There’s no question that physical activity is an essential part of diabetes treatment. Studies have shown that exercise leads to improvement in insulin sensitivity, with better glucose control on days when people exercise, particularly in the afternoon. Exercise is also key to cardiovascular health and may help boost mental health, research shows.
But deciding how to exercise is a challenge for many people, particularly those who are obese or have other conditions that may limit certain exercise choices. Even once you’ve chosen how to exercise, it can be difficult for many people to stick to a routine, particularly if you aren’t part of a structured exercise program.
A new study that looked at the benefits of Nordic walking — a version of walking involving poles, similar to ski poles, to incorporate greater arm movement — offers some lessons on what kinds of exercise programs work best for people with obesity.
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Greater adherence to walking program under supervision
The study, published in the journal Nutrition, Metabolism & Cardiovascular Diseases, involved 27 participants (ages 50 to 80) who were randomly assigned to either a Nordic walking or a regular walking program. At first, for six months, participants went through a dietary intervention and supervised exercise program for their assigned form of walking. For the next six months, participants were asked to continue their exercise program without supervision.
Participants had their aerobic capacity (a measure of heart and lung fitness) as well as their arm and leg strength measured at the beginning of the study, then again after six months of supervised exercise and once again after six months of unsupervised exercise. They also had their step count and average heart rate recorded during each exercise session, for both supervised and unsupervised exercise.
As noted in a Healio article on the study, all of the participants were overweight or obese when they joined the study, had a stable body weight for at least three months beforehand, and weren’t involved in another exercise program.
From the end of the six-month supervised exercise period to the first three months of the unsupervised period, participants in both groups saw an increase in the number of steps they took during exercise sessions. But then during the next three months, both groups saw a decrease in the number of steps they took. There was no difference in the average heart rate in either group. But while the regular walking group saw a drop in adherence to the exercise program after the supervised phase ended, the Nordic walking group was just as likely to do their scheduled exercise sessions during the unsupervised phase.
During the six-month period of unsupervised exercise, neither group saw a difference in average body-mass index (BMI, a measure of weight that takes height into account), total body fat or lean body. At the very end of the study, the regular walking group had a 9% reduction in fat mass compared with the beginning of the study, while the Nordic walking group saw no reduction. However, the Nordic walking group was more likely to maintain gains in strength during the supervised period, ending up with a 33% improvement in arm curls and a 31% improvement in a chair stand compared with the beginning of the study. They also saw a 13.5% improvement in a six-minute walking test, compared with an 11% improvement in the regular walking group.
Nordic vs. regular walking: which is better?
One clear lesson from this study is that overall, people see the most gains in structured, supervised exercise programs, and are more likely to stick to assigned exercise sessions in many cases. But the study also showed that difference kinds of exercise — even if they seem quite similar — may have different kinds of benefits in overweight and obese people, and lead to different levels of sticking with your exercise schedule.
It’s not clear why members of the regular walking group lost body fat during the study, while members of the Nordic walking group did not. Given that Nordic walking is similar to regular walking but involves greater use of the arms, a reasonable person might expect similar or greater fat loss from that activity. Since this was a small study, it’s possible that individual factors are in play, but more research is needed to figure out why, apparently, regular walking leads to greater fat loss.
But when it came to benefits like improved muscle strength and aerobic capacity, Nordic walking was better at maintaining gains made during the period of structured exercise. On top of that, people appeared more motivated to stick with Nordic walking than regular walking. All in all, these results suggest that Nordic walking may be a good way to improve your fitness and strength as part of a supervised exercise program, and to maintain at least some of those gains on your own after a supervised program has ended.
Want to learn more about exercising with diabetes? Read “Add Movement to Your Life,” “Picking the Right Activity to Meet Your Fitness Goals” and “Seven Ways to Have Fun Exercising.”