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Today we talk to Greg Wells about the relationship between type 2 diabetes and exercise. A professor in the Faculty of Kinesiology and Physical Education and an associate scientist in physiology and exercise medicine at the Hospital for Sick Children, Wells is at the forefront of the new field of exercise medicine, which investigates the use of physical activity to treat and prevent chronic disease.

What’s the relationship between type 2 diabetes and physical activity?

Type 2 diabetes and obesity are closely linked. We know that if we intervene with physical activity there is an improvement in physiology. If we intervene with nutrition and physical activity, the combined affect appears to be amplified. That’s a critical factor in the successful treatment of type 2 diabetes. It isn’t exercise alone, it isn’t diet alone, it’s the combination of exercise and good nutrition.

In terms of physical activity, there are two components. One is habitual physical activity—movement as part of daily life. Gardening, house chores, walking to and from school, playing in the playground. The more you move, the better. This is where we’re having a lot of success with children with obesity and other chronic diseases.

The other component is exercise, which we define as structured physical activity that is a little more intense. It’s harder to incorporate exercise into life. It’s extremely effective, but adherence to it in the long term is challenging.

It also appears when we talk about exercise that a multi-faceted approach is good. If we can incorporate aerobic or cardiovascular exercise, that’s really important. Strength training also has benefits. The nice thing is that it looks like a whole bunch of different things work. And when we combine them, they’re even more effective, which is great, because people get bored of the same exercise routine. It means you don’t have to do the same thing all the time. You don’t have to worry so much about what it is exactly that you’re doing. Just do something. If you get bored, change it up and do something else.

How important is this? We know the incidence of type 2 diabetes is up. What are the consequences of this for our society?

If a child is diagnosed with type 2 diabetes at age 10, they will live on average 19 years less than a healthy person. Because of the rapidly accumulating instance of obesity in our population and all the diseases associated with it—type 2 diabetes, but also cardiovascular disease, psychological disorders and inflammatory diseases—it may be that the generation coming up will be the first generation that does not live as long as the one before it. Thousands of years of progress have been wiped out because of North America’s problem with high-calorie, low-nutrient foods and lack of exercise.

When we talk about exercise having a positive effect on the physiology of type 2 diabetes, what does that mean?

You can reverse the effects of type 2 diabetes by doing exercise. It doesn’t cure it, but you can temporarily alleviate the physiological problems associated with it. For example, exercise can reduce the insulin resistance that is associated with type 2 diabetes for up to 72 hours.

Consider interval training, where you do some higher intensity work. It’s turning out to be really, really important. This may be because higher intensity exercise works the sugar processing system in the muscles, which is what’s affected in type 2 diabetes.

So in theory if you exercised every couple of days you could halt the effects of diabetes in your body?

Yes.

How much exercise are we talking about?

We’re looking for people to take part in about six hours of activity a week. It seems like a lot, and it’s hard to incorporate that into our lives, but that seems to be the threshold where most chronic diseases can be avoided and treated. But, remember, it can be anything. It can be walking to and from the subway station, it can be gardening in your back yard, it can be going for a run or a walk.

It doesn’t have to be an hour at a time?

It’s better if it is, but if you accumulate the six hours in any way, shape, or form, that’s fantastic.

You mentioned that you see best results when you combine exercise and dietary interventions. We spoke with Thomas Wolever of nutritional sciences last week about the relationship between food and type 2 diabetes, but can you give us an overview of what you’d recommend in terms of food?

The simplest thing to do is avoid high-calorie, low-nutrient foods and shift to nutrient-dense food. For example, a soft drink is very high in calories and has essentially no nutrients, whereas blueberries are extremely high in nutrients and very low in calories.

You have to go back and think about what works. What has worked forever is a balanced approach. Any time that humans get into extreme anything, it never works. In the 1970s and 1980s low-fat was all the rage. It worked for a while but then it ended up causing problems. Then the trend was low-carb. Both approaches failed when long term results were examined.

We have to adopt a balanced approach. We’re looking for high-quality fats, high-quality carbohydrates and high-quality proteins against a background of lots of fruits and vegetables and being very well hydrated. Try to get as many nutrients as you can in a reasonable amount of calories.

The same principle applies to exercise. We want to be doing as many different types of things as we possibly can. If you only do yoga, you get extremely flexible, but your cardiovascular fitness will deteriorate. If you only lift weights, you build a lot of muscle tissue, but you lose out on the cardiovascular side.

The human body is amazing. It adapts extremely well and it responds well to variety and change and movement. If we adopt those simple principles, anyone can make positive changes in their lives.

We’re talking about type 2 diabetes specifically, but your own work focuses more on other diseases. What other diseases can we prevent or treat with diet and exercise?

Pretty much everything: obesity, cystic fibrosis, inflammatory diseases like arthritis, maybe even cancer. Almost every psychological disease: ADHD, Alzheimer’s, anxiety, depression.

Tell us a bit about your research.

I’m in a field of investigation called exercise medicine. We look at how chronic diseases cause exercise intolerance. For example, obesity damages muscle tissue, which causes people to have difficulty exercising. Then we look at how exercise and nutrition can be used to treat and reverse that chronic disease without the use of pharmaceuticals.

My research is on muscle and lung. I deal a lot with cystic fibrosis. We have a huge study going on right now on obesity in children. I use advanced imaging techniques to look at metabolism. So I use MRI to investigate muscle function and lung function.

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So, people are talking. But what does Obama’s declaration mean for the likelihood of him being a two-term president? And what does it mean for Mitt Romney and the Republican Party? U of T Scarborough political scientist Professor Christopher Cochrane, an expert in analyzing the left-right debate in politics, offers his take.

Q. Obama’s announcement certainly grabbed the headlines, but was it as bold a move as it initially seemed to be?

A. It’s certainly a major step for Obama to come out and support gay marriage, but I don’t think it’s as politically risky as it’s being made out to be. Of the people who are ardently opposed to gay marriage and who would vote exclusively on this issue, very few of them would have voted for Obama anyway. This speaks to the way that people’s opinions on different issues are packaged together. Obama is a supporter of abortion rights, for example, and support for abortion rights is strongly linked in public opinion with support for same-sex marriage. The Democrats are not going to lose people on same-sex marriage who they had not already lost on other issues.

Q. How will it impact Mitt Romney’s campaign?

A. This may galvanize the Tea Party behind Romney, but he has to be careful that he doesn’t alienate independents who are drawn to the Republican party for their economic policies, but not so much for their social policies. I think Romney’s timid reaction to Obama’s claim – effectively, that it’s a state’s rights issue – indicates his own concerns about the politics of same-sex marriage, and perhaps even some ambiguity about his own position on the issue.

Q. Politics is really owning the headlines lately, isn’t it?

A. The Obama announcement and its implications is great fodder for the established culture war industry in America. In the past two weeks, Canadians have seen the abortion question raised in the House of Commons, protests over the role of the state in education in Quebec, the President of the United States express support for same sex marriage, and unprecedented appeals, from all sides, to the radical right in France. Immigration, abortion, gay marriage, tuition rates, fiscal austerity – it’s hard to imagine that just a few decades ago the words “left” and “right” were effectively a foreign language in Canadian politics.

Find out more about Professor Cochrane’s research at: www.chriscochrane.ca

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Science Rendezvous showcases the best and brightest in science and technology in Canada. The public will get a chance to meet with world-class researchers, take a behind the scenes tour of some of the cutting-edge research labs, participate in hands on experiments and activities, watch amazing demonstrations of the integration of science, architecture and human ingenuity, and most of all, have fun while experience science in a whole new way! This one-day event will make science accessible to people of all ages and from all back-grounds.

Please share this message widely with your colleagues, friends and family and encourage them to participate. More information on the U of T events organized by all three campuses can be found at:

• Watch a Science Rendezvous video on YouTube
• Events across the GTA and Canada: www.sciencerendezvous.ca
• U of T St. George Campus: Download Brochure | More details
• Toronto Zoo – organized by U of T Scarborough (UTSC): More details
• U of T Mississauga (UTM): More details

We hope to see you on May 12!

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That’s Professor Lindsay Schoenbohm, of U of T Mississauga’s Department of Chemical and Physical Sciences, commenting about how global society is going to have to get serious about dealing with the forces that have created climate change if our planet is to remain healthy in the future.

Schoenbohm and 15 other U of T researchers in the early stages of their careers are featured in a new publication from the Office of the Vice President, Research called Life in 2027: Ideas about tomorrow from our next generation.

“The focus of this report is how global society will fare in the near future,” said Professor Paul Young, Vice President, Research. “The researchers we feature represent the next generation of scientists and scholars who will be among those leading progress on the challenges we all face now. We chose 2027 to highlight how research today might impact tomorrow as U of T enters its third century of operation.”

The report profiles some of the university’s most accomplished early career researchers, asking them about everything from global warming to why we have so much trouble with work-life balance.

Young notes that Life in 2027 acts as a companion piece to Excellence, Innovation, Leadership: The University of Toronto Strategic Research Plan, 2012-2017, which was published earlier this year. “The work of all of these researchers links directly to our strategic research plan, which sets out the priorities U of T must develop to create an environment in which researchers like these can do their work.”

Professor Indigo Esmonde of U of T’s Ontario Institute for Studies in Education is another of the Life in 2027 researchers. Esmonde is combining a background in math and a commitment to social justice to imagine a different world.

“I work with teachers who want to bring social justice issue into the math classroom. Thinking deeply about issues of equity is more often done in social studies classrooms, but if math is not a part of it then we’re missing something. One of the biggest reasons to learn math is to make the world a better place.”

Other researchers profiled include:

Jennifer Murphy, Chemistry; Daniel Wigdor, Computer Science and Mathematical & Computational Sciences, U of T Mississauga; Anne-Claude Gingras, Molecular Genetics and Samuel Lunenfeld Research Institute at Mount Sinai Hospital; Daniel Roth, Paediatrics and the Hospital for Sick Children; Joyce Poon, Electrical and Computer Engineering; Sabine Stanley, Physics; Matthew Roorda, Civil Engineering; Holger Syme, English & Drama, U of T Mississauga; Emma Master, Cell & Systems Biology; Christopher Cochrane, Political Science and U of T Scarborough Department of Social Science; Suzanne M. Cadarette, Pharmacy; Julie McCarthy, Department of Management, U of T Scarborough and Rotman School of Management; Imogen Dickie, Philosophy; and Aziza Chaouni, Architecture, Landscape and Design.

The Life in 2027 package also includes By the Numbers, a detailed look at U of T’s research performance by way of sophisticated statistical analysis.

• Read the report
• Read the statistical supplement

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