Everyone knows or should know that regular physical activity is important. Why is it then that so many adults and kids do not do it? According to Impact of Physical Activity on Cardiovascular Risk Factors in Children With Type 1 Diabetes, (Herbst, A., Kordonouri, O, Schwab, K, Schmidt, and F, Holl, R, 2007) almost half (44.7%) of 23, 251 kids, ages 3 to 18, followed in a study do not exercise at all. Perhaps there are convenient built in excuses like "I am too busy with work or school" or "I have every intention to start but I am just too tired most days."
What also is perplexing is most people overestimate the amount of physical activity they actually do and underestimate the amount of food eaten each day. It is also common for parents to not realize their kids are obese. Many of these same parents are obese themselves. Maybe it is too much computer time or sitting in front of the TV after school rather than going out to play
You would think that kids with Type 1 diabetes would be encouraged to exercise more than kids without Type 1 due to cardiovascular risk factors associated with the disease. After all, habits are formed early in life and often carry through to adulthood. An interesting study was done in Germany and Austria involving 209 centers with over 23,000 kids with Type 1 diabetes ages ranging from 3 to 18. The following cardiovascular risk factors were evaluated: plasma lipids (cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides), blood pressure, A1c, and BMI (body mass index). The table below shows a breakdown of these risk factors.
Regular Physical Activity
Regular Physical Activity
Regular Physical Activity
More than 3 days/week
n (# of subjects) 10,392 kids 8,607 kids 4,252 kids Age (years) 12.7 (+/- 4.3 yrs) 12.6 (+/- 3.7 yrs) 13.9 (+/-3.1 yrs) Diabetes duration (years) 4.7 (+/- 3.8 yrs) 4.7 (+/- 3.7yrs) 5.1 (+/- 3.8 yrs) A1c (%) 8.1 (+/- 1.9%) 7.8 (+/- 1.6%) 7.8 (+/- 1.6%) Any dyslipidemia (%) 41.2 (+/- 49 kids) 36.0 (+/- 48 kids) 34.4 (+/- 47 kids) Triglycerides (mg/dl) 126 (+/- 102) 114 (+/- 85) 114 (+/- 92) Cholesterol (mg/dl) 181 (+/- 48) 178 (+/- 45) 176 (+/- 38) HDL (mg/dl) 61 (+/- 19) 63 (+/- 19) 63 (+/- 17) LDL (mg/dl) 99 (+/- 35) 96 (+/- 35) 95 (+/- 32) Elevated systolic blood pressure (% of patients) 8.4 (+/- 28) 7.5 (+/- 26) 8.6 (+/- 28) Elevated diastolic blood pressure (% of patients) 3.5 (+/- 18) 3.2 (+/- 17) 1.9 (+/- 14)
It may seem strange for a study to focus on these parameters since some clinicians scoffed at the notion that chronically high blood sugars at an early age can contribute to complications, especially cardiac ones. The thinking has changed in recent years and this study shows evidence that risk factors can be present at a young age. What is really exciting is the study plainly shows that the more exercise done per week the lower the risk factors based on the parameters measured. This is better than a pill that may carry side effects or other risk factors.
The good news is something can be done about it and parents can play a major role in making sure it happens. If a child had an infection, most parents would be very diligent about making sure antibiotics are taken each day along with the proper dose prescribed by the doctor. So why not treat exercise as medicine? The study shows kids who exercise on a regular basis have less risk factors that can cause complications down the road. The problem is diabetes is a "pay me now or pay me later" disease. If one does not practice tight control with his or her diabetes now the chances of suffering with complications increases significantly as time goes on. There are documented cases of people with diabetes suffering heart attacks or kidney failures in their 20s.
One good measure to determine fitness level is body mass index or BMI. BMI is a measure of an individual's weight in relation to his or her height. This is one way to determine whether or not someone needs to lose weight. To determine BMI multiply a person's weight in pounds by 703. Next square a person's height by multiplying height in inches by height in inches. Divide the value in the first calculation (weight by 703) by the value you get in the second calculation (height squared). The final number is a person's BMI.
An example would be:155 lb person x 703 = 108965
5' 3" person (63 inches) x 63 inches = 3969
108965 / 3969 = 27.5
According to the U.S. Department of Health and Human Services, a person is considered overweight if he or she has a body-mass index of 25 to 29.9 and obese if he or she has a body mass-index of 30 or higher. People with a body-mass index below 18.5 are considered underweight.
The U.S. Department of Health and Human Services deems a person overweight if he or she has a body-mass index of 25 to 29.9 and obese if he or she has a body mass-index of 30 or higher. As with any measurement there may be some limitations. Very muscular individuals (i.e., athletes) may actually have a high BMI but be in excellent shape. Individuals with a BMI below 18.5 are considered underweight. So a good goal would be to have the entire family with a BMI between 19 & 24 for optimal health.
In summary, everyone has a good idea exercise is beneficial for kids with diabetes but now there is science to prove it can decrease risk factors associated with heart disease.
Rick Philbin, MBA, M.Ed., ATC
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Last Updated: Friday September 07, 2012 11:14:19
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