I am a physical therapist (diabetes care instructor, cardiac rehabilitation instructor) in Japan.
We will tell you the best deals on diabetic exercise therapy and cardiac rehabilitation.
Previously, promoting the activation of brown fat cells also increased the metabolism of the whole body and expected to have a weight loss effect. I posted on my blog that the brown fat cells are around the shoulder girdle, and that the effect may be obtained by exercising the shoulder girdle.
However, brown fat cells gradually decrease and disappear in some people from childhood to adulthood. There are many research results that people who disappear and do not have brown fat cells are more likely to become obese.
So, what should you do if you don’t have brown fat cells?
In my opinion, it is good to exercise to promote the activation of beige cells.
Beige cells are cells that have a similar thermogenic effect to brown fat cells. As an image, it is a cell that is located between brown fat cells (heat production) and white fat cells (energy storage).
As a feature, it is “inductive” and there is a possibility that exercise can activate the metabolism of the whole body as well as brown fat cells, so I think that it is probably easy for anyone to get the effect.
This “inducible type” means that it can change from white fat cells (mainly subcutaneous fat) to beige cells.
So where are these beige cells abundant?
It seems to be common in the neck, upper clavicle, axilla, and around the spine.
I have come up with exercises that can stimulate these areas, so I would like to introduce them. Of course, there is no medical evidence for this, so be careful.
If you are interested, please give it a try.
bibliography ・Ichitaro Abe: Diversity of Differentiation and Development of Brown and Beige Fat Cells and Systemic Metabolism.History of Medicine vol280.No11.2022.
Sleep deprivation has been found in epidemiological studies in Japan and abroad that people with exercise habits are less likely to be sleep deprived.
In particular, habitual exercise seems to be effective in maintaining sleep time and quality.
It seems to be especially effective for people who tend to have insomnia on a regular basis, such as the elderly.
As for the type of exercise, resistance exercise can wake you up if you do it intensely (there is a paper that it has an effect on the quality of sleep), so I think aerobic exercise and stretching that last a long time and do not have a high exercise load are good
It is said that the most effective time to exercise is to exercise from evening to night (about 3 hours before bedtime).
The key is to temporarily raise the temperature of the brain by exercising a few hours before bedtime. When you do this, the amount of decrease in brain temperature is greater than when you do not exercise. Sleep is more likely to appear when the temperature of the brain drops, so it is easier to get a good night’s sleep as a result.
I will tell you how to stretch that was also shown in the paper.
I think that the time of one stretch is about 30 seconds to improve arteriosclerosis.
Please give it a try.
Bibliography:
・Ministry of Health, Labour and Welfare Health Information Site for Prevention of Lifestyle-related Diseases
・Toshiya Nagamatsu et al., Effects of low-intensity, short-duration stretching exercise on core body temperature, stress response, and mood.Journal of Physical Fitness and Physical Fitness 110:1-7, 2012
Sleep deprivation has been found in epidemiological studies in Japan and abroad that people with exercise habits are less likely to be sleep deprived.
In particular, habitual exercise seems to be effective in maintaining sleep time and quality.
It seems to be especially effective for people who tend to have insomnia on a regular basis, such as the elderly.
As for the type of exercise, resistance exercise can wake you up if you do it intensely (there is a paper that it has an effect on the quality of sleep), so I think aerobic exercise and stretching that last a long time and do not have a high exercise load are good
It is said that the most effective time to exercise is to exercise from evening to night (about 3 hours before bedtime).
The key is to temporarily raise the temperature of the brain by exercising a few hours before bedtime. When you do this, the amount of decrease in brain temperature is greater than when you do not exercise. Sleep is more likely to appear when the temperature of the brain drops, so it is easier to get a good night’s sleep as a result.
I will tell you how to stretch that was also shown in the paper.
I think that the time of one stretch is about 30 seconds to improve arteriosclerosis.
Please give it a try.
Bibliography:
・Ministry of Health, Labour and Welfare Health Information Site for Prevention of Lifestyle-related Diseases
・Toshiya Nagamatsu et al., Effects of low-intensity, short-duration stretching exercise on core body temperature, stress response, and mood.Journal of Physical Fitness and Physical Fitness 110:1-7, 2012
Today, I would like to introduce my walking course.
It is a course centered on Monzen-Nakamacho.
The departure is Kiba Park, which is a very large park. There is a bridge in the center and it is divided into two. In the northern area, there is also the Museum of Contemporary Art Tokyo, where the Dior exhibition was held the other day.
In the south area, there is a grassy square, and there is also a stylish café and dog run in the park. This Kiba Park alone is enough for walking, but it is more fun to walk around the city.
Monzennakamacho is a merchant town in the Edo period, and it is an area called “SITAMATI” and is very traditional.
There is the famous Tomioka Hachimangu Shrine here, which is associated with SUMO wrestling. There is also a statue of Tadataka Ino who measured and created a map of Japan on foot.
Finally, go to Toyo Town and reach the goal. Toyocho is a business area and is dotted with large Japan companies.
If you have trouble finding a place to come to Tokyo, please take a walk.
When trunk function decreases, the performance of the movement of the hands and feet coming out of the trunk decreases.
The same is true for walking, and if you don’t have a strong core, you won’t be able to walk efficiently.
What I would like to introduce this time is one-legged bridge exercise.
If you flip the gait, you will be in a one-legged bridge position. This means that it is more effective to do exercises that are similar to the movements you want to use as a similarity to exercises.
The inner muscles used for walking are mainly the transverse abdominis and the internal and external oblique muscles. I think that a one-leg bridge is a good exercise that makes use of these muscle groups.
The key is to raise your buttocks as you exhale, and touch your buttocks to the ground while inhaling lightly. Breathing further utilizes the inner muscles, including the diaphragm.
Exercise as slowly as possible. Moving slowly can produce smooth movement of muscle coordination.
Specifically, it is this coordination that allows you to slowly lower the body that falls when descending the stairs.
Exercise walking is a brisk walk in which the elbows are bent at 90 degrees, the arms are swinging wide, and the legs are strides at a brisk pace.
The effects of this way of walking are as follows:
・Outer muscles of the upper and lower limbs
(Internal and external oblique muscles, rectus abdominis muscles, quadratus lumbar muscles, lateral fibers, erector spinae muscle group) to increase the metabolic rate.
・Exercise of the shoulder girdle is said to increase the catabolism of the whole body by stimulating brown fat cells, and converts body fat into energy.
・Although the oxygen intake is about the same as jogging (6~7METs), the increase in heart rate is suppressed compared to jogging, and exercise can be done more safely.
However, some people may feel embarrassed if they do it in the city, so it may be better to pull your elbows firmly and focus on stimulating the shoulder girdle rather than swinging your arms widely.
Please give it a try.
reference
・Ohno, Hideki, et al.Differentiation from white adipocytes to brown adipocytes by exercise and their regulatory mechanisms.Kyorin Medical Association Journal Vol. 43, No. 3
Tanaka et al., Differences in energy metabolism from the viewpoint of exercise modes.Physical Therapy 17(2)83-86.2002
Draw-in walking is walking with the navel concave as you exhale.
As an effect, oxygen intake increases, metabolism increases, and it is also effective for blood sugar control and weight loss in diabetes.
In addition, it is said that muscle contraction is obtained selectively in the trunk local muscles (transverse abdominis muscles, posterior fibers of the internal oblique muscles, and deep multifidus muscles) during draw-in, which increases the segmental stability of the spine and is effective for low back pain.
The disadvantage is that systolic blood pressure rises due to constant abdominal pressure and exercise.
Therefore, I think that alternating draw-in and draw-out (inflating and returning to the original belly) can suppress the rise in blood pressure, but there are no research results yet.
If you are interested, please give it a try.
bibliography ・Physical response of Yakabi et al. draw-in gait.Physical Therapy Science 32(2):307–311,2017 ・Richardson CA, Hodges PW, Hides JA, et al: Exercise Therapy for Segmental Stability of the Spinal Column: Scientific Basis and Clinical Practice of Low Back Pain Treatment.Akihiko Saito (translation), Igakushoin, Tokyo, 2002, p95. ・Tanemoto, S., Watanabe, S.: Effects of exercise intervention on standing center of gravity sway on deep trunk muscle groups, Physical Therapy Science, 2012, 27: 47-50.
“Core function is quite important, as you may already know.
The core consists of the pelvis and the scapula, ribs, and sternum, but there is only the spine between the pelvis and the ribs.
To ensure stability of the core, you need to build muscle. There are muscle groups such as the abdominal muscles, back muscles, and gluteal muscles.
All of them are anti-gravity muscles, and the type I fibers (slow-twitch fibers) are abundant in them, which is a characteristic that makes them easy to maintain until middle age.
It is difficult to notice that they are maintained until middle age.
And it declines rapidly after the age of 70.
By the way, the strength of the limbs decreases linearly, so you may notice that you get tired easily on stairs, etc.
So what kind of training is good? Some people may imagine upper body exercises to train their abs.
However, some people may not feel motivated to do so.
In that case, how about doing draw-in?
Breathe lightly during various exercises and daily activities, and try moving while slightly hollowing out your navel while putting a little force on your abs.
Then the transverse abdominal muscle of the inner muscle will work. The transverse abdominal muscle also plays a role like a corset that covers the core.
I think it is effective not only for core training but also for preventing lower back pain.
Diabetes is a terrible disease that can cause systemic illness by advancing arteriosclerosis.
The reason why diabetes makes arteriosclerosis and arterial occlusion more likely is that the primary cause is oxidative stress. High blood sugar itself increases oxidative stress.
When oxidative stress becomes stronger, the endothelial cells that move the blood vessels flexibly age and become the cause of arteriosclerosis.
In addition, high blood sugar causes a reaction called “glycation reaction” in which sugar and protein combine. As a result of this reaction, collagen in the blood vessel endothelium is glycated, and
a substance called “advanced glycation end products (AGEs)” is produced.
AGEs have a harmful effect on blood vessel cells, and LDL cholesterol and macrophages accumulate there, forming plaque.
Roughly speaking, it looks like the following figure.
If you develop arteriosclerosis, it’s terrible. There is currently no medication that only treats arteriosclerosis.
So the only way is to use dietary therapy and exercise therapy.
Strength training is not recommended for arteriosclerosis alone because there are reports that it can exacerbate arteriosclerosis (although it is generally recommended).
Aerobic exercise is effective for arteriosclerosis according to textbook-level descriptions.
What I would like to recommend this time is stretching.
There are many reports that stretching improves arteriosclerosis.
Blood vessels run in the same direction as muscles, so they are closely related to muscle flexibility.
In other words, if your body is stiff, your blood vessels may also be stiff and arteriosclerosis may be progressing.
The reason why stretching improves arteriosclerosis is that after stretching, nitric oxide (NO) is secreted from the blood vessel endothelium, which has a vasodilating effect.
By the way, it is effective to rest for about 30 seconds after stretching for 30 seconds to secrete NO efficiently.
It is important to stretch your hands and feet alternately and rest them.
Here are some recommended stretches. Please try them out.
bibliography
Nishiwaki M et al. Four weeks Of regular static stretching reduces arterial stiffness in middleaged men、 Springerplus 2015;4:555.
Yamamoto K et al, Poor trunk flexibllity is assocated with arterlal stiffening. Am J Physiol Heart Circ Physiol 2009 297:H1314-8
Kruse NT et al, lnfluence of passive stretch on muscle blood flow, Oxygenation and central cardiovascular responses in healthy young males. Am J Physiol Heart Circ Physio1 2016;310:Hl210-21.
Higaki et al Acute effects of the different relaxation periods during passive intermittent static stretching on arterial stiffness 2021 Nov 15;16(11)
In reality, many diabetic patients do experience a decline in muscle strength. Although there is a muscle strength test called MMT (manual muscle testing) that involves applying resistance with the hands, it is quite approximate. The test results are highly subjective, and many people are classified as MMT5, the highest level, even if they can resist strong resistance. This makes it difficult to motivate people to exercise.
For diabetic patients, it is important to measure muscle strength using a handheld dynamometer (HHD) to obtain detailed numerical values in kgf, similar to grip strength. The red muscles in the figure above are particularly prone to weakness in diabetic patients. However, MMT is not very effective in detecting this weakness. Although it may seem like a minor issue, it can lead to frailty, long-term care, and other problems in old age. No one wants to spend the latter half of their 100-year life in bed.
Two simple exercises that are effective for efficiently training these muscles are shown below. These are classic self-weight exercises that are widely used in the physical therapy community.
Although they are simple, they are highly effective when performed correctly. They are much better than unusual exercises.
It is better to perform the standing exercise by standing up and sitting down from a chair.
If you do squats in the air, your form may be compromised, and you may hurt your knees. Sitting down in a chair once eliminates the recoil and makes it easier to use your muscles.
Try doing it slowly about 10 times, and you will feel tired. Crossing your arms will also train your abs effectively.
If you are at risk of falling, place your hands on the wall. This exercise can also help improve your balance if you do not hold anything.
The key is to raise your heels slowly for about 3 seconds until your toes are raised. Diabetic patients often have stiff toes and reduced blood flow, so this exercise is effective.
When lowering your heels, do it slowly. If you just let gravity do the work, your muscles will not be used, and your anterior tibialis muscle will not be used much.
Doing this exercise about 10 times is a good guideline.
Everyone, please use these inefficient exercises to prevent muscle weakness.