ADA 2008: Exercise trumps fit and fat in diabetes

Forget the arguments over fit and fat in the development of diabetes and the resulting complications. Both fitness and fatness can be addressed by the same prescription: physical activity.

"Exercise is pleiotropic," according to Timothy Church, MD, PhD, Pennington Biomedical Research Center, Baton Rouge, LA. "Exercise benefits nearly every cell in the human body. Don?t talk ?fit? to your patients, don?t talk ?fat.? Just get them moving!"

Fit and fat both play important roles in the development of diabetes and its complications, Dr. Church said. Excess weight is a significant risk factor for developing diabetes and cardiovascular disease.

"Study after study shows that the fatter you are, the greater your risk," he said. "But if you are talking about dying from cardiovascular disease, fitness is more important."

Physical activity is key, Dr. Church continued. As little as 10 minutes of walking daily can increase cardiovascular fitness and aid weight loss. More exercise is better. Thirty minutes a day, five days a week, is a reasonable target.

"The relationship between activity and benefit is curvilinear," he said. "The greatest relative benefit comes to people at the couch potato end of the activity spectrum. If we could just get people off the couch just a little bit, we could benefit them tremendously."