The Importance of Walking

"I believe walking is so important that I call it ‘my most important diabetes pill,’ " explains Usman Ahmad, MD.

Ahmad, a diabetologist for over 30 years and chair of the Department of Medicine as well as director of the Diabetes Center at the University of Pittsburgh Medical Center-McKeesport, was diagnosed with type 2 diabetes in September 2002. "I was expecting it. Both my mother and my father have diabetes," he says.

Ahmad, age 58, walks at least three miles a day three times a week. "Sometimes I do power walking on an inclined treadmill carrying a weight."

He also does muscle toning and stretching exercises twice a week. "But no body building," he adds.

"Of course, I didn’t start any of this until my doctor gave me a thorough exam and cleared me for the exercises. Even though I am a diabetologist myself, I followed my own advice when I was diagnosed: Find a doctor you trust, then do what he or she says. We diabetologists do the same things we tell our patients to do."

Fat to Flat
Two years ago, Ahmad’s AlC was 11.3 (Your A-1-C is a blood sugar check "with a memory." It tells you your average blood sugar for the past two to three months. The longer your A-1-C is near your target, the less risk you have for complications. Even if your A-1-C is higher than your target, lowering it by even one point will reduce your risk. If your number is 7 or higher, you may need a change in your diabetes care.) "But now it is under six. The ADA target number is seven or below," he explains.

Although Ahmad’s doctor put him on insulin for several weeks when he was first diagnosed, he now takes metformin and rosiglitazone. "But I am sure that the walking is the most important factor in bringing my AlC into normal range," he adds.

Walking has not only helped Ahmad, who is 5′ 11”, drop from 184 to 166 pounds; it has also helped bring his blood pressure and cholesterol under control.

"And walking has helped me go from having a fat belly-some people call it apple shaped-to a flat belly. A belly that sticks out like an apple is carrying a lot of fat. That’s the most dangerous shape belly to have, especially if you have diabetes or heart disease," Ahmad explains.

"But there is hope. I have been flat bellied for over a year. I am sure the walking is responsible for that, too. And you don’t have to be a power walker to gain the benefits. just keep walking."

Only one thing has interfered with Ahmad’s successful walking program: he doesn’t enjoy walking on a treadmill.

"For me, walking inside is one of the most boring things you can do. I walk outside when weather permits, but when I have to walk on the treadmill, I put it in front of the TV and choose programs I really like. That way, the time goes by quickly and it’s almost fun.

"But just in case I get lazy, I have requested my wife, Ellen, not to give me supper unless I have had my ‘walking pill.’

"I also have the support of my college-student son, Adam, and my daughter, Helen, a third-year medical student." Ahmad adds that Helen has gone from being his "fashion policewoman" to his exercise guru.
Shoes

"I choose my shoes carefully. Shoes should be very comfortable, maybe even one size larger than usual. For me, a soft leather shoe is worth the extra money. And I pick cotton socks that have good, thick padding on the sole.

"Then I keep checking to be sure that the sole of the shoe doesn’t become hardened. It must remain soft and flexible so it doesn’t rub or cause blisters anywhere."

Ahmad adds, "Always keep in mind that your health is your responsibility. Follow your doctor’s advice. Get a little book and keep written records of your weight, blood glucose, blood pressure, AlC, and cholesterol.

"And remember, all of these are helped by walking."
  

1. Start small.
Believe me; the hardest part is getting started. If you’ve been sedentary for a long period of time, I suggest you start your new exercise program by walking three times a week. For the first week, you may want to walk for only 15 minutes at a time at a slow pace. Once you see that it’s not too hard after all, gradually add more workout days and extend your workout time from 15 to 30 and then from 30 to 45 minutes. Finally, pick up the pace! After eight weeks, you should be able to walk 45 minutes, 5 days a week at a fairly brisk pace.
One easy way to add a bit of intensity to your walk is to add a weighted walking vest. I prefer using a weighted vest instead of walking with free weights and ankle weights. Free weights and ankle weights can do more harm than good, since they concentrate the weight on your arms and legs, thereby putting undue stress on your muscles.

2. Warm up and cool down.
To warm up, walk around while gently swinging your arms and raising your knees up to waist level (or as high as possible). Gently stretch the muscles of your calves, the backs of your legs, your waist, and back. Hold each stretching position for 30 to 45 seconds. Go to the point of tension but not pain. Breathe deeply and pay special attention to those parts of your body you will be exercising. Repeat this process immediately following your workout.

3. Drink enough water.
Moderate exercise in a temperate climate can result in the loss of half a gallon of water per day, so be sure to drink enough water throughout the day and during your workout. Remember, this is in addition to the eight glasses you need e day for normal, healthy functioning.
Since regular, filtered tap water and even bottled water, may be full of  contaminates you may want to consider using a convenient while bottle that has a filter built-in. All you  do is pour water in and the filter cleans it for you.
4. Eat for energy.
The best way to build energy is to have at least 30 percent of your diet consist of protein. High-quality protein will give you more energy and help fight the inflammation that develops around strains, sprains, and bruises. The best protein sources include legumes and whole grains, free-range poultry, and organic eggs, as well as foods high in omega-3 essential fatty acids, such as flaxseed, salmon; and tuna.

5. Reduce stiffness and ease sore muscles.
When you’re first starting out, it can be helpful to use moderate amounts of sodium and potassium bicarbonate before, during, and after exercising to reduce and even prevent stiffness and sore muscles. Just drinking one-half to one teaspoon dissolved in a 4-ounce glass of distilled water will do the trick. Alka-Aid makes a combination of potassium and sodium bicarbonate. It is available in most drug stores. If you cannot find it, then you can use just sodium bicarbonate (baking soda). 

You can also try methylsulfonylmethane (MSM), one of the most powerful natural anti-inflammatories. I recommend taking 250-750 mg of MSM three times a day, with meals, before any particularly strenuous activity or if you are sore after your work out.