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Diabetes and Exercise – Why the Connection is Vitally Important
Nearly twenty-one million people in the US live with diabetes, and an estimated 6.2 million of these people do not know they have diabetes because they have not been diagnosed. On average, people with diabetes have medical costs that are 2.3 times higher than those without diabetes, according to the American Diabetes Association. Another study in Population Health Management estimates that diabetes costs our nation $218 billion in health care each year. However, most cases of diabetes can be prevented or reversed through exercise, weight loss and a healthy lifestyle.
I wonder. What if the 6.2 million undiagnosed people know they have diabetes? Or have the estimated 57 million Americans with pre-diabetes been educated on how they can maintain their health and avoid becoming type 2 diabetics?
Being diagnosed as pre-diabetic does not mean that type 2 diabetes is inevitable. If you lose weight and increase physical activity, you can prevent or delay diabetes and even bring your blood glucose back to normal (ACSM 2006). (See sidebar for defined diabetes terms)
This is a very important thing that many people do not understand – if you exercise and lose weight, you can prevent or delay diabetes.
Do you know the signs of diabetes? Look around you. Are you seeing any signs of diabetes in your friends and family right now? (See sidebar for common signs of diabetes) It’s very possible that there are people around you every day who have diabetes (or will become diabetic). The Centers for Disease Control and Prevention estimates that one in three Americans may develop diabetes in their lifetime. Those statistics are staggering and, for the most part, preventable.
What about type 2 diabetics who have been diagnosed? What if we educated them so that through diet and exercise, they could reduce or eliminate their medications? What would this do for our health crisis? I know that we would first have to break through many myths, magical solutions and limiting beliefs. Not even the pharmaceutical companies will be happy that I’m giving away this secret. But damn it, our healthcare system is in crisis! Our nation is sick! There, I said. So let’s get down to the business of taking personal responsibility for our health.
Many of you who are trying to understand diabetes and take responsibility for your health immediately have several questions:
o Should you cut out sugar?
o Does your weight put you at risk?
o If you’re skinny, you don’t have to worry, right?
o Can exercise and diet really help you?
o How do I control my blood sugar level?
And there are also problems that you may not even know to ask yourself:
o Having diabetes for more than five years can increase the likelihood of developing cardiovascular disease
o Regular exercise can make you more sensitive to insulin, which can reduce medication doses
First, let’s talk about insulin, the main drug that keeps diabetics functioning, and then you’ll be able to clearly see the answers to your questions.
How does insulin work? Insulin is the main hormone that controls the entry of blood sugar from the bloodstream into the body’s cells to be used as energy. How does exercise affect the hormone insulin? Exercise acts on the body similar to insulin. When you exercise, your muscles need a constant flow of sugar to keep contracting and moving you. Exercise increases the rate at which your muscles take up sugar from your bloodstream; so exercise works just like insulin by dumping excess sugar from your bloodstream into your muscles. This action, therefore, lowers blood sugar. One twenty-minute walk a day can reduce glucose levels by twenty points.
Here’s a great example that explains the function of insulin in your body. Think of insulin as a bus for a moment. Glucose (sugar) is a passenger. There are two types of diabetics. Type 1 diabetics do not produce insulin (or have no insulin), which, according to the Centers for Disease Control, accounts for 5% – 10% of all diagnosed cases. The other type (Type 2), have insulin resistance, which means that the bus is there, but does not pick up passengers and fewer buses run on the route. According to the Center for Disease Control, type 2 diabetes accounts for 90-95% of all diagnosed cases.
When you exercise, your muscles work harder than usual and require more fuel than usual; so your muscles send their buses to pick up the sugar in the bloodstream and bring it back to the muscles. Working muscles take up insulin and (for type 2 diabetics) can even show buses (insulin) working again (pick up passengers).
Exercise has many benefits for a diabetic. It increases glucose uptake into cells, improves insulin sensitivity by improving glucose metabolism and reduces the risk of cardiovascular diseases. Lowering blood glucose levels improves insulin sensitivity making it more effective. Exercise can reduce dosage requirements or the need for medication and improve the ability to lose and/or maintain weight when combined with intuitive eating. (See sidebar for a checklist of safe exercises)
There are many popular myths about diabetes. Here are a few that I hear a lot.
Myth #1 – Diabetics can’t eat sugar or sweets, and the only reason they have diabetes is because they ate too much sugar. Yes, simple carbohydrates or sweets raise blood glucose levels, but if you eat them in moderation and include them in your meal plan, you can safely eat some sweets
Myth #2 – If I’m thin, I’m fine. Diabetes is only a disease that affects obese people.
Not entirely true, 20% of people with type 2 diabetes are thin. Yes, obesity puts you at risk for type 2 diabetes, high blood pressure, and high cholesterol. The key thing to remember is that there is no atypical “diabetes” body type, genetic trait, race, age or gender. Type 2 diabetes is caused by lifestyle choices, and diabetes is a disease that should be taken seriously.
Myth #3 – There is no natural cure for diabetes. If I take insulin or insulin sensitivity medication, I can continue with the same lifestyle and be fine. Well, there is a natural remedy, it’s called exercise and a balanced diet. You can keep diabetes under tight control by monitoring your glucose levels, combining exercise with a balanced diet, or using medication.
Myth #4 – I’m just borderline and a blood sugar reading of 170 mg/dl is normal for me. You may feel normal as a diabetic, but high glucose levels are not safe. There is no such thing as a limit. You are either diabetic or you are not. This is a serious illness that requires you to take personal responsibility for your body. There are serious health complications associated with diabetes, especially when you stress your body with high blood sugar. You need to start changing your lifestyle in order to live a quality life in the long run.
Myth #5 – Exercise! What can it do for me? Blah! Blah! Healthy lifestyle Blah! Yes, yes, I know. The American Diabetes Association recommends 150 minutes of exercise per week. This is a 20-60 minute workout, in continuous sessions, 3-5 times a week. The Diabetes Prevention Study found that exercising for a total of two hours a week can reduce the risk of developing diabetes by 50%, which can be as little as 20 minutes, 6 days a week. Take a short, ten-minute walk before and after work and you can prevent diabetes or lower your glucose levels.
The fact is that over 90% of diabetes cases are preventable and can be maintained with some natural remedies such as exercise, a healthy diet and/or in combination with low-dose medications without involving our $218 billion health care system. Start gradually and exercise a little each day until you reach the recommended guidelines. Eat a balanced, healthy diet and lose your all-or-nothing attitude. Educate yourself about your disease, identify your beliefs about diabetes, and change your lifestyle starting today. (See I want to learn more sidebar)
Diabetes is a serious problem, but you can do something about it!
Defined terms for diabetes
o Type 1 = Autoimmune disease that destroys insulin-producing cells in the pancreas. The body cannot produce its own insulin because the beta cells of the pancreas, which are responsible for producing insulin, have been destroyed. About 5-10% of all diagnosed cases (CDC 2005)
o Type 2 = the body loses sensitivity to insulin so that the body’s cells are unable to use insulin properly (also known as insulin resistance or adult-onset diabetes). About 90% – 95% of all diagnosed cases (CDC 2005)
o Pre-diabetes = If you have a fasting plasma glucose (FPG) test and your levels are 100 mg/dl to 125 mg/dl you have been diagnosed as showing signs of diabetes unless you make some lifestyle changes
o Gestational diabetes = When pregnancy hormones interfere with the mother’s insulin, causing glucose levels to rise. This is a form of insulin resistance that in most cases ends with the birth of a child.
o Metabolic syndrome = A combination of medical disorders that increase risk factors for the development of cardiovascular disease, obesity, hypertension, low-density lipoprotein (HDL), high cholesterol, and elevated plasma triglyceride levels.
o Hypoglycemia = abnormally low blood sugar that can be caused by excess insulin or your diet. Signs would be: tremors or shaking, nervousness, rapid heart rate, increased sweating, headache, decreased concentration or attention, fainting and coma
o Hyperglycemia = abnormally high blood sugar level. The signs would be: frequent urination, intense thirst, nausea, abdominal pain, dry skin, disorientation, difficulty breathing and drowsiness.
Do you know the signs of diabetes? Some very telling signs include:
o frequent thirst, hunger and urination
o weight loss
o frequent infections
o blurred vision
o slow-healing cuts/bruises
o tingling and numbness in the hands and feet
o recurrent skin, gum and bladder infections
Safe Exercise Checklist
o Get your doctor’s approval before starting any exercise program
o Test your blood glucose before exercise, immediately after exercise, and again two hours after exercise
o Follow general guidelines for a safe exercise session; warm up, cool down, stretch, stick to type 1 (3 to 5 RPE) and type 2 (3 to 6/7 RPE) intensities, drink plenty of water
o Wear shoes that fit well, are well cushioned and supportive
o Wear polyester or cotton polyester socks to keep your feet dry and reduce foot trauma
o Avoid strenuous, vigorous or static activities unless specifically approved by your doctor
o Bring a carb snack of 10-15 grams of carbs
o Carry identification that tells others you have diabetes in the event of a hypoglycemic response http://www.n-styleid.com
o Know and monitor the signs of exercise-induced hypoglycemia
o Do not exercise if your blood glucose level is 250 mg/dl or if you have ketones in your urine
o If you have autonomic neuropathy, peripheral neuropathy, neuropathy, retinopathy, or any other diabetes-related condition, you must get your doctor’s approval before starting an exercise program. These conditions require specific and strict guidelines.
o Practice with a partner until you know your answer to the exercise
o Always check your feet before and after exercise for lesions
o Drink lots of water. A good rule of thumb is to have a bite or two at least every fifteen minutes
Want to learn more? Additional resources:
o Live for free! CD and workbook system http://www.livingfreediabetes.com
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