Do you prescribe regular exercise for your patients with metabolic diseases? Of course you do. You want the best health outcomes for your patients and you know that regular exercise can be a remarkably effective intervention for the prevention and treatment of numerous cardiometabolic diseases and weight management issues. But do you know how much exercise is required to induce metabolic benefits? Even more importantly, do your patients adhere to your exercise prescription?
Regardless of your answer to my first question, it is likely that you prescribe exercise in accordance with any one of the major American health and medical associations. With little to no exception these recommendations are typically 3-5 sessions per week at moderate to high intensity for 30-60 minutes per session. But did you know that with just a single session of exercise – similar to that described above – an otherwise sedentary, obese person can significantly improve insulin sensitivity? Did you know that a single session of exercise is sufficient to significantly reduce hyperglycemia for at least 24 hours in individuals with type 2 diabetes? Or, that muscle contraction stimulates glucose uptake independent of insulin action, and that this process is normal in people who are obese and/or have type 2 diabetes?
The key take home messages are: 1) there are significant metabolic benefits resulting from each session of exercise and 2) “fitness” is not required to incur many of the metabolic benefits of exercise. Equally important is understanding that many of the metabolic benefits of exercise are not well-retained in the absence of exercise (i.e., the metabolic benefit is rather short-lived). Taken together, it is important that exercise be prescribed like many medications – as independently beneficial events.
With the proper sell, this approach may also help to limit perceived barriers to (the benefits of) exercise. Substantial evidence indicates that the answer to my initial question about patient adherence to exercise prescriptions is unfortunately poor. But what if patients knew that they could be healthier today, just by exercising one time? What if exercise was sold as individually beneficial events? What if a patient knew that physical activity (via muscle contraction) could help regulate their blood glucose concentration?
By shifting the focus of improved metabolic health through exercise to a daily event – encouraging patients to be healthy today, regardless of what happened yesterday or what may happen tomorrow – you might even help more individuals meet current exercise recommendations.
About Sean Newsom, PhD
Dr. Newsom received his doctoral training at the University of Michigan in the School of Kinesiology, and his postdoctoral training in the Department of Pediatrics and the Division of Endocrinology, Metabolism and Diabetes at the University of Colorado School of Medicine. He joined the faculty in the College of Public Health and Human Sciences at Oregon State University in the summer of 2015.