Type 2 diabetes has been on the increase in recent years. In Spain alone it affects 5.1 million people, and 537 million globally, according to the International Diabetes Federation. “The phases of treatment for those suffering from this disease consist of diet, exercise, oral drugs and insulin administration,” explains José Viña, Professor of Physiology at the School of Medicine at the University of Valencia. A meta-analysis published in 2022 in the Sports Medicine journal found that a short light walk after eating helps lower post-meal glucose spikes.
After meals, nutrients (including glucose) enter the bloodstream from the intestine and sugar levels in the body increase, according to Carmen Sanz, professor of cell biology at Complutense University of Madrid. When exercising, in this case walking, the contracting muscle absorbs this type of sugar “to provide energy to the cells and reduces the need for insulin,” says Viña, who directs the INCLIVA Foundation’s line of research on Metabolism and Organic Damage - Aging and Associated Diseases.
In people with type 2 diabetes, the cells do not adequately respond to insulin, which is the hormone responsible for regulating blood glucose levels. “Physical activity is another mechanism that is periodically performing this function in the muscle,” says Sanz.
In the study, researchers compared the effects of a light stroll after a meal compared to the impact of standing. The authors found that, although the latter could improve postprandial (after-meal) blood sugar levels, the former was more effective. Standing was shown to cause a 9.5% reduction, and walking a 17% decrease, according to the study published in Sports Medicine. Valentín Fuster, director general of the Spanish National Center for Cardiovascular Research (CNIC), points out that the effects are further enhanced if, in addition to walking, regular sport is incorporated.
The CNIC has discovered that people with insulin resistance or prediabetes are at greater risk of developing artery diseases, like atherosclerosis (the accumulation of fats, cholesterol and other substances inside the arteries and on their walls), explains Borja Ibáñez, the center’s scientific director. “We are striving to understand the mechanisms that cause organs to become insulin resistant and how this is linked to this condition.”
Type 2 diabetes carries a high hereditary component of up to 50%, and physical activity can reduce the risk of developing it, according to Viña. This pathology is also highly associated with the prevalence of obesity, as explained by Pedro José Pinés, member of the Management Committee of the Diabetes Area of the Spanish Society of Endocrinology and Nutrition (SEEN). Walking may be an example of achievable physical activity to start improving the physical condition of patients.
In addition to walking, it is also important to perform endurance exercise, advises Pedro José Pinés, member of the Management Committee of the Diabetes Area of the SEEN, both for diabetics and for those not suffering from this disease. “Performing two to three sessions a week of endurance exercise can be an alternative for people who are unable to walk,” adds Pinés.
For those unable to dedicate a lot of time to sports, he recommends high-intensity interval training, lasting between 10 and 30 minutes. For individuals who already take walks on a daily basis, incorporating these activities can enhance their benefits.
Viña, the INCLIVA Foundation expert, assures that breaking up the sedentary lifestyle at least every 30 minutes and keeping active as long as possible “has positive effects on the health and glycemic control in people with type 1 and type 2 diabetes.” In this regard, Fuster, of the CNIC, stresses that the practice of exercise not only has an impact on sugar levels and diabetes, but also on cardiovascular health, including blood pressure and cholesterol. However, the studies included in the meta-analysis did not reveal meaningful results on the effect of walking after meals on blood pressure.
The researchers recommend the inclusion of breaks at work for light walking. They believe that this is more practicable than the engagement in moderate to vigorous physical activity in the work environment and propose this practice as an alternative for those people for whom it is contraindicated. Both Fuster and Viña support this recommendation. “A working environment where people can go to exercise for a while helps a lot,” says the CNIC director. Viña recommends walking for five minutes every 55 minutes of work time to combat sedentary lifestyles. The authors of the meta-analysis found that a 30-minute daily increase in light physical activity was associated with a 17% reduction in mortality.
The research included studies that proposed two-minute intervals of exercise for every 20 minutes of sedentary time and five minutes every half hour. Ibañez, from the CNIC, affirms that it does not need to be strenuous to be beneficial. Ideally, 30 minutes a day of light to moderate activity is fine, but “any type of exercise is beneficial for health, for blood sugar levels and for insulin sensitivity,” he concludes.
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