Studio Bungee Rehabilitation and Fitness Boutique. The 1st Astrodurance Bungee Fitness in Georgia.

I have the extreme pleasure of contributing to a very unique fitness studio called Studio Bungee (www.studiobungee.com. The very first Astrodurance bungee fitness boutique studio in the state of Georgia.

This award-winning rehabilitation fitness boutique has helped so many people struggling to reach their goals of weight loss, post-physical therapy, adaptive equipment limitations, exercise therapy, nutrition, lack of flexibility, and mobility.

So many people in Georgia are suffering from MS, STROKE, ARTHRITIS (RA), JOINT PAIN, POST SURGERY, HIP REPLACEMENT, KNEE REPLACEMENT, SCIATIC NERVES, CANCER, DIABETES, LEVEL 2-3 OBESITY any many more lifestyle diseases. They need to exercise but feel like it’s too painful on the joints. Or, they feel like it’s too challenging for them to complete the exercises they need to lose weight and/ or gain mobility and flexibility.

The Astrodurance Bungee System is a revolutionary rehabilitation and fitness exercise system. It is a motion-based exercise regiment that defies gravity and provides low impact exercises that are easy on the joints, but it’s guaranteed to rev your cardiovascular system within 15 seconds after starting. It will raise your metabolism, increase your stamina, endurance, flexibility, increase cognitive awareness and productivity.

It gives the user the ability to perform exercises they may not be able to perform naturally without the assistance of the bungee like pushups, jumping jacks, planks, running, burpees, and more. It will reduce blood pressure and put less pressure on their joints giving the user the ability to perform exercises for great results.

The bungee cords are set to your weight plus 30-40 lbs of resistance to immediately engage the core muscles and the glutes to help stabilize the body to increase balance, build lean muscle, burn hundreds of calories and spike the user’s metabolism in the process to deliver maximum results.

As a seasoned fitness professional, I am really amazed at how quickly I can get my heart rate up, build lean muscle, burn calories, increase my conditioning, and performance. It’s one of the best workouts I’ve had in years. I have shaved off 2 inches of my waist in less than 1 month and reduce body fat by 5%.

Now I have the knowledge and understanding first hand of the bungee fitness and rehabilitation workouts and can deliver quick results for clients. Especially for the clients who have challenging physical and mental “limiting factors” like, bending, jumping, joint pains, or recovering from a Stroke.

The results are amazing and the clients love the variety of classes and exercises from each trainer.

Classes are 30 minutes of fun, effective, high energy, motivating, and inspiring to keep clients coming back for more. Clients are happy with their progress and are trusting the process to succeed in their goals.

I highly recommend people to try one of Studio Bungee’s nutritional, Ab, flexibility, dance, introductory, all level fitness, yoga, and adaptive equipment classes.

Or if you’re finishing your physical therapy or chiropractor sessions let Studio Bungee’s Certified Personal Trainers assist you with furthering your goals TODAY.

Reach out to Christal McNair (owner) at 770-693-2630 or visit http://www.Studiobungee.com for more information.

Here’s to your health,

Terrance Hutchinson

Certified Fitness and Nutrition Specialist.

Hоw Tо Mаіntаіn A Hеаlthу Wоrk-Lіfе Balance

Wе аrе living іn a digital аgе and аrе аlwауѕ соnnесtеd tо оur соmрutеrѕ, tаblеtѕ, and ѕmаrtрhоnеѕ. Juѕt a few dесаdеѕ аgо, whеn the wоrkdау ended аt 5 PM, workers packed uр аnd turnеd thеіr minds off for the evening. However, bесаuѕе of оur соnѕtаnt соnnесtіоn through tесhnоlоgу, сlіеnt emails, рrороѕаlѕ, аnd projects hаvе bесоmе a раrt оf the tіmе ѕреnt оutѕіdе оf the оffісе. These extra hours аnd іnаbіlіtу to step аwау from work hаvе саuѕеd mаnу іndіvіduаlѕ to саll fоr a work-life bаlаnсе, whісh рlасеѕ еmрhаѕіѕ оn jugglіng work аnd mаіntаіnіng a personal life wіth fаmіlу and friends оutѕіdе оf thе оffісе.

Thеrе аrе mаnу people оut thеrе whо wish to kеер themselves hеаlthу and fit, but not all оf them аrе аblе аnd willing to take саrе of thеmѕеlvеѕ. Many people rеmаіn caught up іn thеіr dаіlу соmmіtmеntѕ аnd wоrkіng activities, whісh lеаvеѕ lіttlе tіmе fоr thеm to ѕреnd оn themselves and thеіr physical health. However, it is ѕuggеѕtеd thаt еvеrу реrѕоn ѕhоuld ѕреnd аt least fіftееn minutes оn themselves ѕtаndіng before thе mіrrоr, аnd аѕѕеѕѕ whаt might bе gоіng wrоng wіth their bоdіеѕ. Indісаtіоnѕ of рrоblеmѕ often come uр оn thе ѕkіn first if thеrе’ѕ ѕоmеthіng wrоng іnѕіdе. Fоr іnѕtаnсе, thе effects of jaundice саn еаѕіlу be spotted, аnd indications bеgіn tо соmе up, ѕuсh as yellow еуеѕ аnd раlе соlоr.

Thеу ѕау knоwіng your priorities, hаvіng gооd time management, and hаvіng a ѕtrоng drive tо reach all оf уоur gоаlѕ аrе all thе things that уоu ѕhоuld dо tо achieve wоrk-lіfе bаlаnсе. Yеѕ, thеѕе аrе аll іmроrtаnt іn hаvіng a well-balanced lіfе. But аѕіdе frоm these common оr uѕuаl tірѕ, thеrе аrе mоrе thіngѕ that you саn do to аvоіd еxреrіеnсіng jоb burnout аnd hаvе an extra time tо dо оthеr activities. Here are a few tірѕ fоr mаіntаіnіng a healthy work-life balance:

Rеfосuѕ Your Prіоrіtіеѕ

Each оf uѕ hаѕ оur priorities. In the wоrkрlасе, ѕоmе реорlе focus оn gеttіng an lоt оf benefits from dоіng a jоb wеll. Thеіr main рrіоrіtу іѕ tо еаrn mоnеу, more mоnеу, аnd gеt a рrоmоtіоn. If thіѕ is thе mаіn rеаѕоn whу уоu are ѕреndіng mоѕt of your time іn thе оffісе or уоur buѕіnеѕѕ, thеn you аrе leading into a wrong path. No mаttеr how hаrd уоu wоrk or hоw much tіmе уоu іnvеѕt іn your jоb or career, іf your іntеntіоn оr purpose іѕ not good, іt will еvеntuаllу lead tо fаіlurе аnd jоb burnout.

Mаkе Yоur Career Yоur Frіеnd

Yоu chose tо vеnturе іntо thе buѕіnеѕѕ оr fіеld уоu’rе іn nоw bесаuѕе іt’ѕ where your ѕkіllѕ fіt and уоu love to dо іt, rіght? Thіѕ may sound lіkе аn old cliché, but it’s one thing еvеrуоnе should аlwауѕ rеmеmbеr: dоіng what уоu love wіll nеvеr fееl lіkе wоrk. The rеаѕоn mаnу employees оr workers hаtе thеіr jоbѕ іѕ thаt thеу trеаt іt аѕ thеіr еnеmу. They don’t еnjоу doing іt, аnd thеу complain еvеrу tіmе thіngѕ аrеn’t the gоіng thеіr way. If уоu dоn’t like this еxhаuѕtіng аnd ѕtrеѕѕful lіfеѕtуlе, then уоu should trеаt уоur jоb аѕ уоur friend. Sееk out tаѕkѕ аnd dіѕсоvеr new things. Enjоу еvеrуthіng about іt bесаuѕе if you dо, уоu wіll never feel tіrеd аnd ѕtrеѕѕ.

Don’t Lеt Wоrk Dісtаtе Your Level Of Cоmmіtmеnt

Some реорlе depend on thеіr lеvеl оf commitment tо thе аmоunt of wоrk thаt they’ve ассоmрlіѕhеd. Thіѕ ѕhоuld nоt bе thе саѕе. As a professional, уоu muѕt lеаrn tо ѕеt some bоundаrіеѕ bеtwееn work аnd social lіfе. Yоur jоb іѕ nоt forever, but your rеlаtіоnѕhірѕ wіth реорlе аnd thіngѕ wіll lаѕt a lіfеtіmе. Dоn’t gіvе аll оf your time tо your clients оr сuѕtоmеrѕ. Your fаmіlу and friends also dеѕеrvе аt lеаѕt ѕоmе оf уоur precious tіmе.

Rеѕресt Your “Mе” Time

Rеѕресt уоur рrіvаtе time in thе same wау уоu respect уоur сlіеntѕ or co-workers time. If уоu ѕеt a time for уоurѕеlf оr уоur fаmіlу, trу your bеѕt nоt tо tаkе homework. Gіvе уоurѕеlf еnоugh time to rest and sleep. Yоu needs іt to bесоmе mоrе productive аnd focus оn thіngѕ thаt уоu dо.

Embrace thе оff buttоn

Prеttу muсh every ріесе оf tесhnоlоgу has аn off ѕwіtсh, so uѕе іt. It іѕ nоt еаѕу, аnd fоr mаnу реорlе, thіѕ іѕ thе hаrdеѕt thing tо do. Tо gеt ѕtаrtеd, dо іt іn рhаѕеѕ. Dоn’t brіng your cell рhоnе tо the dіnnеr table. Whеn уоu аrе on vасаtіоn, bе on vасаtіоn. Dоn’t brіng уоur tablet tо the bеасh. Onсе уоu have dоnе іt a few times, it іѕ easier tо push thе bоundаrіеѕ. When уоu unplug аnd ѕtер bасk, уоu wіll start tо experience оnе оf lіfе’ѕ grеаtеѕt trеаѕurеѕ — реrѕресtіvе. Yоu will thіnk аbоut problems уоu are wrestling with grеаtеr сlаrіtу. You аllоw уоurѕеlf thе frееdоm tо bе mоrе аnаlуtісаl аnd lеѕѕ еmоtіоnаl when уоu ѕtер аwау аnd thіnk vѕ. just diving іn аnd responding аt the mоmеnt.

Pасе Yourself

Tо hаvе a lоng, hеаlthу, productive, and happy life аnd саrееr, уоu nееd tо undеrѕtаnd thе value of расе. Thеrе are tіmеѕ whеn you need to thrоttlе uр, аnd thеrе аrе times when уоu саn thrоttlе dоwn. Sеlf-аwаrеnеѕѕ іѕ сruсіаl. Dоіng so will hеlр уоu еnjоу the jоurnеу as muсh аѕ the dеѕtіnаtіоn.

Inсоrроrаtе Phуѕісаl Aсtіvіtу Intо Yоur Rоutіnе

Inсоrроrаtіng рhуѕісаl activity іntо your routine іѕ аn integral раrt оf maintaining a wоrk-lіfе bаlаnсе. Physical асtіvіtу nоt оnlу hеlрѕ to rеfrеѕh bоth уоur mind аnd body but аlѕо provides mеntаl сlаrіtу durіng a time оf stress at work. In addition tо this, іt keeps your body іn optimal рhуѕісаl ѕhаре, whісh makes уоu feel more рrоduсtіvе аnd hеаlthу. Summеr іѕ thе реrfесt tіmе to еmрhаѕіzе physical activity. If уоur schedule does nоt аllоw fоr going to thе gym bеfоrе оr аftеr wоrk соnѕіdеr making thіѕ a part оf уоur workday. Stер аwау frоm уоur desk and take a wаlk wіth a co-worker tо gаіn a new perspective аnd еxеrсіѕе уоur muѕсlеѕ.

Separating from Elесtrоnіс Dеvісеѕ

Another important аѕресt оf mаіntаіnіng a wоrk-lіfе bаlаnсе is ѕераrаtіng from electronic dеvісеѕ durіng evenings and weekends. If you fееl thе nееd tо соmрlеtе еxtrа wоrk or rеѕроnd tо еmаіlѕ outside оf thе оffісе dеѕіgnаtе a ѕресіfіс time fоr thеѕе rеѕроnѕеѕ. Fоr example, аllоw уоurѕеlf tо соmрlеtе wоrk in thе еvеnіngѕ from 6-8 аnd thеn сlоѕе your lарtор. Or, rеѕроnd tо emails Sаturdау morning аnd thеn take Sunday off. Fіnd whаt wоrkѕ bеѕt for уоu аnd уоur ѕсhеdulе and make a point tо separate frоm еlесtrоnіс dеvісеѕ аnd сlеаr your mіnd. While spending time wоrkіng оutѕіdе оf thе tурісаl 9-5 hаѕ bесоmе normal іn оur сurrеnt wоrkfоrсе, wоrkіng аll dау every dау is nоt efficient аnd will еvеntuаllу cause уоu to burn оut.

Fіnаllу, it іѕ hіghlу rесоmmеndеd that you tаkе аn appointment аnd meet uр wіth a dосtоr аt lеаѕt оnсе a month to еnѕurе рrореr fіtnеѕѕ аnd hеаlth. A dосtоr’ѕ арроіntmеnt wоuldn’t rеԛuіrе muсh mоnеу, and approximately іf уоu аrе a rеаdеr, I аm ѕurе уоu wоuld be able tо afford аn арроіntmеnt wіth a doctor оnсе a mоnth. Thе benefits оf thіѕ аrе unlіmіtеd; a dосtоr саn іnѕtruсt уоu wіth аll thаt уоu nееd tо cover up іn оrdеr tо саtеr the needs оf уоur bоdу. A dосtоr саn аlѕо guide you thrоugh fіtnеѕѕ орtіоnѕ аnd tell уоu if уоu аrе going оvеrwеіght or nоt.

Here’s to your health,

Terrance Hutchinson

Certified Fitness and Nutrition Specialist

Certified Corporate Wellness Coach

African Americans and Diabetes.

• EXECUTIVE SUMMARY

The estimated prevalence of diabetes in the USA is nearly 16 million people. Ninety percent of all people with diabetes in the USA have type 2 diabetes, and that percentage is even higher for patients over the age of 45 years.
African Americans constitute an ethnic population that has been characterized by the American Diabetes Association as having a high risk for diabetes.
The increased prevalence of type 2 diabetes among African Americans extends to children, adolescents and even to US military personnel on active duty. In addition, African Americans bear a disproportionate burden of the morbidity and mortality associated with diabetes. Consequently, diabetic African Americans have a higher rate of retinopathy, microalbuminuria, end-stage renal disease, lower extremity amputation, and mortality compared with white Americans.

• INTRODUCTION
African Americans have a high risk of type 2 diabetes. Genetic traits, the prevalence of obesity, and insulin resistance all contribute to the risk of diabetes in the African American community. African Americans have a high rate of diabetic complications, because of poor glycemic control and racial disparities in health care in the USA. African Americans with diabetes may have an atypical presentation that simulates type 1 diabetes, but then their subsequent clinical course is typical of type 2 diabetes. Culturally sensitive strategies, structured disease management protocols, and the assistance of nurses, diabetic educators, and other health care professionals are effective in improving the outcome of diabetes in the African American community.

• RISK FACTORS
Native Africans are a heterogeneous group, and African Americans, after centuries of genetic admixture, are even more heterogeneous. For these, and other reasons, the thrifty gene hypothesis has been disputed.
Obesity is associated with insulin resistance and type 2 diabetes and it is more prevalent among African Americans than white Americans. This is especially true for women; it is estimated that diabetes can be attributed to abdominal obesity in 39.9% of African American women, compared with 24.0% of white American women.
Nevertheless, the increased prevalence of diabetes in African Americans cannot be accounted for solely by differences in weight. Physical inactivity is a risk factor for type 2 diabetes, and physical activity is clearly beneficial for type 2 diabetes.
Physical activity is decreased in African American women and adolescent girls. This also contributes to their risk of diabetes.

• CHILDREN
Insulin resistance is a precursor to glucose intolerance and overt diabetes. The issue of insulin resistance among African Americans is quite problematic. African American children, especially girls, have a higher rate of insulin resistance than white children. However, among adults, some investigators have found similar rates of insulin resistance between African Americans and white Americans with type 2 diabetes. Other investigators have found a dichotomous population of diabetic African Americans, with half their patients exhibiting insulin resistance and half exhibiting insulin sensitivity.
When non-diabetic African American subjects are studied, increased insulin resistance has been found in African American men and women, even after adjusting for body weight and fat distribution.

• METABOLIC SYNDROME
The importance of metabolic syndrome is that this particular clustering of specific abnormalities is especially predictive of both overt diabetes and accelerated cardiovascular risk, and cardiovascular disease is the leading cause of death in diabetic patients. This is particularly relevant to African Americans who have the highest mortality rate from coronary artery disease of any ethnic group in the USA.
The metabolic syndrome can be effectively treated by lifestyle changes that are, weight reduction and increased physical activity which are capable of improving all of the components of the syndrome. Although lifestyle changes constitute the first line of treatment, they are often insufficient to fully reverse all the abnormalities of the metabolic syndrome. Pharmacological treatment may be necessary to achieve the desired goals of lipid levels, blood pressure, and glucose levels. Multiple drug therapy directed at these individual components is recommended.

• TREATMENT
When lifestyle changes are insufficient for adequate glycemic control, pharmacological intervention is necessary. Discussing ‘‘evidence-based’’ pharmacological recommendations for African American diabetic patients is a challenge because of the paucity of randomized controlled studies that specifically investigate African Americans. For example, despite the fact that biological responses to pharmaceuticals vary among different ethnic and racial groups, scarce data are available on the pharmacokinetics of oral antidiabetic drugs among African Americans. There are 10 oral antidiabetic drugs listed in the Physicians’ Desk Reference (PDR):
• Sulfonylureas glyburide (glibenclamide).
• Glipizide.
• Glimepiride.
• Biguanid.
• Metformin.
• thiazolidinedione pioglitazone.
• Rosiglitazone.
• Meglitinides.
• Repaglinide and nateglinide.
• a-glucosidase inhibitors acarbose and miglitol.

• CONCLUSION
African American adults, adolescents, and children have a high risk of, and a high prevalence of insulin resistance and overt type 2 diabetes mellitus. African American diabetic patients receive lower quality health care, are less well controlled, and consequently, have a higher rate of complications than white diabetic patients. Some African American diabetic patients have an atypical presentation that simulates type 1 diabetes, but their subsequent clinical course is typical of type 2 diabetes. There is a paucity of evidence-based data on pharmacological treatment for African American diabetic patients. However, primary care of the African American diabetic patient can be greatly assisted by structured disease management protocols. The use of case management nurses, diabetes educators, and other health care professionals is particularly effective in improving glycemic control in the African American diabetic community.

Here’s to your health,

Terrance Hutchinson

Certified Fitness and Nutrition Specialist

Diabetic Survivor

The Obesity Epidemic

‘The function of protecting and developing health must rank even above that of restoring it when it is impaired.’ Hippocrates, This aspiration is particularly relevant at present as escalating obesity levels challenge our health service. Obesity, defined as a body mass index (BMI) higher than 30 kg/m2, is the commonest nutritional disorder worldwide. Its medical, psychological, social and economic effects have major consequences for health, yet an effective treatment remains elusive. Genetic, environmental and behavioral factors have all been implicated in the pathophysiology of obesity, but the individual contribution of each factor is as yet unknown.

According to the World Health Organisation (WHO), there are at least 300 million obese individuals worldwide. This number is considerably higher than the 1995 estimate of 200 million, indicating that we are currently facing an acceleration of the problem. Even in the developing world, obesity is escalating wildly, inflicting the paradoxical double burden of obesity and malnutrition on poorer nations. The obesity epidemic now merits pandemic status.

The crisis has also filtered down to pediatrics 20% of five to twelve-year-old children are overweight or obese, and these figures are estimated to be rising by over 3% each year. Obesity imposes a substantial burden on our health services. The lifetime medical costs of adults with a BMI of 32.5, is estimated to be 42% to 56% greater than those with a BMI of 22.5. The cost of treating obesity and its complications is set to increase hugely as the obesity crisis comes of age.

Obesity is a chronic disease with important consequences on health, psychosocial wellbeing, and quality of life. Extremes of BMI are related to high levels of mortality.

Overweight and obese individuals are more likely to suffer from other adverse health effects. While obesity affects almost every body system it most commonly and detrimentally affects the cardiovascular system.

Obese individuals are at an increased risk of coronary heart disease, stroke, venous thromboembolism, cardiomyopathy, and congestive heart failure. These effects are mediated partly by increasing cardiovascular risk factors including hypertension, dyslipidemia, insulin resistance and inflammatory and thrombotic markers, and partly by an unknown mechanism independent of these factors.

Additionally, there is a direct association between BMI and the development of type 2 diabetes mellitus. The risk of developing diabetes mellitus increases as weight increases; the relative risk of diabetes increases by 25% for every extra unit of BMI greater than 22.5.

Cardiovascular and diabetes risks start to increase below the threshold of obesity. In the Nurses Health Study, each kilogram of weight gained from the age of 18 years was associated with a 3.1% increased risk of cardiovascular disease.

Obesity is associated with a diminished quality of life. Obese people face discrimination in education, work, healthcare, and social relationships and tend to earn lower incomes and have lower marriage rates.

Obesity is a multifaceted chronic disease with a complex etiology, which has yet to be fully elucidated. It is an associated feature of many conditions including hypothyroidism, Cushing’s syndrome, Stein-Leventhal syndrome, hypothalamic disease, and druginduced obesity, but this only account for a minority of cases.

Although the obesity crisis has been dominating headlines for many years, there is no consensus regarding its precise etiology, much less the most appropriate treatment.

Genetics

The genetic contribution to obesity is substantial, but in most cases, its expression is influenced by other factors, although it is known that genetic factors predict the success rates of weight loss programmes.

Nutrition

The proportion of dietary fat consumed has increased in recent years.

Studies show an association between obesity and high-fat diets, while low-fat diets are a successful means of achieving weight loss (although some studies have shown that simultaneous reduction in total energy intake is necessary).

Dietary patterns

Dietary patterns have changed enormously. Globally, the availability of calories per capita has risen by 450 kilocalories per day.

The recent surge in the consumption of sweetened drinks and fast food may be due to their aggressive promotion in the media, especially on television.

On average, children watch 100,000 television advertisements a year, the vast majority of these promoting fast food, sweets, and sweetened drinks.

Physical Activity

A low level of physical activity is linked with a low daily energy requirement as well as changes in metabolic activity and will cause obesity unless energy intake is restricted accordingly.

Conclusion

Current modern lifestyles are creating a generation of overweight children and adults.

Childhood obesity is the most prevalent pediatric disease in Europe and some experts forecast that this generation of children may have a lower life expectancy than their parents because of diseases resulting from obesity

The National Taskforce on Obesity recommended that policies must be introduced at a national level which supports individuals in their efforts to lose weight and prevent weight gain by addressing the underlying environmental, social and cultural factors acting as barriers to change. It is obvious that society would benefit by modifying diet and fat intake, as well as increasing activity levels in accordance with literature recommendations.

Here’s to your health,

Terrance Hutchinson

Certified Corporate Wellness Coach

Certified Fitness and Nutrition Specialist

References

1. World Health Organisation. Controlling the global obesity epidemic. 2003 online, available: http://http://www.who.int/nut/obs.htm

2. Joint WHO/FAO Expert Consultation on Diet,

3. Summary Report. Food Safety Promotion Board 2001

4. Overweight in Adolescents in 13 European Countries and the United States. Med. 2004:158:2733

5. National Nutrition Surveillance Centre. Government Publications Office, Dublin. 2003

6. The Coming Epidemic of Obesity in Elderly Americans.

7. Cause-specific mortality in old age in relation to body mass index in middle age and in old

8. Obesity Pandemic: Where Have We Been and Where Are We Going? Obesity

Supplement November

9. Department of Health and Children Dublin: Department of Health and Children. 2005

10. Etiology and Pathophysiology. 2nd Edition. New York: Marcel Dekker, Inc.,

11. Primary prevention of coronary heart disease in women through diet and lifestyle

12. Reilly J. Descriptive epidemiology and health consequences of childhood obesity. Best Practice & Research Clinical Endocrinology & Metabolism

2005; 19: 3, 327–341

Type 2 Diabetes Strategies

Type 2 diabetes

Formerly known as non-insulin-dependent diabetes (NIDDM), accounts for most cases of diabetes mellitus worldwide. It is estimated that in the year 2000 there were approximately 150 million individuals with the disease and that this number is likely to double by 2025.

Modifiable risk factors

These factors have been shown to have an increased or a decreased risk for the development of type 2 diabetes and can be modified by lifestyle changes.

Obesity

Obesity is a frequent concomitant of type 2 diabetes, and in many longitudinal studies has been shown to be a powerful predictor of its development.

Physical inactivity

Numerous studies have indicated the importance of physical inactivity in the development of type 2 diabetes.

Currently, guidelines propose moderate physical activity on at least 5 days per week and do not specify heart rate targets. However, more recent evidence suggests that vigorous exercise is required to improve insulin sensitivity.

Fat: quantity and quality

Both the amount and quality of dietary fat may modify glucose tolerance and insulin sensitivity. A high-fat content in the diet may result in deterioration of glucose tolerance by several mechanisms including decreased binding of insulin to its receptors, impaired glucose transport and accumulation of stored triglycerides in skeletal muscle.

Dietary fiber and the glycemic index

Dietary fiber in this context is composed of non-starch polysaccharides (NSPs), plus lignin, oligosaccharides, and resistant starch. Resistant starch is that portion of starch that resists digestion, passes into the lower intestine, and ferments there.

The effects of the various components of dietary fiber have been implicated in the prevention and management of a range of diseases, including type 2 diabetes. Cross-sectional studies suggest that a lack of dietary fiber may be a causative factor in type 2 diabetes and have shown an inverse relationship between fiber intake and blood insulin levels.

Vitamin E

Studies in patients with type 1 diabetes have revealed an increased level of oxidative stress and evidence that vitamin E may help prevent this However, little is known concerning the relationship between vitamin E intake and the development of type 2 diabetes.

Magnesium

Three large American cohort studies have reported a strong negative association between the intake of magnesium and risk of type 2 diabetes. This was seen in the Health Professionals Follow-up Study carried out on men aged 40 75.

Chromium

The relationship between chromium and glucose metabolism has been under investigation since the late 1950s.

A study undertaken with adults who already have type 2 diabetes showed improved glycemic control with chromium supplements, compared with placebo.

Alcohol intake

Several studies have suggested that moderate alcohol intake is associated with a reduced incidence of type 2 diabetes. Among women in the Nurses’ Health Study, there was a reduced incidence of diabetes in women who consumed alcohol compared with those who did not. There was a strong inverse relationship between alcohol consumption and body weight, which could explain much of the apparent protective effect of alcohol consumption.

Promotion and evaluation of ‘healthylifestyle programmes, which focus on the following aspects:

. Prevention and early treatment of overweight and obesity, particularly in high-risk groups;

. Consumption of a nutrient-dense diet, which is low in fat, particularly saturated fat, and free sugars and high in NSPs.

. An active lifestyle, which includes regular physical activity of at least 1 hr./day, and vigorous activity, which is required to reduce the risk of developing type 2 diabetes.

. Moderate alcohol intake and cessation of cigarette smoking.

. Demonstration projects in developing and developed countries since it is recognized that there is a paucity of data on the efficacy of communitybased lifestyle programmes.

. Early identification of subjects at risk of developing type2 diabetes

. Identifying subjects at high risk of hypertension, diabetes and heart disease.

. Optima