S Ravi, 49, who lives in Washington, DC, US, writes in an email interview: “In 2011, I was diagnosed with both high blood pressure and type 2 diabetes. For a person who led a very active life with no history in family, was vegan, and who took pride in being fit, the diagnosis came as a shock. Not wanting to start taking medication right away I started with a lifestyle change. It was not just about the revision of my diet but also about walking whenever I could, every single day. After several months, I found that my fasting blood sugar had come down to the prediabetes range."

Prediabetes is a condition where the person’s blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes. “Since then I have been consistent with my walks and now walk up to 5 miles (around 8km) daily. I don’t need medication for my blood sugar yet and am hoping that I won’t need it in the near future either," writes Ravi.

Many people with prediabetes get diagnosed with diabetes within a decade. But Ravi is unlikely to be one of them as long as he sticks to his diet and exercise regime, says Shashank Joshi, consultant endocrinologist, Lilavati Hospital, Mumbai. “I have many such patients who have successfully been able to keep diabetes at bay with a disciplined lifestyle. It requires motivation and discipline but can be done." In other words, it’s difficult but doable.

And while walking 5 miles every day may seem a lot, the new physical activity guidelines for healthy Indians, published in 2012 in the Diabetes Technology And Therapeutics journal, suggest 60 minutes of a combination of moderate-intensity aerobic activity, work-related activity and muscle-strengthening exercises. In comparison, the American Heart Association, a non-profit, suggests just 30 minutes of aerobic exercise five times a week, plus two days of strength training, for healthy Americans, essentially white Caucasians.

So why is it that Indians need to exercise more than white Caucasians? It turns out that we lead more sedentary lives and eat a more energy-dense diet than our forefathers did. Doctors and researchers believe that a sedentary lifestyle plays a critical role in the development of type 2 diabetes and cardiovascular heart disease among Indians.

And this isn’t a recent theory, it has been around for a long while. According to a 2013 paper published in the Journal Of The Association Of Physicians Of India, the Charaka Samhita, a foundational text of Ayurveda, has over 120 shlokas or aphorisms on exercise. Each chapter of the text prescribes certain kinds of exercise for certain diseases and clearly states that exercise can minimize the symptoms of, or even cure, over 20 different diseases, including obesity and diabetes.

Western medical literature has established that regular exercise helps reduce blood pressure, maintain a healthy weight and increase the levels of HDL cholesterol, the kind of cholesterol that is cardio-protective. HDL scavenges the harmful cholesterol and prevents it from damaging the heart blood vessels. Regular exercise is also great for managing work-related stress because it helps eliminate stress hormones from the bloodstream, thereby reducing the harmful effects of stress, improves circulation of nutrients, induces fatigue (therefore improving sleep), and regulates appetite.

Stress can predispose us to a host of illnesses, including diabetes and heart disease. The mind can get used to gradual increases in stress and “forget" that it is stressed. The person continues to function as if nothing was the matter, but it can precipitate disease. It’s a bit like the “boiling frog" experiment, often used as a metaphor to explain how coping with gradual change can have disastrous consequences.

The experiment goes something like this: When a frog is thrown into hot water, it jumps out immediately, but when the same frog is put in water that is heated gradually, it boils to death. While the experiment isn’t entirely accurate, it makes the point quite effectively.

So what kind of exercise do we Indians need to do for an hour each day? Anoop Mishra, director, diabetology, Fortis Flt Lt Rajan Dhall Hospital, Vasant Kunj, New Delhi, says the exercise needs to be broken down into 30 minutes of moderate-intensity aerobic activity like brisk walking or biking, 15 minutes of work-related exercise like taking the stairs in the office building or walking during breaks, and 15 minutes of muscle-strength training with light weights. If that sounds like too much of a prescribed plan to fit into a busy life, he suggests, “Change the way you take a break in the office." At work, you could take a walking break instead of a coffee or doughnut break.

A study published in the journal Applied Physiology, Nutrition And Metabolism in July shows that taking frequent active breaks of 5 minutes from work can manage blood insulin levels the same way that sustained 30 minutes of moderate exercise can when the same amount of energy is expended. When asked about the research results, Dr Mishra says: “Yes this may be true, but for us Indians, we must do both. Be as active as possible in the workplace, and exercise outside too."

American explorer and educator Dan Buettner has researched the way the world’s healthiest and longest-living people go about their lives. In his book, The Blue Zones—9 Lessons For Living Longer From The People Who’ve Lived The Longest, Buettner writes that walking is a simple exercise that all centenarians do, almost daily.

I am going to put on my sneakers and go for a walk now.

Sujata Kelkar Shetty, PhD, is a wellness consultant and a clinical scientist trained at the National Institutes of Health in Bethesda, US

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