Cycling CME

A unique CME learning experience for Physicians, PA-C's, and other Medical Providers who love to bike

Active CME:  Combining Continuing Medical Education (CME) and Bicycle Touring for the Healthcare Provider

Filtering by Tag: Exercise

Cycling and Diabetes Prevention

We have clear epidemiological evidence of the strong protective effect that regular exercise has on decreasing the incidence of cardiovascular disease, diabetes and some cancers. Although it is challenging to get individual patients to exercise more, increasing the general population’s activity level would have significant impact from a public health standpoint. Active travel (walking or cycling) is another way to incorporate physical activity into daily life. Many studies have shown the relationship of active commuting and a decrease in cardiovascular disease while more recent studies have evaluated the association of commuting and the decrease in the risk of developing Type II diabetes.

One of the first studies looking at diabetes was a large population based study by Rasmussen et al which examined the associations between recreational and commuter cycling and the risk of type 2 diabetes (T2D) in Danish adults, while taking into account personal and lifestyle habits. They followed over 50,000 adults between 50-65 years old who were initially free of T2D, for the next five years. Over that time, 7000 people in the study developed T2D. The study found that both commuters and recreational cyclists were associated with a lower risk of developing T2D. Interestingly, a late-in-life initiation of cycling also lowered the risk of T2D. These findings are important as the percentage of patients with diabetes continues to increase and health care looks at ways to both treat and prevent this disease.

A commentary by Panter and Ogilvie also noted the importance of the finding that those who took up cycling after the study began benefited and had a lower risk of developing T2D. They suggest that it is not too late to gain the benefits of taking up cycling, even in this age group. However, they also point out that while cycling is clearly successful in Denmark and the Netherlands, Panter and Ogilvie reference a similar study by Sahlqvist et al on adults in England which reported a much smaller quantity of cycling in adults. They ask the question of how other countries might increase the amount of cycling to attain health benefits as seen in the Dutch study.

As we have mentioned here before, the physical environment is an essential part of the planning to promote increasing active travel, both walking and cycling. Is the environment safe, available, and convenient for walking and cycling? Those factors directly correlate to the amount of recreational and/or commuting, both walking and cycling. Panter and Ogilvie champion the idea of how improving the accessibility and safety of our walking and cycling environments will improve public health. This is described as an “upstream” or primordial intervention which will lead to disease prevention.

As promoters of the benefits of physical activity and cycling, we should educate our patients, family and friends on the health benefits of exercise. In addition, we should educate our local officials on the benefits of a safe and convenient environment for walking and cycling for our community. Safe walking and cycling access should be a priority of local and national governments. This will benefit us all.

References:

Rasmussen MG, Grøntved A, Blond K, Overvad K, Tjønneland A, Jensen MK, et al. (2016) Associations between Recreational and Commuter Cycling, Changes in Cycling, and Type 2 Diabetes Risk: A Cohort Study of Danish Men and Women. PLoS Med 13(7): e1002076. https://doi.org/10.1371/journal.pmed.1002076

Panter J, Ogilvie D (2016) Cycling and Diabetes Prevention: Practice-Based Evidence for Public Health Action. PLoS Med 13(7): e1002077. https://doi.org/10.13

Cycling CME

Get America Moving!

Get Moving America!

The Department of Health and Human Services published the second edition of, Physical Activity Guidelines for Americans, this week in the Journal of the American Medical Association. This edition has the updated recommendations for physical activity for the first time in ten years. As they noted in their report, the main recommendation is, “Get Moving America”. The guidelines have many of the key points as first outlined in 2008; however, studies show that only 20% of Americans meet those recommendations for activity.

While the guidelines are similar to 2008, they do include areas with new research demonstrating evidence for the health benefits of increased physical activity. The studies showed that increased physical activity improved health and weight status in young children, improved cognition in youth, reduced risk of cancer at additional sites, more brain health benefits, improved sleep, reduction in falls in the elderly and improved quality of life.

One of the newer areas of emphasis includes the importance of increasing movement in the lives of the sedentary, even if in very short increments. The previous message was using at least 10-minute increments of aerobic activity toward the goal of 150 minutes per week. The message in the 2018 guidelines is that all movement is helpful. For individuals who are very sedentary, even adding light intensity activity reduces all-cause mortality, decreases cardiovascular disease and reduces incidence of type 2 Diabetes.

The guidelines also review a summary of the literature on promoting physical activity and note the following: individual level interventions by medical providers can increase the amount of physical activity in youth and adults especially when based on behavioral change theories. Therefore, the message from providers must include increasing physical activity. In addition, other research shows that multi-component school based programs can be effective and improving the built environment is essential to increase safe physical activity.

At Cycling CME, we believed strongly in the importance of physical activity in the treatment and prevention of chronic disease as well as improving quality of life. As medical providers, we have an obligation to encourage and guide others to make physical activity an integral part of their lives. Have an active day.

Cycling CME

References:

Piercy, KL, et al. The physical activity guidelines for Americans. JAMA. 2018