Americans – and people with diabetes in particular – are constantly reminded that exercise is good for them. Exercise lowers blood glucose levels, protects against a variety of diseases, and helps keep a person fit, so he can perform the physical activities he enjoys. Numerous exercise recommendations and “prescriptions” have been published over the years by various organizations, but how much and what kind of physical activity is really needed for good health?
The American College of Sports Medicine (ACSM) develops guidelines for exercise and other forms of movement based on scientific research, and it periodically updates those guidelines as more studies are conducted and more is learned. Currently, the ACSM recommends that most adults do 150 minutes of moderate-intensity exercise per week. This works out to 30–60 minutes of moderate exercise five days a week. Alternatively, the ACSM says that doing 20–60 minutes of vigorous activity three times a week delivers the same benefits. Examples of moderate-intensity exercise include brisk walking, bicycling at a moderate pace on level terrain, and recreational swimming. Examples of vigorous activity include jogging, bicycling quickly or on hilly terrain, and using aerobic machines at a fast pace with vigorous effort.
The ACSM also recommends performing strength training 2–3 times a week (3 times a week is recommended for people with Type 2 diabetes, because strength training increases insulin sensitivity), as well as flexibility and neuromotor exercises 2–3 times a week.
Neuromotor training focuses on motor skills such as balance, coordination, gait, and agility. Examples of exercises that provide neuromotor training include tai chi, yoga, and other activities that challenge a person’s balance. Recommendations for balance and flexibility were added by the ACSM in 2011 because these types of activities help to prevent injury and falls.
Why are guidelines needed?
Human beings are built to move, stand, and walk, yet most people spend much of the day sitting – at work, while commuting, at play, and at rest. Scientists now realize that sitting, in itself, is an independent health risk factor. Studies have shown that adults who spend more than four hours a day sitting and watching TV or using a computer have a higher risk of death from any cause and a much higher risk of cardiovascular events than adults who spend less than two hours a day in those activities. So just standing up represents an improvement over sitting, and walking is even better.
But Americans don’t walk very much. Pedometer studies have found that Americans walk an average of about 5,100 steps per day and as little as 2,300 steps per day. In contrast, a study of a traditional, Canadian Amish group showed Amish men walk an average of 18,000 steps, and Amish women walk 14,000 steps per day. Perhaps not surprisingly, the Amish group had a much lower obesity rate than Americans.
You might think the remedy to all of this sitting (and not much walking) is more time at the gym or more time spent jogging, but research has shown that while formal exercise is important for good health and physical fitness, so is just moving around.
The scientific term for the energy a person expends on everyday activities, from brushing teeth, to washing dishes, to going up and down stairs, is non-exercise activity thermogenesis, or NEAT. “Expending energy” is another way to say “burning calories,” so doing more “NEAT activities” may help with weight maintenance as well as improved overall health.
Modern technology and conveniences have a lot to do with why Americans get less NEAT these days. Today, cars enable people to walk less, computers have taken the place of going to the library and searching the stacks or the card catalog, online shopping has taken the place of physically going to stores, and remote controls have taken the place of getting up and changing the TV channel. A British study found that a woman doing housework in 1950 burned 1,000 calories a day cooking, cleaning, and doing laundry, whereas today, household chores burn only 560 calories a day.
All of these changes add up. And while you might not want to go back to scrubbing the kitchen floor by hand, with some thought and planning, you can add more NEAT movement back into your daily routine. Not only will you burn a few more calories and, even more important, sit less, but you may also find yourself feeling less stressed as a result.
Increasing your NEAT
How can you incorporate more movement into your day without giving up all of the modern conveniences and labor-saving devices you value and appreciate? Think back to the days before cell phones, remote controls, home computers, e-mail, the Internet, and movie rentals. Were there activities you enjoyed (or think you might enjoy now)? How about raking the lawn? It can feel meditative and is a lot quieter than using a leaf blower. What about going out to watch a movie rather than renting one to watch at home, or spending some time shopping in person? Doing things in person (rather than from your computer) often brings you into contact with other people, and that can contribute to a richer experience.
How would you feel about turning off your cell phone, tablet, and computer for a while each day? These devices can keep you in touch, but they can also keep you constantly on call, which is both distracting and stressful. Answering calls, texts, and e-mails also takes up a lot of time. What would happen if you turned off your electronic devices for an hour and could use that time to do something you wanted to do? Would you spend some time in nature? Use an hour to straighten up a messy area in your home? Prepare something healthy to eat?
If you’re not sure how to fit more movement into your day, try thinking through your usual daily routine, and ask yourself these questions:
• When do I find myself sitting?
• When is it important to me to sit or rest?
• When would I be happier doing something else?
Patterns often develop out of default. Does this sound like your routine? “After I finish my work on the computer, I surf the Web or play an online game to relax (or to use up the time until I go to bed).” How about this? “I watched my favorite TV show, and after it was over there was nothing else I particularly wanted to watch, but it was easier to watch more TV than to do something else.”
Visualize or write down how you would like to fill your days, evenings, and weekends. What are some ways to take breaks if your usual day involves a lot of sitting? (Remember that even short walks throughout the day add up to meaningful benefits.) What makes an enjoyable evening or weekend? Does your imagined pleasurable evening or weekend include more physical movement than a typical evening or weekend, when nothing special was planned? (Chances are, it does.) Once you have thought of activities you’d enjoy, what are some steps you can take toward fulfilling your vision?
Not everyone enjoys active pursuits, but even sedentary activities can be made a bit more active. If your perfect evening is watching a movie or reading a book, for example, consider how you can prompt yourself to get up and walk around or stretch every 30–60 minutes. One study had college students watch 90 minutes of television every evening, and during the commercials they were instructed to walk in place. All that walking added up to 3,000 steps, or about 1 1/2 miles. You can make up your own rules, such as getting up each time a particular character enters the scene in a movie, or each time you reach the end of a chapter in your book.
If you have children in your home, consider activities the whole family can do together. Many Y’s and city rec centers have family swim times, for example. Perhaps an after-dinner family walk or bike ride can become a tradition. Maybe you can set up a croquet game or a badminton net in the backyard, or draw a hopscotch course on a driveway or sidewalk. Or go to a nearby park to play catch or Frisbee. In the winter, sledding, building snowmen, or visiting the outdoor ice rink can be good, active fun.
For indoor activity, play games on a Wii or Xbox Kinect. These games don’t replace the need for exercise or active play for children, but they do get you up and moving. Wii yoga is done on a Wii platform that measures your balance. In other Wii games, a handheld control tracks your motion. Xbox Kinect has a camera, and your body becomes the remote control.
More movement at work
Many jobs require sitting or staying in one place for hours on end or even all day. The degree to which you can add movement to your workday will depend on your job and workplace, but any movement is good. Just standing (rather than sitting) is active. Standing and doing some arm stretches is great. Walking to the restroom at the other end of the building (rather than one closer to your office) can add a bit of a break to your workday.
Some workplaces are replacing desks where you sit with desks where you stand. But even if yours isn’t, standing while talking on the phone or while waiting for something to load on your computer contributes to NEAT. Software programs, apps, and timers can prompt you to stand and stretch or walk about every hour or so. Try using a timer or setting on a smartphone that has a pleasant chime or subtle buzz. You will be more apt to respond if the sound is pleasant!
Add some balance challenges to your work breaks. For example, try standing on one leg while standing close to your desk or something else sturdy in case you need to hold on. If that’s easy, try using a balance board or a Bosu for more of a challenge. (A Bosu is a fitness training device that looks like half a rubber ball. Use it or a balance board at work, if you have space, or elsewhere, if not.)
How often should you move at work? Most people spend about 60% of their waking day sitting or lying down. Aim to get up or walk around once every 30–60 minutes.
For someone who stands all day at work but can’t walk around much, it may be energizing to take a quick walk at the end of the day. In addition, some simple stretching and deep breaths might help energize and move some different muscles.
(To learn about resources you can use in your effort to do more NEAT activities, click here.)
Setting larger goals can help motivate you to perform activity on a daily basis. For example, learning to play a musical instrument, taking dance lessons, or learning to cook takes time, but working on goals like these adds movement and fun to your day. So does planting the flower or vegetable garden you’ve always wanted, taking swimming lessons, or starting a walking meditation practice.
What if your ultimate goal is too much to do now? Look for steps that bring you closer to it or are an approximation of what you’d eventually like to be doing. For example, if you think you’d one day like to ride your bike across the United States or hike the Appalachian Trail, start by biking or hiking locally. Log your mileage, and map your progress against a map of the country or the trail. Reward yourself at intervals (perhaps when you reach a state line) with something that is meaningful for you.
Changing your lifestyle patterns requires planning. If your plan for adding movement to your life is to see who in the family walks the most steps during commercials, for example, decide when it will happen. (After dinner, when the family gathers to watch TV before bed.)
How will the number of steps be counted? (Each person will count his own steps and write them on a sheet of paper. Alternatively, everyone will have a pedometer; I will pick some up tomorrow after work.) When will you start? (We’ll start this Saturday.) How will you remember? (I’ll put a note on the refrigerator so we don’t forget.)
Doing an activity with friends or family members who support your efforts can be very helpful, because you can help keep each other on track. But most important, adding more everyday movement shouldn’t be just another chore on your overloaded to-do list. It should be an opportunity to do more of what you enjoy!