Letters to the Editor
Many Other Healthy Lifestyle Centers for People with Diabetes
I read with fascination the article in your June 2004 issue on the Lifestyle Center of America and followed up by checking out their Web site.
From there I did a Google search and found Green Mountain at Fox Run (associated with the Joslin Diabetes Center); Structure House (associated with Duke University); The Pritikin Center in Florida and Canyon Ranch (in Tuscon, Arizona, and western Massachusetts).
They all have specific programs for diabetics, they all sound fabulous and they are all very expensive!
I would love to get away for a week or two, have someone else do all the meal planning, organize some exercise time and health education classes, make some new friends and have some fun. It would be a vacation, a break from the stress of doing all that work for myself.
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Help! How Can I Reduce Body Fat?
I found Ann Swank’s “How to Exercise as You Grow Older” (July 2004, page 42) very valuable.
I have had type 1 for 46 years. I’ve just turned 61, and despite exercising three times a week and eating a dietitian-approved and calorically appropriate low-fat diet, I find my waist widening and my abdomen fat increasing.
In fact, I recently learned that my body fat, which, about a year ago had been good (a BMI of 23) has risen to a BMI of 30.
My exercise routine includes:
- Treadmill for 40 minutes at 4.4 to 4.6 miles per hour
- Weight training for about 20 to 25 minutes
- Outdoor bike riding for one hour at 8 to 13 miles per hour.
Still, my clothing is getting tighter. Lipid tests show I’m a low cardiac risk, so I’d be happy to reduce my aerobic exercise if it wouldn’t worsen my status. While I can’t exercise every day, do you think it’s wise to switch from the biking to more weight training? I understand that the weight training assists in maintaining muscle mass.
How would you recommend that I lower my body fat?
Oceanside, New York
We asked Ron Zacker, RD, CDE, to address this reader’s letter:
Congratulations on exercising regularly and putting so much effort into your diabetes management. It sounds as though you are actively involved in your care, and it is paying off by lowering your cardiovascular disease risk factors.
You mention in your letter that you’ve experienced a 7-point increase in BMI over the past 12 months, despite no change in diet or exercise. This is perplexing and seems unlikely. Although you didn’t mention your height, based on the average height for a U.S. female of 5’4”, BMI increase from 23 to 30 would suggest a 40-pound weight gain (an increase of 30 percent of your bodyweight) over 12 months. This being the case, your clothing wouldn’t merely be feeling “tighter”—more likely, it would be impossible to put on! Is it possible that your BMI was calculated incorrectly?
As an aside, BMI, or body mass index, is not the same as your percentage of body fat. BMI is calculated by dividing your weight in kilograms by your height in meters squared. The BMI, therefore, isn’t much different than the old height and weight tables and does not necessarily reflect body fat levels.
As to your last question about how you can lower your body fat, I would offer the following:
Research has demonstrated time and time again that people tend to underestimate their calorie intake and overestimate energy expenditure from physical activity. Do you believe you are objectively and accurately assessing your lifestyle? If you haven’t already done so, you might consider keeping a detailed journal of your eating and exercise for a short time to see if it makes a difference.
When combined, aerobic exercise and weight training offer both novel and additive benefits in the quest for lowering body fat. If you are struggling to lose body fat, the question isn’t if you should pick one over the other, but to do a little more of both. A typical exercise prescription for individuals with diabetes who are cleared by their healthcare provider for increased levels of activity would be to do weight training two or three times weekly and aerobic exercise three to five times per week.
You might also consider working with a trainer who can help push you a little during your workouts to make them even more productive. There is such a thing as overtraining, but at this point you could consider adding more volume, in terms of exercise frequency, to your routine.
Before you change your exercise routine, be sure to consult your endocrinologist or your diabetes team. They can assess any special needs you might have and predict what adjustments you might have to make in your diabetes management as a result of the increased activity. You might also consult your doctor about any possible contributing factors that might be applicable to you, such as thyroid or hormone replacement therapy.
Remember that even if your ultimate cosmetic goals are not achieved, the exercise you perform helps to keep you healthy in innumerable ways and should never be abandoned out of frustration with the bathroom scale. You are already successful and reaping benefits by choosing a healthy lifestyle. Congratulations again.
Ron Zacker, RD, CDE
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