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Diabetes and Alzheimer’s Disease – Is there a connection?

The simple answer to the above questions is YES! There is a closer correlation than what you might think. Research over the past 10 years indicates the increase in Diabetes related Alzheimer’s by 50-150%, with researchers also leading us to the concept that impaired insulin signaling has an important role in the pathogenesis of Alzheimer’s and the proposal that Alzheimer’s represents “Type 3 Diabetes”. As there is an increase in the aging population worldwide, evidence suggests that there will be 115 million people worldwide who will suffer from Alzheimer’s by the year 2050.

Where is the connection?

Firstly, let’s talk about Diabetes. Diabetes can either be autoimmune (Type 1) or caused by insulin resistance in peripheral tissues and is most frequently associated with aging, a family history of diabetes, obesity, and failure to exercise (Type 2). Insulin receptors are expressed on all cell types in the body, including the brain. Insulin resistance has long been recognized as a central feature of Type 2 Diabetes, but research from the past few years has shown that it also occurs in the brains of individuals.

Insulin enters the Central Nervous System (CNS) across the capillary endothelial cells of the blood–brain barrier. Insulin has intense effects in the CNS, regulating key processes such as energy homeostasis, neuronal survival, learning, and memory. Within the brain, insulin receptor density is highest in the olfactory bulb, hypothalamus, hippocampus, cerebral cortex, and cerebellum which suggests that insulin signaling has an important and diverse role in the brain.

Evidence suggests that systemic insulin resistance or high circulating levels of insulin affects the function of the blood-brain barrier resulting in a change of permeability which could lead to impairments in glucose utilisation and energy metabolism, resulting in neurodegeneration. This can cause Mild Cognitive Impairment (MCI) leading to early stages of dementia, in particular, Alzheimer’s. Alzheimer disease is the most common form of dementia among the elderly and is characterized by progressive loss of memory and cognition.

Will I develop Alzheimer’s if I have Diabetes?

The simple answer is NO! Not if the individual manages their diabetes correctly through intervention strategies such as diet and exercise. Exercise can reduce the risk of further chronic disease progression through changes in; fat mass, blood pressure, insulin sensitivity, glycaemic control, neural adaptations and many other cellular adaptations.

A study conducted by Northey and colleagues in 2018 concluded that a combination of aerobic and resistance exercise significantly increases cognitive function through vascular adaptations and promotion of neurogenesis, leading to reduced cellular damage.

Overall, exercise intervention is a promising, cost-effective treatment that can aid in Diabetes management and benefits cognitive function reducing the risk of dementia. On the other hand, for patients with Alzheimer’s disease, exercise intervention could slow down the rapid cognitive impairment.

As Accredited Exercise Physiologists we can help provide these services leading to a healthier lifestyle and providing exercise as medicine. If you would like more information you can email on info@absolutebalance.com.au to book a consultation with one of our team members.

Joel Skinner (B.Sc Exercise Science and Rehabilitation)

Accredited Exercise Physiologist (AEP) (AES) (ESSAM)

 

 

References

Arnold, S. E., Arvanitakis, Z., Macauley-Rambach, S. L., Koenig, A. M., Wang, H. Y., Ahima, R. S., Craft, S., Gandy, S., Buettner, C., Stoeckel, L. E., Holtzman, D. M., & Nathan, D. M. (2018). Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums. Nature reviews. Neurology, 14(3), 168–181. doi:10.1038/nrneurol.2017.185

Northey, J.M., Cherbuin, N., Pumpa, K.L., Smee, D.J., Rattray, B. (2018) Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British Journal of Sports Medicine. 52 (3), 154-160. doi:10.1136/bjsports-2016-096587

Butterfield, D. A., Di Domenico, F., & Barone, E. (2014). Elevated risk of type 2 diabetes for development of Alzheimer disease: a key role for oxidative stress in brain. Biochimica et biophysica acta, 1842(9), 1693–1706. doi:10.1016/j.bbadis.2014.06.010

Understanding your energy systems in the fight against lifestyle diseases

It has never been so easy to consume calorie dense foods. With fast food, mobile app delivery systems, and delicious food blogs online, the temptation to consume the sugary goodness has caused an increase in lifestyle diseases around the world. Obesity, fatty liver disease, type II diabetes are on the rise due to consuming more calories than we expend. These conditions are reversible through creating pathways towards a caloric deficit.

A caloric deficit put more simply is creating a decrease in the number of calories we eat that the body can use to convert into usable energy. Decreasing the number of usable calories means the body must begin converting energy that has already been stored. This could be in the form of carbohydrates (glycogen), fats (lipids) or protein (muscle). Creating a caloric deficit is the most effective way of reducing weight and can be done through both diet and exercise.

The duration of exercise and intensity will determine which energy source will be the most suitable to sustain the desired activity level.
Within the first few seconds of muscular contraction, adenosine triphosphate phosphocreatine (ATP +PC) which is stored in the myosin of the sarcomere (muscle complex) is used very quickly. When phosphocreatine is broken away from adenosine triphosphate (ATP), energy is released, and ATP is created as a by-product. This energy source is useful for movements such as a quick take-off in a sprint to a bicep curl. Once this source becomes depleted, the body then looks for its next supply which is in the form of glycogen. Glycogen is the glucose stored in the body. This conversion takes slightly longer but allows the body to convert the glycogen into usable ATP through glycolysis. This equation does not require oxygen which means that the fuel source is suitable for anaerobic activity no longer than approximately 90 seconds. Glycolysis is used for movements that require a lot of stopping and starting and is a useful form of energy for explosive bouts in sports like soccer or netball.

From here, lipids become the next source of energy. Lipolysis is the desired conversion of fat into triglycerides which are easier to be metabolised into energy. This conversion of fats into energy can last from minutes to hours depending on how much fat is available before the body begins to use protein. As expected, by utilising fat as a fuel source, you’re likely to experience fat loss. Exercise must continue past the thresholds of each previous energy system before lipolysis can be used. Oxygen is required for this conversion which means the exercise becomes aerobic. Long walks, running and swimming are examples of aerobic activity and are also common exercise prescriptions for fat loss.

With this information about energy systems, how can exercise assist in creating a caloric deficit? If your goal is to reduce body fat, by understanding how to put yourself into your desired state of energy conversion you can decrease the time frame needed to achieve your goal through diet alone. Whilst different exercise forms and duration and are often limited to their energy source, it is important to include cardio (aerobic), resistance training (anaerobic) and mobility to reduce other comorbidities such as sarcopenia, osteoporosis or hypertension.

If you’re living with a lifestyle disease or chronic conditions exercise has been proven to have a positive effect and decrease symptoms.  The team here at Absolute Balance understands how to exercise you appropriately to your condition and will help you achieve your goals against lifestyle diseases. Get in contact with us today by calling 9244 5580 or via email at info@absolutebalance.com.au.

 

Emily Longmuir
BSc. Exercise and Sport Science

Exercise Physiology Student

 

Berg, J., Tymoczko, J., & Stryer, L. (2019). Fuel Choice During Exercise Is Determined by Intensity and Duration of Activity. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK22417/

P, A. (2019). Human fat cell lipolysis: biochemistry, regulation and clinical role. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16311212

The Role of Muscle Mass in Type 2 Diabetes Mellitus

Diabetes is classified broadly into type 1 and type 2 diabetes. Type 1 accounts for approximately 5-10% of cases with Type 2 diabetes accounting for 90-95%. Type 2 is diagnosed normally during adulthood and is generally associated with insulin resistance and eventually loss of insulin secretion. This means the glucose in our blood is no longer being adequately controlled by insulin which can lead to heart, eye, kidney and nerve problems.

Exercise is imperative for the prevention and treatment of type 2 diabetes and the role of resistance training plays an integral part. When partaking in resistance exercises, we create an energy need within the muscle which allows blood glucose to enter the muscle and leave the bloodstream which reduces our blood glucose levels. More importantly, it also allows us to build up GLUT 4 receptors. These are transporters that are located in muscles that are activated during exercise. They are responsible for up taking glucose into the muscles to be used for energy. By building up muscle mass and GLUT 4 receptors through exercise, diabetics will have a better ability to reduce their blood glucose levels. This leads to better long-term control and improves insulin resistance, blood pressure, reduces fat mass and increases strength. Resistance training can also reduce the stress hormone cortisol which has also been linked to insulin resistance.

The exercise recommendations for type 2 diabetics are at least 150 minutes per week of aerobic and resistance training. It is recommended that exercise is performed daily due to enhanced insulin action. Performing resistance training before aerobic exercise, when combined in one session, will also reduce the likelihood of postexercise hypoglycemia.

Lifestyle changes that focus on exercise and dietary interventions are recommended for weight loss in the prevention and management of type 2 diabetes. If you are looking for an individualised programme, contact an accredited exercise physiologist.

Taylor Downes

Exercise Physiologist (Student)

B.Sc. Sport & Exercise, B.Ed. Human Movement (ESSAM)

References

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., et al. (2016). Physical Activity/Exercise and diabetes: A position statement of the American diabetes association. Diabetes Care, 39(11), 2065-2079. doi:10.2337/dc16-1728

Ahlqvist, E., Storm, P., Käräjämäki, A., Martinell, M., Dorkhan, M., Carlsson, A, et al. (2018). Novel subgroups of adult-onset diabetes and their association with outcomes: A data-driven cluster analysis of six variables. The Lancet. Diabetes & Endocrinology, 6(5), 361. doi: 10.1016/S2213-8587(18)30051-2

Don’t let asthma limit you!

Asthma is identified as a chronic inflammation of the airways resulting in wheezing, tightness of the chest, coughing & difficulty breathing.

Experiencing an asthmatic episode can be frightening and individual’s often fail to understand how to prevent these episodes. A common trigger of an asthmatic episode is physical activity and individuals will begin to exclude the hobbies they love such as team sports and gym workouts from their daily regime. Studies reveal exercise is an exceptional (and free) method to alleviate the signs/symptoms of asthma and increase VO2max when training effectively. Find out how!

Use the below tips to alleviate the signs/symptoms of asthma and regain confidence in exercise.

  1. Avoid training in cold, dry and high-pollutant environments. These types of environments are considered triggers of asthmatic episodes.
  2. A warm up is CRITICAL: 15 minutes of aerobic exercise is proven to decrease the frequency of asthmatic symptoms during exercise. Warming up encourages a “refractory period” (a symptom-free period post warm up) allowing the individual to exercise without restriction
  3. Commence with a low-intensity workout and progressively increase as workouts become easier to complete
  4. Breathing through a mask or scarf encourages inhalation of pre-warmed and humidified air decreasing the likelihood of asthmatic episodes

Studies have proven that participation in regular physical activity will increase aerobic fitness and creates ease in completing everyday tasks symptom-free. Partaking in physical activity strengthens respiratory muscles which increases the ability to complete exercise at a higher intensity without limitations. The likelihood of breathlessness will decline, and quality of life rises.

Contact Absolute Balance for a personalised program tailored to your needs and abilities to ensure maximal benefit and management of your asthma. If David Beckham can win league titles with asthma, why can’t you?

Danica Falcone – B.Sc. Exercise, Sports and Rehabilitation
Exercise Scientist (AES)(ESSAM)

 

Reference

Turner, S. (2009). Burden of disease and benefits of exercise in fixed airway obstruction asthma.

Aggarwal, B., Mulgirigama, A., & Berend, N. (2018). Exercise-induced bronchoconstriction: prevalence, pathophysiology, patient impact, diagnosis and management. Npj Primary Care Respiratory Medicine28(1). doi: 10.1038/s41533-018-0098-2

MacAuley, D. & Best, T. (2007). Evidence-Based Sports Medicine. Massachusetts, BMJ Books.

 

Exercise physiologist: How we can help you with chronic disease

Exercise is considered a relatively new treatment option for chronic disease prevention and management. Many doctors and patients are unaware of how exercise can help, and what kind of exercise is right for them or their patients. This is where exercise physiologists (AEP’S) come in. We are the experts in exercise prescription. Often AEP’s are confused with physiotherapists and although they are similar, they are not the same thing. Physios address and diagnose acute musculoskeletal injuries and restore initial function; where as AEP’s use evidence based exercise intervention for chronic disease prevention and management. Although different, physios and AEP’s often work together to ensure the best results for patients.

Exercise as a treatment option has only gained traction in the 21th century, however it was widely regarded as one of the best disease prevention options over two thousand years ago. Hippocrates wrote “In a word, all parts of the body which are made for active use, if moderately used and exercise at the labour to which they are habituated become healthy, increase bulk, and bear their age well, but when left without exercise they become diseased, their growth is arrested and they soon become old”.

As AEP’s we use exercise as medicine. Each individual is prescribed a dose of exercise for their particular pathology. The prescription is given similar to any other medication. For example, exercise A, for B times a day, for C amount of time; whether that is for days/weeks/months or years. The dose and type of exercises are chosen for each individual person based on their needs and ability. They are then progressed based on their individual goals and functional need to perform physical tasks. This is designed for long term management, lifestyle and behavioural changes to effectively manage chronic conditions.

Exercise can be used to manage and prevents a number of chronic diseases which include cardiovascular disease, metabolic diseases such as diabetes, neuromuscular diseases such as Parkinson’s; as well as musculoskeletal conditions such as arthritis, osteoporosis and other acute and chronic musculoskeletal disorders.

At Absolute Balance we empower our clients, provide education and encourage positive behaviour changes through the use of evidence based therapies to help out clients achieve their health goals. For more information contact us today info@absolutebalance.com.au.

 

Claire Hills ( B.EXSpSc,Grad.Dip.(Clin.Ex.Phys))
Accredited Exercise Physiologist (AEP) (ESSAM)

 

What is an Accredited Exercise Physiologist? (n.d.). Retrieved March 18, 2019

Moore, G. E. (2004). The role of exercise prescription in chronic disease. British Journal of Sports Medicine, 38(1), 6-7. doi:10.1136/bjsm.2003.010314

Durstine, J. L., Moore, G. E., & Painter, P. L. (2016). ACSMs exercise management for persons with chronic diseases and disabilities. Champaign, IL: Human Kinetics.