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The heart is often used as a symbol of vitality for good reasons. The heart pushes blood and oxygen to every cell in the body to be used as fuel and carries waste away. Without this process, the body cannot function. The heart plays a role in many aspects of your health and wellness.

Efficiency Matters
The heart beats an average of 60-80 beats per minute, which can add up to millions of beats in just one month. When something works this hard, it is important that it also works efficiently. Well-conditioned athletes can have resting heart rates below 50 beats/minute. Even though their heart beats slower, it can do the same amount of work or more than a heart that beats 60-80 beats/minute. An athlete’s heart pumps stronger during each beat, needing fewer beats to get the job done. Over a lifetime, a difference of 10-30 beats/minute can add up to quite a few beats.

An Ounce of Prevention…
The heart can be affected by physical and mental stressors. You can feel your heart speed up when you sprint across a busy road or when you have a burst of emotion like anger or surprise.

Physical activity can decrease the effect of stress on the heart and body. A fit body and mind will help improve heart health. Regular physical activity can:

Improve physical abilities by:
• Improving the heart’s ability to pump blood
• Increasing energy levels
• Increasing muscle strength and endurance
• Improving agility

Change physical appearance by:
• Toning your muscles which gives you a tighter appearance
• Burning calories which helps with weight loss or maintenance

Improve overall wellness by:
• Helping with stress management
• Improving self-image
• Helping to decrease anxiety and depression
• Improving relaxation
• Improving the ability to sleep
• Creating a social activity opportunity
• Promoting healthier cholesterol levels

If you have heart problems, physical activity can still play an important role. A strong and healthy body can help you manage your condition. Physical activity can help reduce the stress on a sick or weak heart and decrease secondary risks like obesity and diabetes. If you do have heart health issues, talk to your doctor before starting an exercise program.

Even if you are healthy, but have not exercised in a long time, you may need to talk to your doctor to make sure that you are in good physical condition to exercise.

Where to Start
For most people, you can begin right away. Find an activity program that you enjoy. Do not pick an activity that does not fit into your schedule, does not fit in with your personal preferences, or has too many obstacles, because you may lose interest quickly. A program that starts with too much intensity is also likely to lose your interest.

Work towards reaching these basic goals:
• 30-60 minutes of physical activity on most days of the week (total of at least 150 minutes/week)
• Include some strength activities at least 2 times/week

Make It Stick
Long-term regular physical activity will count more than a brief and spectacular burst of activity. Most people do not plan to become sedentary. It creeps up on you. Work to increase your physical activity the same way. Gradually add steps. Find activities you enjoy that can replace more sedentary activities.

Here are more tips that have been shown to be useful:
• Find an exercise partner. You are less likely to skip the activity if someone is waiting for you.
• Write it down or use a fitness tracker. Keep a log of your activities and how much you accomplished either by distance or time. It will help keep you honest.
• A long-term goal is fine, but also make short-term goals, because they provide quicker feedback.
• This is important, make it a priority. Plan it out. Find a time in your daily routine when you can regularly fit the activity in.
• Consider doing your activity in 10-minute spurts throughout the day. Spurts can be as effective as being active for 30 minutes straight.
• Be flexible. Life happens and you may find that you need to make adjustments to your routine. A rigid schedule and goal may not be worth the stress. Keep an open mind to new activities and schedules.

Make It Count
Any physical activity is better than none. But at least a few days per week you should aim for more than a leisurely stroll. A moderate intensity level is best to help you make health changes. Moderate intensity activity is enough to get your heart rate up and make you feel a little out of breath but not feel worn out when you are done.

Do not forget to enjoy your activity for the daily benefits it can bring and know that your heart appreciates it as well!

by Pamela Jones, MA

RESOURCES:
American College of Sports Medicine
http://www.acsm.org

American Heart Association
http://www.heart.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:
American Heart Association guidelines for physical activity. American Heart Association website. Available: http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/StartWalking/American-Heart-Association-Guidelines-for-Physical-Activity_UCM_307976_Article.jsp. Updated September 10, 2014. Accessed October 22, 2014.

Guide to physical activity. National Heart and Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/phy_act.htm. Accessed July 21, 2016.

Haskel W, et al. Physical activity and public health, updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Circ. 2007;116(9):1081.

How much physical activity do you need? Centers for Disease Control and Prevention website. http://www.cdc.gov/physicalactivity/everyone/guidelines/index.html. Updated June 4, 2016. Accessed July 21, 2016.

Promoting physical activity with a public health approach. American College of Sports Medicine website. Available at: http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/promoting-physical-activity-with-a-public-health-approach. Accessed July 21, 2016.

2008 physical activity guidelines for Americans. United States Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx. Accessed July 21, 2016.

Last reviewed July 2016 by Michael Woods, MD Last Updated:10/22/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

Type 2 diabetes usually occurs as a result of genetics and lifestyle. It is marked by abnormally high levels of blood sugar, known as glucose. Glucose is the primary source of energy for our cells that the body makes from food we ingest. The onset of type 2 diabetes is triggered when the body is no longer able to properly use insulin, the hormone that helps cells take in glucose from the blood. When glucose stays in the blood stream instead of moving into the cells, nerves and blood vessels can be damaged. This increases the risk of cardiovascular disease, stroke, blindness, kidney disease, and circulation problems.

What Is Prediabetes?
Prediabetes is a condition that precedes the onset of type 2 diabetes. It is characterized by blood glucose levels that are elevated, though not high enough to be classified as diabetes. Doctors usually refer to prediabetes as impaired glucose tolerance or impaired fasting glucose. The American Diabetes Association (ADA) recommends screening for all adults 45 years old and older. Also, if you are younger than 45 and are overweight or obese and have risk factors for diabetes, you should be screened. Risk factors include:
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle
• History of gestational diabetes or giving birth to a baby weighing more than 9 pounds (4 kilograms)
• History of cardiovascular disease
• Having a condition associated with insulin resistance, such as polycystic ovary syndrome or metabolic syndrome

People of Hispanic American, Asian American, Pacific Islander, Native American, or African American descent are at higher risk.
Having prediabetes means that you are at high risk for developing diabetes and may already be experiencing adverse effects of elevated blood sugar levels.

How Do You Know If You Have Prediabetes?
During a routine office visit, your doctor can order tests, such as:
• Fasting plasma glucose test—For this test, you fast overnight and have your blood glucose measured in the morning before eating. Results in the range of 100-125 mg/dL (5.6-6.9 mmol/L) may indicate prediabetes.
• Oral glucose tolerance test (OGTT)—Again, you fast overnight and have your blood glucose measured after the fast. Then, you consume a sugary drink and have your blood glucose measured two hours later. Results in the range of 140-199 mg/dL (7.8-11 mmol/L) indicate prediabetes.
• Hemoglobin A1c (HbA1c)—This is an indicator of your average blood sugar levels over the previous three months. Results in the range of 5.7%-6.4% indicate prediabetes.

What Can You Do If You Have Prediabetes?
If you are diagnosed with prediabetes, it is important to take action to manage your condition. If you are overweight, your doctor may recommend that you lose weight. Reducing your body weight, even by 5%-10% can help improve your health. In general, changing your diet and being physically active and exercising at least 30 minutes a day will help you stay on track. Participating in a behavioral modification program may further help you achieve your weight loss goals.

Because many of the lifestyle-related risk factors associated with diabetes are also risk factors for other health issues, making lifestyle changes to reduce your risk of diabetes may have a positive effect on your overall health.

Some people can take medication to manage their blood glucose levels, though lifestyle modification should be the first approach to manage prediabetes. Medications that may be used include metformin, pioglitazone, and acarbose.

How Can You Prevent Prediabetes?
The same strategies that are used to lower your risk of type 2 diabetes can be applied to prediabetes, as well. The American Diabetes Association (ADA) recommends these strategies:
• Lose excess weight.
• Exercise for at least 150 minutes per week.
• Reduce your intake of calories and fat.
• Try to eat more fiber and whole grains.

If you do have prediabetes, you can take steps that may slow or avoid the progression to type 2 diabetes. It will take a lot of effort on your part, but the potential benefits—being healthy and living longer—are worth it.

by Julie J. Martin, MS

RESOURCES:
American Diabetes Association
http://www.diabetes.org

National Diabetes Education Program
http://www.ndep.nih.gov

CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:
Am I at risk for type 2 diabetes? Taking steps to lower the risk of getting diabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/risk.pdf. Published June 2012. Accessed April 26, 2016.

American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases. The prevention or delay of type 2 diabetes. Diabetes Care 2002;25:1-8.

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. NEJM. 2002;346:393-403.

Diabetes mellitus type 2 prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 22, 2016. Accessed April 26, 2016.

Diagnosing diabetes and learning about prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/are-you-at-risk/prediabetes. Updated December 9, 2014. Accessed April 26, 2016.

Kanaya AM, Narayan KM. Prevention of type 2 diabetes: Data from recent trials. Primary Care. 2003;30:511-526.

Narayan K, Imperatore G. Targeting people with prediabetes. British Medical Journal. 2002;325:403-404.

Nathan DM. Diabetes Care. 2007;30:753.

Prediabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2016. Accessed April 26, 2016.

Tuomilehto J, Lindstorm J. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2004;344:1343-1350.

10/21/2008 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Greaves CJ, Middlebrooke A, O’Loughlin L, et al. Motivational interviewing for modifying diabetes risk: a randomised controlled trial. Br J Gen Pract. 2008;58:535-540.

10/12/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-S61).

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-S69).

Last reviewed April 2016 by Michael Woods, MD Last Updated: 6/3/014

Tag Archives: blood circulation

Heart Healthy Physical Activity

What Does It Really Mean to Have Prediabetes?