Dr MICHAEL MOSLEY reveals the simple tricks to get more active

Why your sofa could be fuelling the diabetes epidemic: Many of us sit for too long — and experts say it’s killing us. Dr MICHAEL MOSLEY reveals the simple tricks to get more active (without going near a gym)

We’re not exercising enough. We’re eating too much of the ‘wrong’ food. Our waists are too big. It’s pretty hard to ignore the daily barrage of messages about our bodies and health.

The slings and arrows are well-intentioned because it’s known that these kinds of factors play a key role in health and the risk of developing a life-limiting chronic disease, such as type 2 diabetes, arthritis, heart disease, fatty liver disease, cancer, dementia — and, more recently, dying from Covid-19.

Most Brits now spend the last 20 years of their lives in ill health, or with some form of disability. And these numbers are rising — thanks to our expanding waistlines, but also because we are moving too little and sitting for far too long.

Nobody wants to end up like this. But, equally, nobody wants to feel they’re being told off about it. Not least because it can leave you feeling inadequate when it seems that the only option being offered is drastic life change.

‘Drastic life change’ may be what some of you are after; but others, I’m sure, would prefer something less radical.

We’re not exercising enough. We’re eating too much of the ‘wrong’ food. Our waists are too big. It’s pretty hard to ignore the daily barrage of messages about our bodies and health [File photo]

That’s where my new series this week for the Mail comes in.

I’ve delved into the latest research for some simple and — most importantly — doable lifestyle changes that you can make to boost your health and reduce your risk of developing disease such as type 2 diabetes.

The emphasis is on easy changes to ward off these health timebombs: things you can do to reboot your body without having to go to a boot camp!

You also need to decide what you want to change, and why. Research shows that you’re more likely to stick to changes made to improve your health than changes driven by vanity or because someone else has told you to shape up.

What made me change was being diagnosed with type 2 diabetes back in 2012. I was horrified.

As many of you will well know by now, I turned this around by going on my 5:2 diet — eating normally five days a week, then for two days having 800 calories.

The 5:2 diet became and remains popular because it’s extremely easy to do. It fits around your normal life, and you can still eat delicious food.

Since then, I’ve introduced lots of other small, simple changes that have helped me stay slim and fit — without having to sweat it out in a gym. As I explained in Saturday’s Mail, these include eating home-made fermented foods, such as sauerkraut, and sticking to a rainbow diet (different coloured fruits and vegetables), which my gut bacteria love.

I also try to get up at the same time every morning, to ensure a regular sleeping pattern, and go for a brisk walk before breakfast.

Too cuddly for your own good

One of the first things to do is measure your waist (around the belly button). Most of us are in denial about the size of our guts. I certainly was.

When I was diagnosed with type 2 nine years ago, I weighed nearly 14 st, which at 180 cm (5 ft 11 in) gave me a BMI (body mass index) of 27 — just nudging me into the ‘overweight’ category.

I was only mildly inconvenienced by the strain on the button of my 36 in trousers, and I honestly thought I was in good shape. But it turned out my paunch meant I was carrying more fat than my body could happily handle, and this was putting my health in peril.

Back then, there were around four million people in the UK with type 2: last week, it was revealed that it’s now nearly five million.

And this is just the tip of a very large iceberg, because waiting in the wings are another 13.6 million people in the UK with high blood sugar levels that put them at increased risk of type 2 diabetes.

The rise in type 2 diabetes — and prediabetes — is linked to excess body fat, and specifically a bigger waistline.

A healthy waist measurement, according to Diabetes UK, is no more than 31.5 in for women and 37 in for men — but women’s waists have grown by three inches in the past 24 years, from 32.2 in to 35.2 in, and men’s by nearly 2 in, from 36.7 in to 38.5 in.

It seems that almost all of us have a bit of a belly now. And yet it seems we genuinely can’t see it.

For instance, a study by Cancer Research UK found that just 11 per cent of women and 7 per cent of men with an ‘obese’ BMI acknowledged this fact, reported the journal BMJ Open.

In fact, BMI is a rather crude measure of health: knowing your waist measurement is more important. A large waistline can almost double your risk of dying prematurely, even if your BMI is within the ‘normal’ range, according to research last year in the New England Journal of Medicine.

Too much of any body fat is bad for your health. But compared to the fat that lies just underneath your skin, the fat in and around your abdomen (known as visceral fat) is more likely to raise your risk of conditions such as heart disease, Alzheimer’s, type 2 diabetes and stroke.

Research suggests this is because visceral fat pumps out a range of inflammatory chemicals and hormones that are thought to have a damaging effect on our cells’ sensitivity to insulin, blood pressure and blood clotting.

Blame your sofa for excess fat

As I explained in Saturday’s paper, we each have a genetically determined ‘personal fat threshold’, and metabolic problems only start when our weight exceeds that.

Fat is then deposited not in the fat cells but in the liver and pancreas, impairing their function and leading to type 2 diabetes.

This is not just about overeating: it’s also down to general inactivity.

It’s all going apple-shaped

Some people are more prone to gathering fat around their middles than others: typically men, although this can change as our hormones change.

For instance, as a result of declining levels of oestrogen at menopause, women can switch from being ‘pear-shaped’ (a slim waist with fat on the thighs and buttocks) to becoming more ‘apple-shaped’ (with fat in and around the abdomen).

Unfortunately, fat around the middle is a sign of fat around the organs (visceral fat) and is notoriously difficult to shift.

Your body will always look for other energy reserves rather than plundering what it considers to be a precious resource situated conveniently close to important organs in the centre of the body.

While exercise alone won’t help you lose fat from around your middle — you need to lose weight — it’s crucial for helping reduce the risk of regaining fat.

And a great thing, as I show in my new series, 21 Day Body Turnaround (Thursdays at 9pm on Channel 4), is if you put it all together, you can achieve dramatic results — fast.

By following a regimen that included intermittent fasting, more brisk walking and a couple of 20-minute sessions a week of a moderately intense workout, the participants’ weights, waist measurements and aerobic fitness levels improved remarkably in just 21 days!

We spend up to 12 hours a day sitting on our bottoms: throw in the eight hours we spend sleeping, then that adds up to a remarkable 20 hours a day being sedentary.

Jim Levine, an obesity specialist and a professor of medicine at the Mayo Clinic in the U.S., told me: ‘Sedentariness alone … [is] literally killing millions.’

It’s not just the lack of calorie burning: sinister things happen when we’re inactive for too long.

Prolonged sitting has been linked to a sharp reduction in the activity of lipoprotein lipase — an enzyme that breaks down blood fats such as triglycerides and cholesterol and makes them available as a fuel to the muscles.

Too little of this enzyme leads to raised levels of these fats, increasing the risk of heart disease. Extended sitting also prolongs the spikes in blood sugar levels after meals, creating the perfect setting for type 2 diabetes.

The good news is it doesn’t take much movement to make a difference.

One study of post-menopausal women by researchers at the University of Leicester in 2015 found that just standing up for five minutes every half hour was enough to reduce the rise in sugar levels after eating.

I don’t like the gym, either

You might be surprised to learn that despite all my research and writings about health, I don’t enjoy going to the gym or for a run. And I suspect I’m in the majority.

Less than 20 per cent of Brits do anything like the levels of activity recommended by the UK Department of Health (150 minutes of moderate to vigorous exercise a week). If — like me — you hate the idea of going to a gym, let me reassure you that just increasing the amount of activity that you build into your everyday life can have a real impact.

Professor Levine believes the secret of a long and healthy life lies in improving what he calls your NEAT, or non-exercise activity thermogenesis — the calories we burn through everyday living.

In one experiment I did with him, I discovered I spend at least 11 hours a day sitting down. But when I made a concerted effort to keep on the move, taking every opportunity to get up and just stroll around a bit, I was able to double my NEAT and burn 500 extra calories. No sweat.

If you spend a lot of your work life sitting down, find an excuse to get up and move every 30 minutes. You’re aiming for a ‘cocktail’ of light activity, exercise and sitting.

The benefits of a brisk walk

So now we come to the ‘exercise’ bit. And while we know that exercise alone is unlikely to lead to weight loss, it is vital in so many other ways.

It’s a powerful anti-ageing medicine, providing a wide range of health and psychological benefits, from strengthening your bones to improving mood and reducing cancer risk — and type 2 diabetes.

A study from University College London and the University of Cambridge in 2016 found that walking briskly or cycling for 150 minutes a week can reduce the risk of developing type 2 diabetes by as much as 26 per cent.

But what if you, like me, really don’t enjoy exercise? The key is to make it not seem like exercise!

As I explained on Saturday, brisk walking which focuses on speed rather than distance covered might be better for your health. It’s something I’ve incorporated into my daily routine.

Most mornings, I do a brisk 30-minute walk through the local woods with my wife Clare. We often do another walk in the afternoon.

I got enthusiastic about brisk walking after meeting Marie Murphy, a professor of exercise and health at Ulster University, who conducted a huge study published in 2018 that found walking fast is associated with a 24 per cent risk reduction for death of any kind compared with slow walking.

She told me I should be doing at least 100 paces per minute, preferably more like 120 (as a guide, listen to Hips Don’t Lie by Shakira, which has 100 beats per minute, and keep step).

A few short brisk walks a day can even trump the standard advice to aim for 10,000 steps daily.

In 2018, I participated in a study by Rob Copeland, a professor of physical activity and health at Sheffield University, to compare the health benefits of notching up 10,000 steps to three brisk ten-minute walks.

After a few weeks on the new exercise regimen, volunteers doing 10,000 steps a day struggled to meet their target, but the brisk walkers found their task relatively easy. Better still, the brisk walkers saw better health results — a drop in body fat of 2.4 per cent compared with 1.8 per cent in the 10,000-steppers. They also had bigger drops in blood pressure.

Brisk walking is also a good way to control blood sugar levels in prediabetes. For other ‘sneaky’ exercise tips, see the panel below.

Steps to sneak exercise into your day without noticing

Here are some simple ways to incorporate fitness into an everyday routine without having to join a gym.

Get or borrow a dog — they force you out on walks. Or find a friend to go on walks with. You’re more likely to do it!b Join a Zumba class, or some form of dance that involves vigorous movement. It’s fun, it’s social and it gets your heart rate going.
I cycle to the supermarket and, once there, I normally carry all my shopping in a basket rather than use a trolley. That way I build upper-body strength.
Have some simple rules. I take the stairs rather than the lift. Try getting off the bus a stop early. Walk or cycle to the shops rather than drive. Collect the newspaper from the shop, rather than have it delivered. And so on.
Drink lots of water. It will not only keep you hydrated but also mean you have to get up regularly to go to the loo.n Put the wine bottle on the other side of the room, rather than next to you!

The best way to acquire a new habit is to link it to something you already do. So I open the curtains and do my press-ups and other resistance exercises.

I do squats while waiting for the kettle to boil. I do balance exercises (standing on one leg) while brushing my teeth.

This is my resistance exercise routine I do as soon as I get out of bed (most days). I know if I don’t do it then, I’ll never do it later!

This routine, which takes a few minutes, works a range of muscles. Aim to do 30 seconds of each, with ten seconds of rest in between. Repeat if you feel able. There are free NHS videos you can find online that will show you how to do these safely, and also less strenuous alternatives — search ‘NHS Fitness video’.

Push-ups: Lie face down with your palms under your shoulders, the balls of your feet touching the ground. Keeping your body straight, lower it down until your elbows form a right angle with the floor and then push up. If this is too hard, do it with your knees on the ground.
Squats: Standing with feet apart, bend from the hips, keeping the weight in your heels. Make sure your back is straight. Keep bending until your legs are at right angles to the floor, as if you’re preparing to sit in a chair. Push back up without bending your back.
Crunches: Lie on your back with knees bent, feet flat on the floor and hands behind your head. Curl your upper body without lifting your lower back off the floor. Make sure your chin is tucked in towards your chest. When your shoulders and upper back are off the floor, curl back down.
Plank: Lie face down on the floor and then raise yourself on to your forearms and toes so your body forms a straight line from head to toe. Make sure your mid-section doesn’t rise or drop. Squeeze your buttocks and hold the position for as long as possible.
Lunges: Stand with your back straight and your feet shoulder-width apart. Step forward with one leg, bending both knees to right angles and keeping your upper body straight. Pull back to the starting position and repeat, putting the other leg forward.
Tricep dips: Sit on a chair, with your feet flat on floor, hands on the seat beside your hips. Move your body forward off the chair, arms extended — then bend your elbows so your bottom descends. Push yourself back up using only your arms.

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