs and rocks are all obstacles that can trip you up, and low-hanging tree branches need to be ducked in time.
Here are some tips for different types of terrain:
Sand is difficult to run on, especially when it’s loose. Don’t run in a straight line, rather search for the firmest footing. The harder sand can usually be found on the very edge of the trail.
Muddy surfaces can be slippery, be careful!
Rocky trails mean you need to lift your legs higher to avoid tripping. Try to step lightly with a flat foot, so that if it’s not stable or you slip, you can quickly move your foot.
Forest paths can hide rocks and roots. Be on the lookout and avoid stepping on them if you you can.
Looking for runs in you area? Take a look at www.nightjartravel.com/trail-running
Want to see more of our favourite trails? Visit www.sweetlifemag.co.za/community
Expert tip: Get the right shoes.
Ask the expert: Nelfrie Kemp, Podiatry Association of South Africa
The most important tip when taking up any running is to buy the right shoes and make sure they fit properly. Foot care is vital if you have diabetes. When fitting a running shoe, choose a pair one size larger than your normal shoe size as your feet swell when you exercise. It’s a good idea to use sport socks that are thick from toe to heel and fit you perfectly. This will help prevent pins and needles or a burning sensation in the feet. Preferably wear ankle-height socks as secret socks can move and curl up under your foot, which can cause blisters. Always tie your laces, but make sure that it they are not tied too loosely or tightly.
Get more diabetic foot tips at www.podiatrist.co.za
Expert tip: Be aware
Ask the expert: Sarah Hall, Biokineticist
- As well as the trail running, do some balance training either at home or in the gym by doing single leg exercises or balancing on wobble boards.
- Use your whole body while you are trail running: your arms for balance and support, your core to help draw your legs up for climbing the rocky parts, and a mid-foot to front-of-foot strike with shorter, quicker strides for more control and adjustment.
- Pay close attention to what you eat and drink before and during the run, especially on longer runs. Always have something sweet on you in case your blood sugar goes low, and never run alone.
- Know the route you are running by mapping the route on GPS. It will give you a good idea of the height you may be climbing and the exact distance you will be covering. Remember to start with shorter routes and slowly build up distance.
No matter the season exercising outdoors beats running on a treadmill in the gym. If you want to keep fit and have a social life, then soccer, touch rugby or rounders is the answer. Nicole McCreedy tells us how to get started.
The beauty of ball sports is that they’re so easy to learn. All you need to do is find an open space to play, organize some equipment and two teams, and learn a few basic rules. While your focus is on winning, you’ll be walking, running and laughing your way to better health.
The basics of touch rugby are similar to the traditional version of the game – the ball is passed backwards during play. However, in touch rugby you don’t tackle your opponent but rather touch the person running with the ball on any part of their body, clothing or the ball itself using your hand. Because touch rugby is less physical, women can also play without fear of injury. Once touched, the player in possession of the ball is required to stop, return to the mark where the touch occurred and perform a ‘rollball’ without delay. Facing the defending try-line the player rolls the ball between his/her legs. After six touches the ball is handed over from the attacking team to the defending team and the game starts again from the halfway line in the centre of the field. The aim is to score a touchdown over the defending team’s try-line. Five to six players are on one team at a time, and a game lasts for about forty minutes per side.
A game of soccer can be as simple as kicking the ball around with a few friends. Players dribble the ball on the ground, kicking it to pass to each other. For most games, there are eleven players per team – the goalkeeper is the only player allowed to use his/her hands. Teams are made up of defenders, midfielders and forwards. Two defenders patrol the left and right area while the two central defenders play in the middle. The midfielders play both defence and attack, and the forward positions focus on scoring the goals. The centre forwards play in the middle flanked on each side by a wing. In soccer be aware of the offside rule. If you are behind the other team’s defenders without the ball, you are offside. But if the ball is kicked past the defenders, you can pass them. Laduuuuuuuma!
To play rounders you need a small ball (a tennis ball will do) and some kind of bat. There must be a minimum of six players per team. A match consists of two innings, giving each team a chance to bat and bowl. An innings is over when the last batter is caught out, and each person on the team gets a chance to bat. When bowling, the ball must not bounce and it must be above the batter’s knee, below the batter’s head, and not at the batter’s body. The batter hits the ball and then runs in a circle, passing a series of markers on the way. A ‘rounder’ is when the batter makes it all the way around the circuit in one hit of the ball. The team with the most rounders wins. A batter is out if the ball is caught before it hits the ground or if the ball is fielded before the batter reaches a marker. A batter who has missed the ball can run to the first marker and then continue to the next three when the next batsman strikes the ball. Only one person can stand at a base at a time.
Team ball sports are a great cardiovascular workout because they increase your heart rate. They are particularly good for people with diabetes because the body uses up extra glucose and decreases resistance to insulin. Muscle strength, endurance and eye-coordination also improve. Best of all? You lose weight while having a ball!
Ask the expert: Anette Thompson, Podiatrist shoes or barefoot?
SEMDSA, the Society for Endocrinology, Metabolism and Diabetes of South Africa, recently released 2012 guidelines which state that a person living with diabetes should not walk or run barefoot. There are a number of reasons for this – even well controlled, highly active people who have not developed any complications will experience a delay in healing if their skin punctures or cracks. Any break in the skin is a potential entry point for infection: bacterial, viral or fungal.
The goal is to wear footwear that most closely approaches the benefits of being barefoot. ‘Barefoot-like’ sports shoes allow maximum flexibility and give the feet the most natural workout. The benefits are improved blood flow to the feet and lower limbs, which feeds nerves and muscles during exercise. Ensure that the shoes are wide enough, as well as being the correct size. It’s a good idea to invest in good quality socks as well.
You only get one pair of feet – take good care of them.
Sport tips Sarah Hall, Biokeniticist
When playing outdoor sports, especially those you’re not used to, keep these tips in mind:
- A sport specific warm up is essential. Try and focus on the muscle groups you’re about to use and make sure that you pay particular attention to those during your warm up. If you’re about to play soccer, try to loosen up the ankle joints with some ankle circle exercises. Stretch the groin muscles with some lunges and do a couple of lengths of sideways shuffle running along the field.
- Wear supportive footgear to support your feet and cushion the rest of your body as you run.
- Be as prepared as possible. Make sure you have enough water for the extended length of time of play. You must also keep some fast acting snacks handy as the game, although fun, may use up more energy than you think.
Want to have a more flexible body and improve your circulation? Nicole McCreedy tells us why stretching should be part of everyone’s day.
When we’re young, it’s easy to imagine that our bodies will always do what they’re told. But as we age, our muscles tighten and all of a sudden something as easy as bending over to pick up your keys might be a struggle. Stretching is important because it keeps the body flexible and allows your joints to move through their full range of motion. Here’s all you need to know to keep flexible.
For people with diabetes, improving circulation is essential for maintaining good health. Because stretching increases blood flow to the muscles, specifically the legs, it is great for circulation, but that’s not all. Regular stretching will increase nutrients to the muscles, improve your co-ordination, lengthen your muscles, reduce lower back pain, and even increase your energy levels.
How to stretch
While you can stretch anytime, anywhere – in your home or at work – you want to be sure to do it safely. Each stretch should be done in a slow and controlled manner till you feel ‘mild discomfort’. If it feels painful, you’ve stretched too far. Do not bounce or force the stretch.
Ideally, you should stretch before you start exercising. To avoid injury, first warm up your muscles. Run on the spot for a few minutes or do some jumping jacks to get your blood flowing and increase your heart rate. Stretch again at the end of your training sessions to help your muscles recover.
Types of stretching
What kind of stretching you choose to do will depend on your fitness and flexibility.
Static stretching is the most common form and is safe for beginners. Give this a try: to stretch the back of your upper thigh lie down on your back. Lift your right leg up in the air, heel facing the ceiling. Make sure that your lower back stays in contact with the floor and the left leg remains straight on the floor. Grip your raised leg with both hands. You may be comfortable holding your thigh, or you may be able to clasp your knee. Do what feels best for you. Keep your head and neck relaxed. Hold for 30 seconds or less. Change legs.
Passive stretching means you are using something outside yourself to help you stretch. Here’s a passive stretch to try: Relax the muscle you are trying to stretch and rely on a strap, gravity, another person, or your own body weight to stretch the muscle gently. Make sure you are well balanced before you start stretching!
Passive stretching is useful for those who have been injured or are frail. A recent study has found that passive stretching can help regulate blood glucose and is beneficial in treating people who are less physically able.
Dynamic stretching is moving through a challenging but comfortable range of motion repeatedly. Take shoulder circles for instance: stand tall, feet slightly wider than shoulder-width apart, knees slightly bent. Lift your right shoulder towards your right ear, take it backwards, down and then up again to the ear in a smooth action. Repeat six to ten times. Do the same with the left shoulder. What you are doing is actively contracting the muscle in the opposition position to the one that you are stretching.
Love stretching and want to take it further? Try yoga or pilates – both involve active stretching. With yoga, the postures are timed with the breath and are designed to put pressure on the glandular system. In pilates, the sequence of movements focuses on strengthening your core muscles – the deep, internal muscles of the abdomen and back.
What to keep in mind while stretching – Sarah Hall, Biokineticist
Remember that – just like people – each muscle group and joint is individual.
- Make sure that you warm up before you do any activity, and stretch afterwards as well. A quick rule of thumb is to stretch a muscle only if it is tight.
- Do not stretch in such a way that you put another joint or muscle at risk of injury.
- Try to isolate a muscle when stretching. If you are working the hamstring, do not put weight on that leg. Breathe into the stretch to allow the benefits of the stretch to move through that muscle.
- Decide on a reason for stretching a particular muscle: is it to relax, release tightness or restore length to the muscle? Aim to stretch each muscle for between 10 and 30 seconds.
Ask the expert: Dr. Zaheer Bayat, Endocrinologist
Exercise is good for everybody. But for those with diabetes, there are added benefits:
- Exercise lowers glucose levels as muscles require more glucose for fuel.
- Exercise helps in losing weight, which in turn improves morale. Not only will you feel better, you will also look good.
- Exercise improves insulin sensitivity. This can go a long way to stabilizing blood sugar levels
When starting any exercise program, it is important to spend a few minutes stretching, which will help lessen the risk of doing damage to yourself.
Ask the expert: Prof. Wayne Derman, Professor of Sports and Exercise Medicine
“Flexibility is an important part of fitness, so stretching should be included in any exercise programme. It’s also a great way to manage and prevent muscle cramps. Not sure what to do? Get a physio, biokineticist or trainer to assist you with the right stretches for the muscle groups in which you are particularly tight.”
Not a natural fitness fanatic? Don’t worry about it! Susan Erasmus shows how even the most determined couch potato can get some exercise this winter.
If the thought of going to the gym makes you curl up under the duvet and reach for the TV remote, you’re not alone. The good news is that anything that gets your heart rate up and gets you out of your comfort zone counts as exercise. We all know how good getting active is for us: it relieves stress, prevents colds, reduces diabetic complications, promotes heart health and keeps your weight in check…
But can it be fun? Here are 10 easy ways to sneak exercise into everyday life:
Follow the 1km rule.
Unless you’re in a tearing hurry, it’s pouring with rain or it’s the middle of the night, don’t take the car if your destination is less than a kilometre away. Just 10 minutes of walking a day will cut your heart disease risk by half, according to the Mayo Clinic in the USA. “Weight-bearing exercise like walking will also make your bones stronger,” says biokineticist Sarah Hall.
Top tip: Get a pedometer so you can track your progress and count how many steps you take each day.
Play with your kids.
Kids are like Energizer bunnies: they just keep going. Why not join them – even if it’s only for twenty minutes in the park? Ball games or a game of frisbee are a fun way to take your mind off the fact that you’re getting exercise… Best of all? Your kids will love it too!
Move your feet.
It’s as easy as pacing while you talk on the phone (instead of slouching in your chair), walking to the furthest toilets, making the trek to the printer at work or getting up off the couch to change the channel on the TV. Take every opportunity to move your feet and you’ll be surprised how much more active you feel!
Take the stairs… Every time.
The beauty of taking the stairs instead of the lift is that even if it’s raining outside, you’re still doing your daily exercise. You don’t have to climb 20 floors if you work in a high-rise, but even one or two floors will have you feeling stronger than you did before.
Top tip: Watch your posture as you climb the stairs, and ground your heel on each step so you don’t stretch your calf muscles too much.
Walk the dog.
A 20 minute walk with your dog will not only make your pet happy but take you out in the fresh air and get your heart pumping. Make a promise to walk your dog every day – before or after work – and see how quickly your fitness improves.
Make your garden greener.
You don’t have to start chopping down trees or clearing bushes – a bit of light weeding, planting and raking for half an hour a few times a week is all it takes to loosen up the muscles.
Take two wheels, instead of four.
Riding a bike to work or school is not only good for your health, but also for the environment – and your wallet, seeing as you’ll spend less on petrol. As an added bonus, you’ll never have to search for parking again…
Dancing is a fantastic workout – and so much fun you won’t even notice it! You also get to dress up, not down, and being out of breath is part of the fun… Even if it’s freezing outside, you can still work up a sweat dancing – and you never know who you might meet on the dance floor…
Top tip: Dancing is a great way to become more supple. The more we rest, the stiffer we get. So dance away!
Rethink the way you work
Instead of slumping into your office chair every day, why not invest in an exercise ball – it’s not only more fun to sit on, it will also strengthen your core muscles. Another option that is becoming more and more popular is a standing desk, where you’re on your feet all day instead of in a chair.
Laugh it off.
Looking for the most fun way to strengthen your stomach muscles? Rent a funny DVD, go to a live comedy show, or spend some time with a friend who cracks you up. Laughter is a fantastic form of exercise, and the best possible way to get fit!
Ask the expert: Sarah Hall, Biokineticist
“It’s very important to set yourself a definite goal if you want to get fit. This can be done by exercising with a friend, hiring a trainer, or just setting your own personal goal. If possible, a fitness test from a professional can help you deal with an old injury or a medical condition (like diabetes).”
Who said exercise had to be at the gym? Here are some fun ways to get active without even noticing it.
The joy of dancing is that it’s good exercise, but so much fun that you won’t even notice you’re getting fit… Much better than trying to jog around the block! Dancing is, at heart, both art and sport. If you’ve been tempted to pull some moves like you’ve seen on TV’s Strictly Come Dancing and So You Think You Can Dance, but haven’t managed to make the move from the couch to the dance floor, this is the year to do it!
Why dancing is good for you
What many people don’t realise is that dancing has a number of health benefits. Dance is a full mind and body workout that burns calories and lowers your heart rate, blood pressure and cholesterol. As with all kinds of exercise, dancing makes the body more sensitive to insulin, which means the insulin works better in your system. Because dancing is a weight-bearing activity, where the body works against gravity, it can also help strengthen bones, improve balance, posture and coordination. Dancing offers the opportunity to socialise and make friends, and moving your feet to a good tune can be a real pick-me-up. Apart from reducing stress, the biggest benefit of dancing is that it is fun (lots of fun!)
How to get involved
Whether you like to jive, tap, or tango, shake your belly or let yourself go to the beat, there’s a style of dancing that’s right for you. Different types of dance include ballroom, ballet, nia, afro-fusion, hip-hop and free dance, among others. The first step is to have a plan. Ask yourself what style of dance you think you might enjoy – do you like something more formal, or free? Then, consider how much time you can spare in your week, how fit you are and if you have any pre-existing injuries.
Once you know what you want, it’s time to find it! Check community noticeboards and local gyms to find out when and where classes or events are being held, and invite a friend to go with you if you feel too shy to go to the first class on your own. Convinced you have two left feet? Take lessons. Most dance studios hold beginners’ courses and welcome people with disabilities. Learning a new skill can be a real confidence booster and if you start now, you’ll definitely have new skills to show off at your end-of-year Christmas party!
What to wear
Wear comfortable clothing that gives you freedom of movement and shoes that fit the dance form. Some classes, like ballet, tap or jazz, might need special footwear depending on your level. Avoid wearing jewellery, as earrings, rings and necklaces can scratch you or get caught in clothing. Most importantly? Wear a smile.
How to warm up
Remember that because dancing isn’t the same movements that you do in daily life, you need to warm the body up and treat the dance hour like an exercise session, with a warm-up, movement preparation, dance, and cool down. Once you’ve done your warm-up and you understand the main demands of the type of dance you’re doing, you can let your body go and enjoy.
Ask the expert: Sarah Hall, Biokineticist
Here’s how to warm up for each of these dance styles:
Ballroom: A large focus of ballroom is technique and posture, so you need to ensure that in your warm-up you help lengthen your spine. The goal is to engage your neck, shoulder blades and core muscles, so that you reduce strain and tension from this form of dancing.
Nia: This dance is about moving with balance, without too much effort. It is a combination of yoga, modern dance, jazz and tai chi. A whole body warm-up with deep breathing would be best here.
Ballet: Although rhythmic and seemingly calm, ballet is one of the most demanding kinds of dance. Muscle endurance, power and strength, as well as flexibility of joints, are all required. Before starting ballet classes, it’s a good idea to try a few one-on-one classes or test out the poses so you know how far you can move.
Hip-Hop: This is an extremely physical but hugely enjoyable dance form. Hip-hop uses movements that require strength and balance to control your body weight. Body weight exercises that prepare the body for this challenge, like dips, push-ups, sit-ups, lunges and squats, would be great to include in your warm-up. It’s also a good idea to strengthen and protect the spine because it’s such a high impact form of dance.
Free dance: Spontaneous and with no choreography, free dance has no rules and boundaries. So it’s important to combine the tips of all the types of dance above and ensure that you follow the structure from the warm-up to the cool down.
Ask the expert: Fiona Prins, Diabetes Educator
“Being active helps control blood sugar levels, so when you have diabetes it’s really important to exercise. As a rule, aim for 30 minutes a day, five days a week. Regular physical activity will help keep your weight down, reduce blood pressure, raise good cholesterol (HDL) and lower bad cholesterol (LDL) in the bloodstream. Other benefits of exercise include being able to sleep better and better health in general.”
“My friend was just diagnosed with Type 2 diabetes and weirdly the thing that’s bothering him most is what people will think. He doesn’t want to tell anyone because he says they’ll blame him for becoming diabetic – because he didn’t eat healthy or exercise enough. How can I help?” Shan Moyo
First of all, I think your friend is lucky to have someone like who cares enough for him to help him work through the barriers of accepting his diabetes. Because of all the studies that have shown that diet and lifestyle have an influence on Type 2 diabetes, uninformed people forget that there are numerous other reasons for developing diabetes as well. And the Type 1 and Type 2 labels also make people more judgemental.
To some people, their personal health problems and issues are exactly that: personal. Frankly, your friend doesn’t have to share with everybody that he has diabetes, but it is a good idea to let someone close to him know, in case of an emergency. One of the hardest things that newly diagnosed people with diabetes experience and fear is that those who have known you for years start treating you like you’re different. They see your diabetes and not you. But help him look at it this way: no one today would accuse someone with AIDS of giving themselves the condition. So why allow anyone to do it with diabetes?
What can you do? Be an active reader and read your friend like an open book. Listen more and talk less. Help him come to terms with his diabetes and find confidence in managing it. Don’t let him assume that others are judging him: nobody has any power over what other people prefer to think.
Finally, if your friend is really struggling with a lot of mixed emotions, remind him that it’s perfectly normal to feel that way, and that it’s okay to need some help with the burden of managing a demanding condition. And lastly, one of my favourite quotes by Lao Tzu for him: “Care about what other people think and you will always be their prisoner.”
Help him to live free and happy.
– Jeannie Berg, Diabetes Educator
Getting active every day can feel like a bit too much to ask for… Which is why Cindy Tilney’s asked the experts to give us easy ways to keep fit – no matter how old you are!
We all know exercise is good for us, but exercising to the max – especially in later life – can be too much of a good thing. It’s essential not to stress the body by exercising too hard, says Professor Wayne Derman, the Director of the U-Turn Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of South Africa. “When planning an exercise routine, it’s important to consider any medical condition you might have, as well as any medication you’re taking and how it may affect you while exercising,” says Prof. Derman.
Older age also comes with a bigger chance of aches and pains because of problems like osteoarthritis and rheumatoid arthritis – if these names ring a bell, it’s a good idea to be more careful about the kind of exercise you choose, and to consult a medical professional (a biokineticist, physiotherapist or sports physician) when planning an exercise routine. Be sure to check if any medications you are on will interfere with this routine, reminds Prof. Derman.
“It’s essential to go for a health check and orthopaedic assessment before starting any exercise programme,” says biokineticist, Sarah Hall.
Get checked for:
- Cardiac weakness
- Any existing injuries
- High blood pressure
- Ischaemia (restriction in blood supply)
- Uncontrolled diabetes
Also be aware that falls are more likely if your balance isn’t what it used to be.
The right kind of exercise has benefits for every chronic condition, says Prof. Derman. But watch out for:
- Feeling breathless to the point that you can’t talk when exercising
- Any pain.
“The saying ‘no pain no gain’ is not true,” he says. “Your body should be in a state of relative comfort while exercising.”
So what should you do?
It’s important to include all of these steps in an optimal exercise programme, as they all have different functions, say Derman and Hall. These include:
- The warm up: This involves stretching and preparing your body for exercise.
- Flexibility training/stretching: This focuses on increasing the range of motion of the joints and stretching the body to release tension in the major muscle groups – calves, quads, glutes, hamstrings, back, chest and arms.
- The aerobic phase: Involves movement of the large muscle groups to increase the heart rate. It can be walking, jogging, cycling, aqua aerobics or rowing, for example.
- Muscle strength resistance training: Using elastic bands or circuit training to make muscles stronger. This is particularly important for people with diabetes, as it can help the muscles involved in the absorption of insulin to become more sensitive, which helps blood sugar control.
- Stability training: Exercises like plank position that help balance and core stability.
- The cool down: This involves stretching and relaxation to allow the heart rate to go back to normal and the body to return to a resting state.
Remember: The goal is to exercise 20 to 30 minutes on most days of the week.
3 Top tips for people with diabetes:
- Don’t begin exercising if your blood sugar is either too high or too low (over 16 or below 4.8).
- If you are using insulin, always take something sweet with you when you exercise, in case of hypoglycaemia (low blood sugar).
- Avoid injecting into large muscle groups just before exercising.
What kind of exercise is best for older people with diabetes?
We asked biokineticist Sarah Hall to give us a sample exercise routine. Here’s what she said:
Warm up: 5-10 minute brisk walk
Stretch: Standing calf and quad stretch, chest, shoulder and bicep stretch, lying down hamstring stretch and cat stretch for the back
Aerobic: Step for 2 minutes
Muscle strength: Like bicep curls, wall push-ups and abdominal crunches (sit-ups)
Aerobic: Walk or jog on the spot for 2 minutes
Stability: Plank position
Cool down: Repeat stretches
Who said getting fit has to be a big project? With these five 20-minute workouts, you’ll be on your way to getting active in minutes! Daniel Sher shows us how.
Let’s be honest: most of us have a lot of things on our To Do Lists, and exercising is not the one we want to do most! Our busy lifestyles often get in the way of our health, but how hard is it, really, to get active? Exercising can be easier than you think – there’s no need to run marathons or spend hours at the gym. In fact, a recent study* showed that just twenty minutes of daily exercise is enough to lose weight and control your diabetes better. Here are five simple ways to get active that only take twenty minutes to complete. We all have twenty minutes every day… Why not use them to feel great?
- Before (or after!) work
It might be a part of everyday life, but walking is also a great way to exercise. Taking a walk is a simple and relaxing way to get your heart rate up. Beaches, forests, parks and rivers are all great for a refreshing twenty minute walk, but a quick stroll through your neighbourhood can be just as enjoyable. Choose a time for your daily walk – twenty minutes before work, for example – and try to do this every day. Walk quickly and keep things interesting by changing which way you go from time to time. Join up with a few friends and it will make your walk even more fun.
Ask the expert: Sarah Hall, Biokineticist
“It’s important to practise correct posture when you walk. Follow these tips: walk tall, imagine a piece of string pulling you from the top of your head, lengthening your spine, and use your arms so that you have more power.”
- On your way to work
Most people sit in a taxi, bus or car to get to work. Believe it or not, this is a great opportunity to get some exercise! If you live close to your workplace, choose to walk, jog or cycle instead. And if your home is too far away, get out of the taxi a few stops early, or park further away than usual. Using your morning commute to exercise can help you save time, and also make you feel refreshed for the day ahead. Choosing to walk home (or part of the way home) after work can help to burn away the day’s stress and clear your mind.
Ask the expert: Sarah Hall, Biokineticist
“Buy a pedometer and track how many steps you take and the time it takes you to get from home to work. This is a great way to figure out how active you are during the day, and to encourage you to work on beating your own time and setting your own goals.”
- In the office
Quiet times at work are ideal for a quick workout: you can do an easy muscle-toning routine while sitting at your desk. Start by tightening your three main muscle groups, one at a time (legs, stomach and arms). Begin with a deep breath and clench your legs for five seconds; then take a breather for ten seconds before tightening up your stomach muscles for five seconds. Take another breather, and finish by clenching your arms and chest, which you tighten by pressing your palms together as if you’re praying. Repeat this routine until twenty minutes are up for a quick and easy muscle workout!
Ask the expert: Sarah Hall, Biokineticist
“Add a few arm and neck stretches as well! Hold your drawer, roll your shoulders back and down, and lengthen your spine whilst you sit.”
- At home
We all make excuses to stay inside: it might be raining, you might have a lot of chores to do, or the TV might be calling your name. Don’t let this stop you from getting your twenty minutes of exercise – you can easily transform your household routines into a workout. When you’re talking on the phone, pace around the house or climb up and down stairs, rather than sitting down. What about your errands? Sweeping, mopping, scrubbing and washing can give you a great workout and a clean house at the same time. Feel like watching your favourite TV show? No problem – use this time to jog lightly on the spot, whilst gently punching your arms in front of you like you’re boxing. Just be sure to pull the curtains so your neighbours don’t think you’re crazy!
Ask the expert: Sarah Hall, Biokineticist
“Treat this just like any other exercise session. Start with the easy tasks first, then stretch. Follow this with the activities that get your heart rate up, and then end with the chores that involve lifting things. Remember: if you are treating it as a workout, don’t forget to cool down and stretch at the end.”
- On the weekend
If you’re looking for a simple way to exercise and to have fun at the same time, dancing might be the answer. And what better time to dance than on the weekend? Listen to your favourite playlist, focus on letting loose and try to enjoy yourself – before you know it you’ll have worked up a sweat. If you know any ballroom steps ask a partner to join you for twenty minutes – fast-paced dances like the swing, salsa or tango are all great for increasing your heart rate. If you don’t know any dance moves, make up your own! Nobody’s watching…
Ask the expert: Sarah Hall, Biokineticist
“Dancing can be a great way to challenge your balance and a useful way to become aware of any imbalances between the left and right side of the body.”
How does exercise help diabetes? Exercise is recommended for most people, but an active lifestyle is especially helpful for diabetics. Why? Exercise can:
– Help your body to use insulin better.
– Prevent cardiovascular (heart) disease and other diabetes-related complications.
– Reduce stress and anxiety, which makes it easier to manage your condition.
– Improve your blood sugar control.
* In the September 2012 issue of The Journal of the American Medical Association.
Do you want to know how to lose weight, feel better and control your blood glucose levels the easy way? Take a walk!
If your doctor keeps telling you to get active but you’re not sure what kind of exercise to do, why not take a walk? Walking is the one of the easiest ways to get fit because you need very little preparation – we all already know how to do it! Studies have shown that people with Type 2 diabetes who walk daily are able to store sugar and burn fat more effectively. The result: better glucose control and weight loss.
That’s not all. Because walking is relaxing it lowers your blood pressure. This decreases your risk of heart disease. At the same time fitness, lung capacity, stamina and mental alertness all improve.
Still not convinced? It can even make you happier―walking is an excellent way to naturally boost your mood.
Because you don’t need special equipment, walking is ideal for beginners. A pair of well-fitting trainers will do the job. The International Diabetes Federation (IDF) recommends 30 minutes of brisk walking daily as part of a healthy lifestyle programme to manage diabetes. However, every journey begins with a single step. Start slowly with 5 or 10 minutes per day and try to add 5 to 10 minutes to your programme weekly.
What is the best technique? Watch your posture. Walk tall. Back straight. Look ahead and keep your chin parallel to the ground. Shoulders should be relaxed. Gently tighten your stomach muscles and tuck your pelvis in to bring it in line with your upper body. Feet must make contact with the ground heal first and then push off with the toes.
Need extra motivation? Use a pedometer, a small device that clips onto your waistband, to track the total steps you take during the day. With your pedometer at hand, find ways to activate your day as much as possible: walk the dog, window shop, use the stairs or walk to visit a neighbour. The end goal is 10,000 steps a day, but anything over 5,000 is a good start!
Want a challenge? Head off-road: go trail walking or hiking. Keep these points in mind when you’re going for an adventure walk:
Be wise. Hike in a group and choose your route according to the least fit person in your group’s abilities. Tell someone where you are going and when you will be back.
Be prepared. Hiking requires planning. Pack enough water for the trip to ensure that you are properly hydrated and take something sweet in case your blood sugar goes low. Avoid blisters and don’t hike wearing new shoes. Protect yourself from the sun: wear a hat and sunscreen.
Be aware of your surroundings. Check the weather forecast, be familiar with the route and carry a map.
Walking is the most recommended and popular form of exercise. It is plain to see why. It can be fun, relaxing and a great way to spend time with people. You can do it practically anywhere and it is a good excuse to visit new places. Best of all anyone can do it and it is really good for your health. Start today― take a few steps in the right direction.
Ask the expert: Diabetic tips for walking
Dr. Zaheer Bayat, Endocrinologist
It is important to balance enthusiasm and common sense when beginning an exercise program.
- Have a pre-exercise examination by your GP. This may include a stress test for patients over the age of 35 or have had diabetes for more than 10 years.
- Discuss with your doctor whether or not your insulin dosage needs to be adjusted.
- Choose an insulin injection site away from exercising muscles.
- Eat a snack approximately 15 to 30 minutes before exercise, and again every 30 minutes during exercise. Choose a snack that’s a slowly absorbed carbohydrate.
- Drink enough liquids before, during, and after exercise to prevent dehydration, which can upset blood sugar levels.
- Test your blood sugar before, during, and after exercise to figure out your body’s typical response to exercise.
- Be sure to keep some juice or sweets on hand in case your blood sugar goes low.
Ask the expert: foot care
Anette Thompson, Podiatrist
- Go for a check-up with your podiatrist so that you know the status of your foot health.
- Blisters, hot spots, breaks in the skin or blood flow problems to the feet may go undetected; foot numbness could also be present without your being aware of it. These need to be treated.
- Wear well-fitting shoes that fit comfortably with at least 15mm length ahead of the longest toe and don’t rub at the heel. Try on new shoes, with socks, in the afternoon when your feet are at their biggest volume.
- Invest in good socks. Diabetic socks are made so that they don’t cut off circulation around the ankle.
- Check your feet after each walking session for cuts, blisters, hot red spots or abrasions.