Ep. 11 Can 3 minutes walks help your teen's insulin sensitivity ?

Intensive exercise can help improve insulin sensitivity, but often teens do not have enough time to devote to organized types of exercise. Can multiple 3 minutes walk help with insulin sensitivity?
 
I discussed a research project that examined this exact question, hope you find it helpful.

Diabetes Care. 2018 Oct; 41(10): 2220–2228.

Effects of Interrupting Sedentary Behavior With Short Bouts of Moderate Physical Activity on Glucose Tolerance in Children With Overweight and Obesity: A Randomized Crossover Trial

Dr Gourgari is a pediatric endocrinologist, certified in obesity medicine expert and weight loss coach for teens with more than 15 years of experience. She helps teens build healthy habits that last, so they can feel happier, be more confident and love their body again .

To get a free copy of 30 healthy and easy recipes for teens that are high in protein, visit
https://lifestyleforteens.com/recipes

To learn more about the LIFT Program, visit lifestyleforteens.com/program

Transcript

Speaker 1: 0:59

Are you getting frustrated with what to feed a teenager who is always hungry? Everybody knows that teenagers have a huge appetite. It seems like you need to feed them constantly to satisfy their hunger. It's even more difficult where teenagers who struggle with their weight truly want to make changes like cut down on junk food or stop ever eating, and they can't. There's frustration, isolation, stress, and that's why I decided to create a recipe collection of 30 easy and healthy meals for teenagers. They're all high in protein to satisfy your teenager's hunger and they can all be ready in less than 30 minutes. If you want to grab a free copy, go to lifestell14scom for the last recipes.

Speaker 2: 2:00

This is the Lifestyle and Weight Loss for Teens podcast. If you are a mom and want to help your child who is struggling to lose weight, you are in the right place. If you are looking for healthy lifestyle tips, dr Gorgary is here to help you understand the science around safe weight loss in teens and children, because what works for adult weight loss is not always the best for children. This podcast is for educational purposes only. Dr Gorgary does not provide medical, psychological or nutrition therapy advice. You should not use this information to diagnose or treat any health problems without consulting your own medical practitioner and now your host, dr Jenny Gorgary.

Speaker 1: 2:45

Good morning everyone. How are you? This is Dr Gorgary. I am here again to present to you another manuscript, another piece of excellent science that was done in children that were overweight, and I do hope that you find this helpful, as personally I believe is a great research, because it does have immediate practical applications and I'm here to share that with you and I do hope you will find it helpful and try to implement that right away in your life. Okay, so let's get started.

Speaker 1: 3:22

The title of this manuscript was Effects of Interrupting Scendentary Behavior with Short Bouts of Moderate Physical Activity on Glucose Tolerance in Children with Overweight and Obesity A Randomized Crossover Trial. So a little bit of a long title, but I just want to give you the exact title in case someone wants to actually find this manuscript and read it. But if I could simplify it a little bit, what the title is trying to say is that what the investigators try to do is try to find out what's the effect of interrupting the sitting behavior, even for small minutes, and not just having like going to the gym for an hour. But if you just could interrupt this prolonged sedentary behavior that is very common, not only about in children, but all children and adults as well, and if you interrupt this, does that improve your future risk for diabetes? So that was the main title. We're going to talk more obviously about this later on. So I also want to say that this manuscript was published in a high impact scientific journal that is called Diabetes Care. It's one of the biggest journals in the field of diabetes. It was published in October 2018. And the first leading author was Dr Mirada Brodney. This was done at NIH, which is one of the biggest research institutions in the United States. Okay, so now that we have this information, let me just give you a brief background or on. What was it that motivated these investigators to go into this research? Why did they do this? So, as I mentioned, it is well-established that doing exercise and being physically active is very important when it comes to prevention of future diabetes.

Speaker 1: 5:33

The American Academy of Pediatrics recommends at least one hour of physical activity in all children as a healthy measure to decrease the risk of future diabetes and other complications. We know that sometimes it may not be visible to allocate one hour every day in terms of setting up this one hour uninterrupted time, and some children do have this time. Let's say, if they have one hour where they play sports. They play basketball, they go soccer so you know that they're getting this one hour. However, we also know that sitting in front of a computer doing homework or watching a movie or even playing video games is also very common. And the question is, what if, instead of like while you're sitting there for a prolonged period of time, you don't collect three minutes to interrupt this behavior, three minutes every three hours? So it may be easier to incorporate that three minutes of physical activity while you're already sitting on the table and doing your stuff than allocating that particular day one hour to just go out and play or play sports. So if we do this small batch of physical activity that may seem not so difficult to do as it is like to allocate one hour, would that improve the risk of diabetes? So that was the main question.

Speaker 1: 7:15

Now, how did the researchers try to evaluate this? How did they try to answer this question? So, first of all, let me just say that they only focused on children, that they were already at high risk to develop diabetes, and that includes children, that they were overweight or obese, and so they had what we call the body mass index higher than the 85th percentile. They chose children between the ages of seven to 11 years of age and they excluded children that they had other medical problems. They excluded children that they already had diabetes or they had other hormonal problems or they were taking medications that they may have affected their insulin and their sugar. So they excluded these children because they only wanted to focus on what is the effect of this small batch of activity in otherwise healthy children that are just overweight. They also excluded children that they had early puberty or psychiatric problems or cognitive delays, again because they just wanted to focus on otherwise healthy children, that their ability to that, their risk for diabetes, would not be affected by something else besides those batch of interrupted activity.

Speaker 1: 8:50

So, in order to make sure that the children that they were participating were healthy, they asked them to come for a screening visit, as we call it, before they actually do the experiment, where they examine them, they ask them questions, and all that to make sure that they were healthy to participate. And then, once they agreed to participate and they passed the screening visits, they were giving a wrist accelerometer. Basically it's like a watch that they were wearing that could capture how much physical activity they did in their regular life for seven or 10 days prior to coming for the visit, and then, when they came for the actual visit, they asked them to have what we call an oral glucose tolerance test. And what is this test? Basically, they gave the children a certain amount of sugar to drink and, while this test lasts for three hours, this test is actually one of the tests that is used to diagnose insulin resistance and diabetes, and the way it works is, when you give someone to drink sugar, you measure after every 30 minutes what is their sugar level and their insulin level after they have a certain amount of sugar. So in patients that have what we call insulin resistance, or in patients and participants that have a high risk to develop diabetes, what you see is, when you drink sugar, your insulin hormone increases and your glucose also increases. So insulin is this hormone that is secreted from your pancreas and maintains a normal sugar. So higher insulin during this challenge, during this oral glucose tolerance test, indicates in simple terms that let me just say that your body has to produce a lot of insulin to be able to maintain a normal blood sugar so you don't get diabetes. So high insulin level after you have any type of sugar indicates that you have insulin resistance, which is a sign of an increased risk for future diabetes. So this is kind of like a standard test that doctors and researchers use to evaluate what's the risk for diabetes.

Speaker 1: 11:38

So basically, they brought kids in and they gave them to drink a certain amount of sugar and then during the three hours after the time that they had the sugar, as I mentioned, every 30 minutes they had to draw blood to measure glucose and insulin, right? So in one group of children they asked them to sit on the table throughout these three hours and don't move at all, only walk to use the bathroom. And the other group, they had a treadmill next to the table where they were sitting and they asked them to walk for three minutes every 30 minutes for three hours during this test. So the total walking time in those three hours was 18 minutes. So this is the small bout of activity. So it was three like just walk on the treadmill for three minutes every 30 minutes. So one group was just sitting there for three hours doing nothing after they had their sugar drink, and then the other group would walk for three minutes every 30 minutes after they had their sugar drink and then they measured what is their sugar level and their insulin level. Now they asked the participants to participate in both of these conditions. Let's call it so they would come another day to do both tests, like, for example, if one child came in one day and they had the uninterrupted sitting experiment one day, then they would come again after a week to a month later on and they would have the interrupted experiment. So each child participated in both of those experiments by one to four weeks apart. So I hope this is clear and the reason they did that is because they wanted to get more data and more information on what happens on the kids whether they have these three minutes of walking versus not having those three minutes of walking after they had their sugar drink.

Speaker 1: 14:09

Okay, now let's go to the most exciting part, which is let's see what they found and what the results were. So, first of all, they were a total of 48 children that they were screened for this experiment. 43 were selected to participate and 35 of them came and completed all the assessment. So the majority, you know they were almost equally distributed in terms of female and male, 40% of them were white, 5% were Asian, 40% were African American or black and the other kids were multiple races or unknown or Pacific Islanders. The average age of the kids was 9.6 years of the age plus minus 1.3 years.

Speaker 1: 15:08

They also looked at their pubertal maturation and they looked at their body mass index. They looked at what was their fasting glucose, what was their blood pressure, and they also looked at what was their insulin sensitivity. And when the researchers look at the insulin sensitivity, what does that mean? So insulin sensitivity is really a terminology the scientists use to kind of like measure this risk for diabetes. So higher insulin sensitivity indicates lower risk for diabetes, and there are specific mathematic formulas that researchers can use to assess this risk, based on how high does your sugar and your insulin go after you have certain amount of sugary drink. Okay, so what the researchers found was that the insulin during the periods where the kids had the interrupted behavior for three minutes was significantly lower than the insulin when the kids did not have that interrupted behavior and their sensitivity index, or what we call the insulin sensitivity index, it was higher in the group that had this interrupted periods of three minutes walking compared to when the group that did not have this interrupted. So higher insulin sensitivity again means lower risk for diabetes. They did not find differences in the actual sugar level and the measurements of cortisone trilisorides, which are some other hormones that also contribute to insulin resistance, but they did find overall during those three hours the overall insulin was significantly lower in the kids that took those total of 18 minutes during the three hour period time.

Speaker 1: 17:36

You want to know the actual numbers. It is, the units are a little complicated and I want to get into this, but the numbers were very different. It was 16,629.9 units per day, per minute, in one group that was exercise. It was 21,145.9 in the group that didn't. The numbers really don't mean anything to you, but I just bring this out to emphasize that there was a very significant difference on how high does the insulin go, even when you take three minutes walk every 30 minutes. So, and that is the main take home message, and it is also important to note here that the amount of average exercise activity that these kids had prior to coming to the experiment was not different. The amounts of how much food they were eating was not different, and that tells us that they were kids, that otherwise they behave pretty much the same in the two groups.

Speaker 1: 18:54

And what is the take home message from this great study. The take home message is that if you can get up and walk for three minutes during your daily homework activity, while you're watching TV, while you're playing your video games, please do that. It does count, everything counts. Three minutes of intense walking every half an hour can reduce your total insulin level, can improve your risk for diabetes. Again, it was a small study. It was only done in kids that they did not have diabetes. It was not done in kids that they were healthy weight and, of course, we don't have long-term data right After years. We don't have sustainability of this. We don't have like what happens if they do this multiple times versus doing it one time. So there is definitely way more research that can be done in this topic. So this was like a short study but had some immediate results, and the investigators are working to expand and look into other directions. However, I believe this by itself does give this important message.

Speaker 1: 20:26

So are you sitting somewhere listening to this podcast? If you do, stand up, walk for three minutes and continue doing what you were doing before, I hope you enjoyed this podcast and I hope you try to implement three minutes every day. In. When you're like sitting for a prolonged period of time. Just give it a try.

Speaker 1: 20:52

You may be surprised that it's not so difficult to perform that, and, of course, that does not mean that they should replace your scheduled activity, right? That was not my intention. Like I don't want you to say, oh okay, I took my three minutes, there is no reason for me to go out and play sports. The contrary, this was like a supplement, like. This was like if you feel that this is something you can do, it may be easier for you to do, or it may be easier for you to start with that, or it may be easy for you to add on on your regular activities that you do. Please do so. It is a fun experiment, in my opinion. Well, I hope you enjoyed it, and that was all I had for you today, and I'll talk to you soon, next week. Take care, my friends. Bye-bye.

Speaker 2: 21:46

If you enjoyed listening to this podcast, I invite you to come check out the LISP program. It's Dr Gorgary's 12-week coaching program for teens and their moms, where we take all this information, we apply it to your daily life and we work together so your teenager learns how to create a healthy lifestyle so they can feel happier, more confident, less stressed and love their body again. Visit the website at lifestyleforteenscom and click on the work with me and free resources to learn more about this program and get free help to start this journey right away. Thanks for tuning in and we'll catch you in the next episode of Lifestyle and Weight Loss for Teens.