There it was-a news headline scrolling across the bottom of my screen saying that stress management can help control type 2 diabetes. The good people at Duke University Medical Center have published research in the Jan. 2002 issue of Diabetes Care that says in black and white what others and we have been saying for some time, which is why there are articles on controlling stress here on the site. Stress can increase glucose levels in people with diabetes, making them more susceptible to long-term physical complications of the disease. Patients in the stress management group showed on average a 0.5 percent reduction on the HbA1c test. Thirty two percent of the patients in that group showed an even greater improvement by lowering their blood glucose level by 1 percent or more. So what can you do to lower your level of stress? First read our articles on the subject as they are filled with ideas. Here we will discuss how regular exercise can lower stress levels, but do learn muscle relaxation, imagery, breathing techniques, and cognitive and behavioral responses to stress.
You may be asking why people with diabetes are at special risk for having stress adversely affect their blood glucose levels. "Experiencing stress is associated with the release of hormones that lead to energy mobilization known as the 'fight or flight' response. Key to this energy mobilization is the transport of glucose into the blood stream, resulting in elevated glucose levels, which is a threat for people with diabetes."
Among the many research-based claims made for exercise in recent years has been that it does reduce anxiety and stress. But some researchers have asked whether people could get the same effect by just sitting quietly. The question is, is the effect the result of just taking time out from the causes of stress, or of the exercise itself. Edward McAuley, a professor of kinesiology at the at the University of Illinois and some of his graduate students published an article in the Journal of Sport and Exercise Psychology that found that exercise had "a significant impact on anxiety" as compared with the effect on subjects who asked merely to sit still. The subjects were asked to either sit in a comfortable chair in a room with few distractions or to exercise in a lab setting. Since this latter setting might elevate levels of stress, the participants were also asked to exercise in a "natural environment" of their own choosing. At four points during each of the sessions--at the beginning and at 12, 25, and 40 minutes--participants were asked to give oral responses to a standard inventory of 10 questions designed to measure their level of anxiety. A researcher followed each participant even in the "natural environment" sessions. The researchers found that "contrary to what you'd expect, the anxiety level for the average participant actually rose at the first two interval questionnaires of the exercise sessions. It then dropped significantly-and significantly below the mere sitting level, during the 15 minutes following exercise. Since McCauley suspects that the questions asked during exercise may be measuring "heightened physical arousal" along with anxiety, he suspects the anxiety-reducing effect of exercise may be greater than what was demonstrated.
So, if you start an aerobic exercise program, what can you expect? Most notably, this type of exercise strengthens your heart and lungs. These vital organs-especially the heart-bear the brunt of the body's physiological stress response, constantly being called upon to "fight or flee" from the job, school, family, financial, relationship, and every other kind of stressor we confront daily. Add to this the fact that for many of us, looking good also means feeling good, and aerobic exercise helps in this area. Exercise improves physical appearance, enhances self-esteem and self-confidence, and offers other mental health goodies. Regular exercisers report more energy and better ability to concentrate. It also offers improved quality of sleep, reduced stress reactivity (not getting as stressed out about things as we usually do), and yes, maybe even slowing down the aging process.
For a long time, it has been known that exercise can lower blood pressure in men, but a group at New Britain General Hospital in Storrs, CT studied 18 pre-menopausal women to see if this is true for women also. Blood pressures and other hemodynamic and blood chemistry parameters were noted before and after a 40-minute rest period and after 40 minutes of cycle exercise. Post-exercise hypertension occurred only in the hypertensive women. This effect was seen for up to 7 hours after exercise. The authors concluded that the post-exercise hypotension effect may be sufficient to normalize the pressure of hypertensive women for most of the day.
What else can exercise do to help you physically? It improves blood flow to the brain, bringing sugars and oxygen, which may be needed when you are thinking intensely. When you think hard, the neurons of your brain function more intensely. As they do this, they build up toxic waste products, which cause foggy thinking in the short term, and can damage the brain in the long term. By exercising you speed the flow of blood through your brain, moving these waste products faster. You also improve this flow so that even when you are not exercising, waste is eliminated more efficiently. It can cause release of chemicals called endorphins into the blood stream. These give you a feeling of happiness and well-being.
Muscle tension increases during stress, and can cause a wide array of stress-related musculoskeletal problems, as well as general feelings of fatigue, and mental and emotional stress. Physical activity, on the other hand, leads to muscle relaxation. A feeling of physical relaxation characterizes a good workout's afterglow. After working hard, muscles relax. One study measuring the electrical activity of muscle found that activities such as walking, jogging and bicycling decrease muscle tension by more than 50 percent for up to 90 minutes after exercise. Physical relaxation translates into mental relaxation as well. This exercise afterglow of relaxation is an important part of exercise's anti-stress value for many people.
Rhythmic exercises such as walking, running, rowing and swimming increase alpha-wave activity in the brain. The electrical activity of the brain can be monitored in the laboratory using an instrument called an electroencephalogram (EEG). Alpha waves are associated with a calm mental state, such as that produced by meditation or chanting. The rhythmic breathing that occurs during some forms of exercise also contributes to an increase in alpha-wave activity. Rhythmic activity performed to music may be stress-relieving in other ways as well.
Some research suggests that regular exercise of moderate intensity may provide a sort of dress rehearsal for stress. Several studies have found that people who exercise regularly have a less physical response to laboratory stressors, such as difficult mental arithmetic tests. Other studies have found that physically fit subjects recover more quickly than sedentary peers from stressors such as cold exposure or emotional frustration. Your response to a session of moderately vigorous exercise resembles your response to stress--elevated metabolic rate, cardiac output, energy substrate levels, muscle tension, stress hormones, etc. Regular exercise may "train " the body to cope with and recover more quickly from emotional stress, as well as exercise stress.
The physical part of exercise may be only part of the stress-management story. Physical activities may provide a diversion from sources of stress. When you are actively engaged in tasks demanding concentration and motor skills, it's hard to keep your mind on your worries. Don't believe this? After watching the terrorizing events of Sept.11th, my friend and I took a long jog and walk, not to firm up, but to lower our levels of anxiety, and it worked for a while that awful morning. Exercise may relieve boredom or provide opportunity for social interaction. Perhaps most important of all, physical activity can be fun, and to quote Dr., Seuss, "fun is good."
BSP
