How Much Exercise Should I Do?
Dec 2, 2014, 01:00 AM
My last two blogs reviewed the specifics of intensity and type of exercise recommended for a person with diabetes (PWD), and for most adults for that matter. This is the final blog in the series about the prescribing exercise using the FITT Principle (F=frequency, I=intensity, T=type and T=time). 
When prescribing exercise, frequency and time go together; the more time spent exercising in one bout, the less frequently exercise would be done. In general, the goal for aerobic/cardiovascular endurance exercise for most people is 150 mins./wk. This can be split up in a variety of ways: 30 mins. on 5 days/wk., 50 mins. on 3 days/wk., or even several times per day such as 10 mins. done 3 times/day or 15 mins. done 2 times/day. As diabetes educators (DEs), we should work with an individual to determine what is most reasonable and achievable.
If a person has limited time, limited motivation, gets bored quickly, or lacks the ability to perform a longer bout of exercise (30 or more mins.), we might suggest starting with 5, 10 or 15 mins. at a time. Other people do well with one bout of 30 mins. or more, certainly if going someplace to exercise (a park, mall or gym). As DEs, we would ask the PWD about reasonable options based on their ability, interests, time, etc. and individualize the general exercise prescription, providing knowledge about how to be flexible day to day with regard to time and frequency.
What about the person who isn’t up to doing a regular bout of exercise? Some people do well with an increase in activity throughout the day. One problem with this is tracking what was actually done. A pedometer can be useful to track steps. It can be a surprise to see the final daily total; some walk more and others are shocked at how few steps are taken.
Is 150 minutes/wk. enough for everyone? The answer is probably “no.” This is the initial goal for general health, blood glucose (BG) control, and for cardiovascular endurance. But, for a person who wants to lose weight, more exercise is needed, with most people who are successful with weight loss/maintenance of weight loss doing 200-250 mins./wk. If this sounds like too much for an individual, encourage him or her to start slowly and try to increase as exercise becomes a part of the routine; better to do some than none. Once a person is able to do 30-40 mins./day, he or she may be able to increase to 50-60 mins./day to meet all of their goals. 
It may be helpful for the person to track exercise as a motivational tool and to know how much has been done over time. This can be done by noting the time of exercise or total daily steps on a calendar, a BG log sheet, a separate exercise log, or by using one of the many apps that will help log exercise (and food intake). A couple of possibilities are “Lose It!” and “MyFitnessPal.”
Finally, follow up with the individual to see how it is going. I encourage this and specifically say to please check in whether things are going as planned or if they aren’t. We work as a team, DE and PWD, to adjust the plan as we move toward a successful exercise program.
To summarize, a person will tend to follow an exercise program if it is specifically prescribed; using the FITT principle, you as a DE can work with an individual to create a successful, specific plan and adjust as needed to help promote lifelong exercise and better health.