Group Program Helps Those with Prediabetes Boost Physical Activity
If you're at risk of getting type 2 diabetes, or already have been diagnosed with prediabetes, your doctor probably has encouraged you to start moving and keep moving, as regular exercise can modify that risk.
The challenge for many, of course, is how to make that happen, with often-overwhelming work schedules and family tasks.
Now, a new study finds that enrolling in a lifestyle intervention program that encourages both weight loss and increased activity really does help people boost their workout time. The researchers followed 223 people enrolled in such programs, tracking the effect on physical activity.
"People increased their activity and substantially, adding an additional 52 minutes a week," says Yvonne Eaglehouse, PhD, a postdoctoral scholar at the University of Pittsburgh Graduate School of Public Health. She led the study, published in June in the Translational Journal of the American College of Sports Medicine.
After 6 to 12 months in the program, the men and women added that 52 minutes on top of the 120 they were doing, she says. "We are getting people to beyond the national recommendation of 150 minutes [a week].''
And, they kept moving, maintaining the increased activity even six months after the one-year program ended, she found. The programs are widely available across the country.
Experts have long promoted physical activity as a way to reduce diabetes risk. Its value was shown in a study published in 2002 known as the Diabetes Prevention Program. Researchers followed more than 3,000 people at risk for diabetes and found that those who lost 7% of their body weight and increased exercise to 150 minutes a week sharply reduced their risk of getting diabetes.
Researchers also found that those who met the physical activity goal but didn't meet the weight loss goal still reduced their risk of getting diabetes by nearly 50%.
However, research on how much the programs help people boost exercise time is lacking, Eaglehouse says, so she set out to evaluate that.
Eaglehouse tracked men and women, average age 58, who either had prediabetes, metabolic syndrome (a cluster of risk factors such as high blood fats, high blood pressure and high blood sugar) or both. The program she tracked, a modification of the Diabetes Prevention Program, is known as the Group Lifestyle Balance Program. It includes 22 sessions over a year.
Costs are minimal, Eaglehouse says, requiring only fees for materials such as printed informational materials.Instructors help participants make lifestyle changes to get to both the weight loss and physical activity goals.
At the study start, the researchers assigned some to the group getting immediate program information and others to a group told they would start the program in six months. The active group could attend group meetings or view DVD instruction by themselves. The delayed start group got general health information in the mail during the waiting period.
All participants reported their physical activity. At six months, the group participating added almost an hour of activity to their weekly routine, which was 15 minutes more than the delayed start group.
Secret to Success?
The program helps people set goals for physical activity, monitor their progress and experiment with the types of activity that works for them, Eaglehouse says. Group meetings help, too, she says.
"It's all about what works for the individual but having the group support," she says. "They discuss strategies that work for them, such as keeping sneakers by the front door, so it cues them to go for a walk when they get home from work."
Others find recruiting a friend to walk with them keeps them accountable, and having company keeps them motivated, she says. Activity did tend to decline in the winter, the researchers found. Not surprising, since the centers studied were in Pittsburgh.
"Any increase in physical activity is meaningful," says Minisha Sood, MD, director of inpatient diabetes at Lenox Hill Hospital, New York. She reviewed the findings. The program may especially appeal to those who balk at buying gym memberships, she says, which can be expensive.
"People are more generally motivated to exercise by taking a walk outside, with either friends or family," she says.
The drop in activity during the winter months in colder climates is not a surprise, either, she says. Nor is it an excuse, as she tells her patients. "I emphasize that exercise is not optional," she says. "Rather, I remind them that our bodies were built to move and that without that, we cannot be in optimal health."
Among her suggestions to patients are finding an exercise app on their smartphone that gets them moving, exercising as a family, finding an exercise partner or turning to home DVD exercise programs.