Chapter 6: Physical Health and Exercise

“If you don’t make time for exercise, you’ll probably have to make time for illness.”

-Robin Sharma

NOTE: I am not a medical professional or physical trainer/ kinesthesiologist. Please consult a professional to ensure these recommendations are beneficial to your specific situation.

There seems to be a near limitless number of options and recommendations when it comes to diet, what to eat and avoid, around Type-2 diabetes. Keto, Vegan, Paleo, etc. it can be a lot to try to absorb the benefits and rules for each diet protocols. Additionally, you’ll likely see nay-sayers around “rival” diets which is also confusing. However, every study and recommendation I’ve seen thus far about reversing Type-2 diabetes promote the idea of exercise to help lower glucose content in the circulatory system. For this reason, I am discussing Physical health, Cognitive health and Sleep before I delve into what I am currently doing in terms of diet. These 3 factors seem to be universally recommended to take on the lifelong battle with metabolic syndrome.

Metabolic syndrome is the name encompassing a cluster of chronic diseases such as diabetes and heart disease simply means that our bodies find it increasingly difficult to manage our metabolism properly. Part of reversing metabolic syndrome requires convincing our bodies to create more and better mitochondria via mitochondrial biogenesis. The main stressor that will do this comes in the form of exercise, specifically Zone 2 and Zone 5 cardio training.

Zone 2 vs Zone 5 cardio

These zones refer to the zones that specifically help stress the body to stimulate mitochondrial biogenesis. The idea here is that your body will then be more efficient in glucose consumption/absorption thus removing it from the blood stream. Zone 2, depending on where you get your information from, is 70% of your max heartrate. If you don’t have access to equipment, you can use the “talk test” which states that you need to be able to speak in full sentences, however it would be difficult to do so. Dr. Attia mentions that Zone 2 exercise should comprise of 80% of your workout regimen per week and should be in minimum of 20 – 30 minutes at a time. Zone 5, exercise refers to hitting 90% or higher of your max heartrate. Very likely you could only do 3-8 minutes of sustained Zone 5 exercise at a time. I recommend HIIT (High Intensity Interval Training) to meet the Zone 5 requirements. Zone 5 should be in sets of 5-10 minutes. For those keeping track of metrics, you want to focus on increasing your VO2max number.

Strength/Resistance Training

Another way to promote better glucose absorption is to build more muscle, which uses glucose as fuel. The ideal way to do this is through strength/resistance training. The easiest protocol to remember here is the "rule of 4". 4 days a week, 4 sets, 4 reps per set (when working with weights). If weights are too advanced or unavailable to you, use Calisthenic (body weight) exercises combined with HIIT for your sets. I should also note that the overall goal for these protocols is to build new habits and be consistent. Please do not push so hard that you injure yourself. I had to build a multi-phase plan that would ensure that I can gradually build strength and endurance which may take longer than you might expect. If you do require a significant amount of recovery time, attempt to continue strength training in a separate part of the body if you can. For example, if your upper body is sore and in pain, try lunges to work out the lower body while the upper body recovers. Please use your judgement.

Stability Training

If I can manage to reverse Type-2 diabetes and live into my 80’s and beyond, it appears that risk of death from falling skyrockets. In the image above, it is clear that falling can be fatal (at any age) but especially for the elderly. This is because as we get older, we start to lose the muscle we have gained during our lifetime. This also highlights the importance of gaining muscle now. Dr. Attia mentions training for the centenarian decathlon by which you create a list of 10 things you'd like to still be able to do when you are 100 and workout for those actions now. It is also my opinion, and experience that a large majority of exercise related injury can be associated with lack of stability and proper form training. As Dr. Attia mentions, Stability is the foundation of everything I listed above. Personally, I think Yoga and Pilates are great ways to gain flexibility and stability.

Trainers

In general, I find having a personal trainer or partner is the ideal way to exercise. However, I realize that this can be a significant cost. I’ve found YouTube to be an incredible resource for free content. My first suggestion is to find trainers who have content you can follow along with. Watch some of their content without following along. Then from there find other trainers that can teach proper form and the biomechanical breakdown on what parts of your body you are actually exercising. Research the exercises with your “forms” trainer that your “follow along” trainer is asking you to do.

Consistency

Because exercise is, in my mind, a counterbalance to eating food. We need to exercise as often as we eat, which is usually daily. In order to ensure we can exercise consistently, we must then start building an exercise regimen unique to our lives, our body composition and ability. I would also recommend start with basics, start with lighter weights and at lower reps than you know you can do. We want to have at least 10 “wins” to reinforce the idea that this will become a habit. I started with bi-monthly phases based on how sedentary I was. ?

Action Items

1.????? Start walking, or low level cardio, for 30 min sessions and build a centenarian decathlon list of actions you'd like to do still when you are 100.

2.????? Research strength training, calisthenic & HIIT trainers (in person or on video). Also research training on form and biomechanics. Find exercises you enjoy.

3.????? Create plan for 80% zone 2, 20% zone 5 (combined with strength training), have daily stretch and stability training.

4.????? Build a phase plan for consistency (ideally at least 10 "wins" in a row) and measure the growth

5.????? Enjoy the process.