Letters to the Editor
Prescribing exercise for diabetes
- Ted Arnold, Bronwyn Penny
- Aust Prescr 2008;31:3-4
- 1 February 2008
- DOI: 10.18773/austprescr.2008.002
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Editor, – In the article 'Prescribing exercise for diabetes' (Aust Prescr 2007;30:130-3), the author adequately takes into account cardiovascular and neurological concerns when advising, for example, jogging or running. However, relative adult weight gain (weight gain compared to weight on reaching maximum height and general maturity) is seemingly not addressed other than in very general terms.
Patients may be at risk of considerable irreversible weight-bearing joint damage if this issue is neglected, since even prolonged walks in obese individuals could result in aggravated ankle, knee and hip degeneration due to the load-bearing involved.
If 'losing a pound results in a four-pound reduction in knee-joint load for each step'1, then surely adding weight might also potentially damage the weight-bearing joints in a fourfold manner as well.
Executive Health Management
Ms Bronwyn Penny, author of the article, comments:
I appreciate Dr Arnold's opinion and am in complete agreement regarding excessive joint loading in obese individuals who may be involved in significant weight-bearing activities.
In this situation, very obese patients may benefit from undergoing initial weight loss coupled with lower limb resistance training to increase lower limb strength and improve mobility before undertaking weight-bearing aerobic modalities.2
Medical officer, Executive Health Management, Sydney
Exercise Physiologist, Diabetes Australia - NSW, Sydney