Recover: Small Moves, Big Impact On Diabetes

Introduction and Debra Atkinsonu2019s Background 0:00

Hi, everyone. Welcome to the Reversing Type 2 Diabetes Summit. I'm your host, Dr. Beverly Yates, ND, and it is my distinct honor to interview Debra Atkinson, a fitness professional who brings so much expertise, guidance and science evidence base to her work. And her work focuses on women who are 40 plus years old, using the latest in science and research and physiology and exercise best practices to really help women have the strength to live the rest of the year as the best of their years. Debra, would you introduce yourself to our audience, please?

Absolutely. And thank you so much for having me. So. Well, this is year 39 for me full time in the fitness industry. I think that's an important acknowledgment to me. There are a lot of fitness professionals who've worked in the business for a long time, but when it's part time, it's a little bit different. So, you know, the toilets backed up. You call the plumber, not the handyman. Right? So and there's a reason for that. You know, what keeps me going is this you know, I quit everything. I left safety and security ten years ago when I was 49, started over and dedicated an online business to women, Flipping Fifty in any stage of perimenopause, menopause, transition or post menopause.

So as you've said, women over 40 generally can be actually women slightly younger. But we're talking all the way to the end. So Flipping Fifty is not the five zero. It is the the second half. How do we do it better? And I think what kept me, what got me there was I had been working with those midlife women for 30 years, not knowing I was doing research, but I'm tail end of the baby boomers. So it was easy for me to relate. And I had so many of them as clients. And when I realized they kept hearing, We're not being served, nobody gets us, my doctor just said, Well, welcome to menopause.

There were no real answers. And then I dove into the research and found that only 39% of all exercise sports medicine research features women. And when we look at hormonal phases, that means potentially seven different unique hormonal phases. If you if you go through infertility and you're doing support with that, that's another one. And that means if we divided all that up, very little research pertains to any one phase of life, hormonal life that a woman is going through. I focus on perimenopause because it's the most volatile and significant to our health for the next 50 years.

That is the reason I'm still here and I still love to get up out of bed in the morning and do what I do. You know, I've taught on all sides in the private sector, taught at Iowa State University as a senior lecturer in kinesiology for 15 years, and I am the master trainer for trainers and fitness gurus. I have a unique perspective about what consumers want because I'm 59 in the boat rowing with you. I know what we want them to know. I know what they know when they come out of school or have a fresh certification.

And again, what we need them to know and I'm trying to close that gap. Wonderful. Thank you so much for introducing yourself. So audience, please listen up, because there was an absolute expert here and has the professional experience, the lived experience, and have seen the difference me in her clients lives. So let's dig in here for the things that are going to be important for reversing type 2 diabetes and pre-diabetes. Right? So, Debra, please tell us what are the three things that are most important in starting exercise, specifically, specifically friends to make changes and to support blood sugar, insulin resistance, or type 2 diabetes control?

Number one, I think before you even start, before you put your shoes on, before you lace up, get your weights or think about what you're going to do, you need to look at where are you right now, Like do a just a self assessment.

Exercise Priorities for Blood Sugar and Insulin Resistance 4:07

No one else should touch you before you assess where am I? What's my level of fatigue and or energy. You're on one or the other side of that fence. We're not neutral, right? I mean, we're either. I'm pretty good with my energy. I'm a seven or an eight on a one through ten scale or no, I'm a two or a three. That should dictate where you begin. And often we instead we look for tell me exactly what to do. But if that person answering the question doesn't ask, where are you now? What's true for you?

So we've got to guide ourselves, you know, first with what do we need so that we don't dig ourselves further in a hole. If we are tired, we start climbing back out of that hole. And if we deserve or need a little bit more stimulus because we're already feeling pretty good. We also dedicate ourselves to the fact that we've never needed intensity more in our lives. We are not delicate. I mean, look behind you, girlfriend, and all the things you've done in your life that got you right here. You are not delicate and we don't need chair aerobics.

Yeah, right. So it's first. Where are you? Number two, We need to realize that, especially where it is, where we're talking about insulin resistance, where we're talking pre-diabetes, or working on reducing our insulin resistance, improving our blood sugar levels. Muscle is your best friend. So we need to look at where's our muscle. Now, again, that could be measuring it. So if you only have a bathroom scale that says this is how much you weigh, I would highly consider finding something that will tell you what is your muscle mass?

Where's your lean muscle mass? Sometimes when you do a bone density scan, if you ask ahead of time, they can tell you that as well. Many doctor's offices now or gyms have a place where you can go and we can all buy a smart scale, an affordable, smart scale just to have in your bathroom and and don't get too caught up in it. Are they accurate? Because here's the thing, if it's off, but when you weigh again, it's off exactly the same. You're seeing change. That's the most important part. So don't get hung up on the numbers so much.

All right. But we need to know that we're gaining muscle, at least maintaining muscle and certainly not losing muscle. That's your feedback. That's your data. So we don't have to know first where we are. We have to know what's happening as we start and when we progress. And then you want to constantly be working on change. So we do need the mobility. We need some amount of aerobic work, but we need a probably lower percentage of aerobic work than we ever did before. It takes far less than we ever knew, and many of us are super stressed.

What we really need is to go out there and be moving to decrease our stress level more than we need to huff and puff and get out of breath. That's great. Thank you for that summary. That's really clear. All right. And encouraging and encouraging. It sounds like you're saying do specific things as opposed to do all the things all the time. Correct. Yes. And that's that's a great point. We want to have purpose. So you want to prioritize what's my number one goal? What do I need? Do I need strength?

Do I need energy or two to get out of fatigue, getting more energy? Do I want to work on bone density? And obviously we're talking about blood sugar levels and insulin resistance. We're potentially talking about improving body composition, but we may be juggling several goals. I mean, don't we want it all? I mean, most of us would put our hands up multiple times. But something is goal number one. Goal number two, goal number three. And if you know that, then in session in those exercise sessions, we can prioritize what's my protocol?

What am I going to do? Great. Thank you so much for that, Debra. Okay. So then that leads us to our next question, which is what mistakes do we make that keep us from making the kind of progress that we want? Well, we are creatures of habit, right? So if listening, please reflect on this. And when you got up this morning, did you do the exact same thing you did the morning before, in the morning before? You know, you get up, you go to the restroom, you go to the kitchen, potentially you hit that button on the coffee maker or you're heating up the hot water and you grab your favorite mug.

You sit in your favorite chair. Exercise is really no different. It's really easy to default to doing the same thing over and over again. And that's not to say that you don't want to lift weights on a regular basis, for instance, but we want to vary the sequence that we do exercises in.

Common Workout Mistakes and How to Start Safely 8:55

We want to vary the number of repetitions or the number of sets in the exercises that we do. So doing too much of the same thing for too long will make the perfect workout for you today. Absolutely wrong for you in three months because your body is so very smart. It will adapt. We keep wanting to surprise it. I don't like to use the word shock your muscles, but. But we do want to continue to create overload in a new and a fresh way because life is very different and we need to make sure that all of the things that we're doing when we're raking leaves one season shoveling and sweeping snow, another, we can do those too.

Okay, great. So with this in mind, how can we make this easy, specifically easy to start easy, the reap the rewards and then to have the desire or to want to keep going to be consistent. I'm going to start and go backwards. How's that? So, you know, when we say how do we start and keep going? Because the other the other parts of the answer are irrelevant. So if we don't do that. So number one, I think start small, start so small that you would finish and say, I could have done more. Fantastic, you're in the right place.

Because if we finish and we go to the edge and all over it, we're going to pay for that. In terms of what I call count compensation. Now we feel we've actually slowed down. We're going to be wanting to rest more a little bit more sooner than is optimal. And some of us don't like to feel that more than others. I think you need to know yourself. Some of us are the milliner with that comfortable soreness of new muscles and we kind of like and encourage it. Others of us shy away from that. So know who you are and allow yourself and or anybody else who's working with you to say, Don't take me there.

I just want to go to the edge, not over the edge so that I'm comfortable between sessions and you're building your confidence. So at the very beginning, there is nothing more important than building confidence. And here's why You're actually not helping yourself accelerate results if you're at the starting line. Just beginning your first 6 to 8 weeks of any exercise program are about the neural connections of your brain to your muscle. That signal getting stronger. It's like ringing ding ending, it's calling it up greenie.

Ding, ding. And that signals getting stronger over those 6 to 8 weeks. But it can't be hurried by lifting a heavier weight. So build a foundation with lighter weights, good form quality repetitions in everything you're doing, and then gradually you can increase that weight in 6 to 8 weeks later. Now you've got a really strong foundation in your ligaments and your joints, and your risk of injury is very low. That certainly makes sense. Thank you for breaking it down for us. So then what are the ways that you recommend for measuring success people have started? How do they now measure success?

Oh guys, this is such a great question. Thank you for asking that. So a lot of times, you know, we look at the destination and we we think our goal is weight loss. Even if you've got a side goal, blood sugar levels, I want to keep them down. I want to stay off medication. I maybe want to reduce my medication. If I'm on medication and we look at that. But yet we want the scale to change because it's been so ingrained, so conditioned for so many decades that that one's a hard one to lose. And here's what you want to look for the Hansel and Gretel breadcrumbs that get you back to home.

And here's what that feels like. You're sleeping a little bit better. You have more energy throughout the day. Your cravings are disappearing, your appetite is normalized, meaning you have an appetite at meal time. Other times not so much. You're full, you're sated, you're comfortable, you are maybe noticing your clothes fitting a little bit better. And you might, if you are human, do this, you might list all those things. I'm feeling better, more energy, I'm stronger picking up more weights. My clothes are fitting better. But I weighed and I didn't want to change.

I didn't lose any weight. And so suddenly you may sound dejected, even though everything was right and you can tell you're going the right way. The destination is not showing up yet, but this is just like Siri or your GPS in your car. You don't actually see the destination when it's telling you you need a right turn up ahead, then a left turn. You still can't see the destination. But we trust that darn thing, don't we? I don't know how I ever got anywhere without it, but you need to have that same trust in the signs and the symptoms that I'm feeling better.

I must be doing something right because your body is going to start showing you all of those signs probably before you release weight. So what for the other things, watch for maybe your girth measurements going down around your waist, your belly, those things are still an indication you're on the right path. So don't get stuck in the other the scale and the weight. And if you have a smart scale, you may see the percentage years of fat go down and muscle go up without the weight changing. Still great news.

Absolutely. That was so clear. Thank you for walking people through that because, you know, you're absolutely right. I've certainly noticed it clinically. People are sometimes disappointed if they don't lose weight right out of the gate, but their measurements are changing how they move, how they feel in their own skin, you know, their power, their strength. All of these things are improving. The numbers will move later on the scale. Okay, cool, cool. All right. So in addition to being a kinesiology, which is a science of movement expert

Measuring Progress Beyond the Scale 14:49

who specializes in hormonal supporting in hormone excuse me, supporting exercise, exercise, it supports hormonal balance. You're also an exercise psychologist. I think the psychology of it is critical. So good for you. I'm glad to know this. With over 40 years of working with your clients and trainers, the people that you train, so you also work with the actual client and you work with trainers. So they do a better job with the people they serve. Right? Which is wonderful. You're spreading your expertise.

What is it that determines whether someone will be successful or not? You know, really, I think making up your mind, number one, that you're going to do this, that this is actually going to become a lifestyle habit it's not necessarily attached to I have to reach this destination in X amount of time. Goals are good, don't get me wrong, but I will be contrarian to the smart goals that so many people seem to love. Having done this for 40 years, do you know that smart goals I think are dumb? Because the one thing we don't factor in is there will be obstacles.

You know, and there is no smarty for the obstacles. Like what will you do when your mom is hospitalized and you're the caregiver? What will you do when Because fill in the blank, something will happen. So I think those things are really important that it may not be perfect, but the best laid plan will go wrong. And so those people who are most successful have an optimal the plan, Right? The optimal plan that here's here's the way I'd love the workout today to go, the week to go. Then there's a plan B When you get a little too busy, you get a little bit too much to do, or you're just energy isn't quite there.

And then there's plan C and that's your if all else fails, I do this. And the biggest reason is what you just mentioned, these six inches are far more important than the any inches down below, because if we don't get the message that I am someone who exercises me, who moves my body regularly, it's just a part of what I do, the same as I brush my teeth every morning and every night. We need to get that message through. So it's the have an optimal plan, have a plan B and have an if all else fails, this is at least something I do on a daily basis.

That's great. That's great. The power of self-talk, you know, whatever goes on between our ears, like if you think you can, you're right. And if you think you can't, you're right either way. So in matters, I've noticed when people get disrupted, often it has to do with things that are absolutely out of their control. The things that you were talking about right. Like life is suddenly, you know, kind of knocked you off balance. Now what? And if you've got good habits in place, it's easier to stay on track if this is new for you.

But right then you have to give yourself some grace, some patience around that. What is there a story or two you could share of people being able to be successful in that? Because I bet people in this audience for University and Type 2 Diabetes Summit will recognize themselves. My experience with the diabetic world has been many of the people are so generous in giving and they tend to be the people who are the rock in their community, their workplace, their family, their neighborhood, whatever their social world is like.

Many aren't so good with the word no like no is a complete sense. So if you have a story or two you could share since you have such a rich career there, I think that would really help people. Yeah. I'll share a couple testimonials from former Stronger Program and that will probably pull also another little tidbit of people who are successful. You know, I think if there's a range, let's say you're applying for a job, if you're applying for a job with me and we say the compensation is between this and this, you're thinking this.

The higher I'm thinking, the lower right. So a range sometimes is not a wise thing. I can't tell you how I know that. But when we're talking exercise, when what we know about strength training, especially for midlife women, and this pertains really to middle and older women and men 2 to 3 times a week, strength training is recommended. Now, here's diving into the research. There's not a difference in the benefit between two and three times a week. So sometimes it is wiser to take the low road, take the two, especially if you are a female, because their risk of adrenal fatigue and overdoing it is far greater actually than under doing it.

In my experience, in working with women, we tend to overdo and push. We also tend to underrate. While we're overdoing and pushing stress and stress tends to actually do negative things to blood sugar while we're trying to do positive things with the exercise. So take the low road, do the least viable thing.

Mindset, Consistency, and Real-Life Success Strategies 19:48

And I call this the MVP, the minimum viable physical activity that you can do to get results and not over tire yourself. So it comes right back to do the least. And we do that in our program. We do twice a week strength training and often people will say, This is the first time I've stuck with it. This is the first time I've done every workout for 12 weeks in a row. This is like phenomenal. These are women in their fifties and sixties. That's that's a pretty big deal. And I think the other the reason is we start in January and we start five or six day a week programs expecting that even though in December we didn't do any that suddenly that's a good idea.

And I say we collectively because in my lifetime I have done the same thing. We all tend to bite off more because it just sounds good. We like thinking about ourselves like that, but that's just a gap. We're not quite ready to assume that full time yet. So I think start small. And here's the other one, and this is going to sound like a shameless plug, but whether it's with us or somebody else, sometimes paying makes a difference. Paying for something that's going to expire. One of the biggest downfalls of lifetime access, lifetime memberships and I'm not talking about the name brand club, just having access eternally is there is no urgency.

There's no reason for you to go today. And that's not necessarily a good thing. That's real. It's called human behavior. Right? We honestly need something KING Or someone to keep us on the hook. So I think we all look for how do I, you know, not be on the hook? I don't want is this going to expire? And I say, yes, Yes, it is. So are you Sooner or later, that's up to you. Well said. Well said. Yeah. It compels the urgency point of view. Right. Because otherwise it's easy to say, oh, I'll get to it tomorrow, I'll get to it next week or oh, I'll get to it next month.

And when those start to accumulate, we're in trouble. Friends. Yeah, Yeah. Your muscle mass is your friend when it comes to blood sugar, you know, just like fiber is a blood sugar sponge. So are active working muscles. They are blood sugar sponges. Okay, So can you paint a picture for us of the most common mistakes you see people make, particularly in this age group? Mm hmm. Yeah. I think number one is shying away from strength training for fear of getting hurt. And and I would be contrarian to that and say your likelihood of getting hurt is far greater if you're not strength training than if you are.

And obviously, we're talking a reasonable, safe, sane program. You know, find an instructor whose Qs make sense to you, who potentially knows when you need to hear a cue before you know to ask where that Q is or how is it. So they're telling you, how do I set up? How should it feel while I'm doing it? Where should I feel it? Where should I not? All of that. So very important. So that's number one. I also think it's it's twofold. So it's it's not being in your sweet spot. So for a lot of beginners and or for a lot of women who have been doing it for a very long time, they tend to pick up weights that are lighter than they could actually handle.

We need to reach muscular fatigue, which is very different than the the lethargy that is overall tired all the time, just muscular fatigue. When you're doing a set which might be ten or 12 or 15 repetitions, for instance. But by the time you're at that very last two or three, you should be feeling, I'm actually starting to cheat the muscles not working or coming in to play. So I think it is not being in your own sweet spot and fearing that that's going to hurt you. So the difference is you put that weight down 30 seconds to a minute later, you can pick it up and you would be fine.

You'd be able to lift it again. That's probably not quite enough rest. But the example is just it's temporary fatigue. You do want to reach that point. If you're doing three sets of exercise, set one, set two and set three. Don't think by the end of set three. All fatigue. No, set one, make that one count. So making sure that to your that to your point you're getting there. That's called overload and it's one of the components of fitness. We need that overload during the exercise so that between exercise before we do it again several days later, the muscle super compensates and that's how we're able to lift a heavier weight later.

Thank you. Let me fix that. I'm thinking for some people that if they're in the early days of resuming exercise or getting back to it, that one of the things that they are probably dealing with is fatigue. Diabetes is famous for the fatigue that people feel. Do you have any tips you can suggest for someone who's looking to get started and staying with it that they may just need to climb over and get some energy going? What would you suggest? Yeah, absolutely. So rather than take those great big workouts where you're talking 30 or 45 minutes or longer and take them in small bites, so you're looking at maybe you go for a ten minute walk, you go out five, come back, five.

How do you feel? If you're feeling good, you can do a little bit longer, but give yourself that ten minute rule. And if you're feeling like, you know, I know I'm tired, I'm not feeling it today, then okay, you're done. But in here, you got that message. I'm somebody who does this regularly. You start to raise that ceiling without overexerting and exhausting and breaking that up into, say, a walk in the morning and a walk in the evening, maybe better. A recent study came out that said even 2 to 5 minutes of moving, breaking up sedentary times, like 2 hours of sitting actually decreases blood sugar levels after meals by 17%.

You were probably the first one out there shouting about that study.

Exercise for Fatigue, Mood, and Daily Blood Sugar Support 26:18

But that's how much proof we have. That little bits of movement. You know, we don't necessarily have to think of it as exercise. You can dance around in your living room, you can march in place in your living room or go for a walk or bike ride or your your favorite activity. But it's that movement of the muscle so that you use the blood sugar that improves it even much later in the day. Absolutely. These are some of the precious gems. So anyone who's listening here, who's really struggling with blood sugar control, please know that exercise can be smaller amounts like there was this shared.

It could be exercise snack, so to speak. This is the only kind of snacking I advise if you're a type 2 diabetic, type 1 to have a different situation plan specifically for type 2 diabetes and pre-diabetes in general. Exercise snacks are a great way to go. So if you can't put together 20 to 30 minutes, 40 minutes of exercise, the 2 to 5 minutes, 5 to 10 minutes, but keep moving throughout the day. Priceless. Priceless. All right, Debra, in your experience, have you found that when people start to feel better and they're exercising and they are enjoying themselves, they're finding it that this is good?

It's not that they're not too sure, they're not in pain, they aren't uncomfortable. What tends to happen next? You know, people change. You know, the words that come out of people's mouths are the kind that, you know, makes a fitness professional get up in the morning. It's you know, I started this for weight loss because so many of us do. We start it for vanity reasons. There's a wedding, there's a reunion. There's I'm just not happy. I started it for weight loss and I got my life back. You know, those kinds of comments, those are big.

You can't ask somebody to say that, You know, I have another favorite client, quote, came out of the blue and I we happened to have a television camera in the room because we were shooting commercial. I said, turn that camera right over here, please. She said, I don't care what the question is. The answer is exercise, right? Yes. Yeah, yeah. So now we my next question here for you, which is share with us what the value is of exercise specifically for mood regulation. Many people with diabetes and all of the blood sugar rollercoaster, you know, they ride blood sugar rollercoaster happening, they come crashing back down.

You know, that whole phenomenon. What is the experience that people can look forward to with exercise as it applies to mood, especially if they tend to be depressed or anxious? Yeah, well, and women are so prone. So women over 65 are among some of the highest ranked, you know, rates of depression and or anxiety. And what we know for sure about depression is more related to cardiovascular exercise. And I'm talking walking. So I'm not talking. You've got to get breathless or go jogging in order to get this.

But there's a trilogy actually, that is almost as effective or more effective than cognitive therapy and medication put together. That's not a recommendation to stop if you're on medication, but to watch and observe. But sunlight getting outdoors in the sunlight movement, say, walking and venting with friends. For women, that is like an SSRI. That is like taking a dose of medication. But get it, no negative side effects. And and what we know about strength and resistance training is what I have found is it's much more beneficial for those who have anxiety.

And I the correlation I believe to be you don't have to get out of breath, you don't have to get sweaty. So it's a lot less intimidating. And it's fantastic for reducing cortisol because of the way you work is the way cortisol is meant to be used. We have a short minute where there's a high elevation of exertion because you're pushing against the weight, but then you stop and there's a break in between. So the breath rate, the anxiousness or the buildup of adrenaline simply isn't there. It's allowed to release in between in just many sets of work hard recovery, work hard, recover, which is really what life was meant to be in the first place.

We've just made it something, something else. Yeah, we like for something else right now, for many of us, that's for sure. Debra, thank you for being such a beacon of light and hope and positivity and, you know, evidence based results, right? And the work that you're doing with the people that you serve, where can folks who are interested in contacting you find more information about you? How do they connect? Absolutely. So we're everywhere at Flipping Fifty and you can find me at flippingfifty.com That's words all spelled out.

And on social media, Instagram, Facebook and YouTube, particularly lots of content for you to consume at Flipping50 TV. All right, great. Thank you so much for being one of our experts here. Frans, as you watch all these sessions, please share this with other people that you know can benefit from the wonderful information that Debra and our other experts are sharing. These are people who dedicated their lives to helping everyone have a healthier, happier quality of life. All right, Debra, thank you for partnering with me on this.

Appreciate you. Thank you so much for having me. And thanks for the work you're doing here. You're very welcome.