Prime Minister Manmohan Singh needs to hit the gym running, literally, as soon as his cardiologists declare him fit enough for some amount of physical exertion, which is usually in about six weeks after surgery.
Experts say exercise — a combination of aerobic exercises such as walking and resistance or weight training — is essential to improve diabetes control and lower risk of heart disease.
“Frailty is the biggest enemy of diabetes because loss in muscle mass and strength is associated with increase in abdominal fat and poor diabetes management," said says Dr K Sreekumaran Nair, professor of medicine and director, research resources at Mayo Clinic, Rochester. Dr Nair is in Mumbai for the 8th International Symposium on Diabetes. With no one appearing more physically frail than the Prime Minister, it is perhaps time he invested in a pair of dumbbells. Muscle loss begins in the 30s and increases rapidly after the age of 65. Weakened muscles not only make it more difficult for older people to stay active, which leads to them putting on fat in the wrong places such as the stomach, but also bring down muscle synthesis leading to insulin resistance and poor blood sugar control.
“With age, people lose muscle mass and strength and need to do some amount of resistance training to build and maintain muscle mass. Most people do some amount walking but do not realising that lifting weights is equally important to counter muscle loss and frailty associated with age,” says Dr Nair.
Exercise is especially beneficial for people post surgery. It increases collateral circulation, pushing blood into the tiny blood vessels in the muscles, heart and the brain. “Exercise improves cognition (brain function) and delays Alzheimer’s, prevents depression by increasing the levels of the ‘happy’ hormones called endorphins and increases the expression of the SIRTIN-3 gene, which is associated with longevity,” he said. Nair, himself a sprightly 61, does flexibility training and aerobic exercises seven days a week for at least 40 minutes. That apart, he does weight-training three days a week.
Several studies have shown that Indians have lower muscle mass and higher body fat percentage than Caucasians, both of which put Indians at risk of diseases such as heart disease and diabetes at a younger age even when they are not clinically overweight. “Being active (and exercising) helps everyone, whether they are thin or overweight. Many people have the misconception that they don’t need to exercise because they are thin and don’t need to lose fat. They couldn’t be more wrong, because more than thinness, it is activity and lean muscle that helps you fight all kinds of diseases and live longer,” says Nair.