Health for life

If youre having difficulty keeping your resolution to exercise 30 minutes a day, 5-days-a-week, then youre going to like this study.

Researches put young men through some very brief, but strenuous, workouts and found their sensitivity to insulin (and so their blood sugar levels) improved:

Extremely Short Duration High Intensity Interval Training Substantially Improves Insulin Action In Young Healthy Males, BMC Endocrine Disorders, January 2009

A total of 16 men, average age 21, underwent 6 sessions of exercise over 14 days.

A session of exercise consisted of:

• 30 seconds of cycling as fast as possible
  
• 4 minutes of rest
  
• The above repeated 4 to 6 times

An exercise session lasted 17 to 26 minutes, but only 2 to 3 minutes of that was actual exercise.

Compared to before training (baseline):

• Postprandial glucose levels declined 12% (measured by AUC: Area Under the Curve)
  
• Postprandial insulin levels declined 37% (AUC)
  
• Postprandial free fatty acid levels declined 26% (AUC)
  
• Insulin sensitivity improved 23% (measured by Cederholm index)
  
• Aerobic cycling performance improved 6%

The authors concluded:

"The efficacy of a high intensity exercise protocol, involving only ~250 kcal of work each week, to substantially improve insulin action in young sedentary subjects is remarkable. This novel time-efficient training paradigm can be used as a strategy to reduce metabolic risk factors in young and middle aged sedentary populations who otherwise would not adhere to time consuming traditional aerobic exercise regimes."

________

Wheres Newt?

After watching the last Iowa Caucuses Republican Presidential debate, the Disease Management Care  Blog continues to be fascinated by The Newts repartee prowess.  Maybe its because the starstruck DMCB has seen the former Speaker in the flesh on a number of occasions.  National health policy conference organizers have known for years that the logorrheic and futuristic Newt Gingrich Big Idea Factory could be counted on to deliver the goods to any audience.

Yet, keynoting prowess is one thing, but being a contender for President an another.  Now that Newt has clawed is way into a leading position in the polls, greater visibility has prompted greater scrutiny. 

Thats why the DMCB likes this New York Times article on Newts unseemly mix of health advocacy and business ties.  Its not pretty, portraying Newt as a cynical political opportunist who has been brazenly willing to ally himself with popular "big-government" ideas.  Whats more, The Times darkly implies that consulting fees from big pharma and insurance companies caused him to promote their business interests.

So what, according to The New York Times, are Newts five sins?

1. While every other service industry relied on information technology, Newt had little patience for a health care system system that perpetuated reliance on pen and paper.  When HITECH passed, private citizen Newt had little problem taking some of the credit and collecting some fees while he was at it.

2. Newt repeatedly observed that ATMs could reconcile complex financial records and yield hard cash from any ATM in the world within seconds, yet Medicares payment systems were inaccurate, byzantine and highly vulnerable to fraud. He called for the orm of Medicare, which later also turned out to be one of the bedrock principles of the Democrats modernizing health orm agenda.

3. Then theres this 1995 "wither on the vine" quote in which he maps out the demise of Medicare because of orms leading Americans to "voluntarily [going to] leave it -- voluntarily."  Fast forward 15 years and Newt is supporting the Ryan-Wyden bipartisan compromise legislative proposal that is likewise based on voluntary choice and doesnt end Medicare as we know it.

4. Newt was also an ardent supporter of comparative effectiveness research (CER)  Newt specifically cited not-for-profit Cochrane as an example of the kind of CER he supported. He doesnt like this $1.1 billion boondoggle.

5. As for funding from insurers and pharma, Newts ideas on enhanced coverage of children and diabetes care attracted like-minded companies and allies.

"Big deal," says the yawning DMCB.  The Times concerns about Newts past lack substantive ballast.  If nothing else, Newts pugilistic skills will make Mitt Romney a stronger contender - assuming he makes it to the championship round .

While the DMCB is at it, it cant help but take a quick look at two other arenas of alleged Newty nuttiness:

1) That infamous criticism about his fellow conservatives dangerous "social engineering" in the Ryan Ver. 1.0 plan:

The DMCB thinks Newt personally liked the plan but disliked the prospect of having it pass over the objections of a leery electorate.  Its one thing to dream up a good plan, but its another to craft it behind closed doors and impose it on an unwilling citizenry.

By the way, that some logic seemed to underlie his recent debate commentary over abolishing "activist" federal courts.  Hes warning that in a divided powers representative democracy, the co-equal legislative and executive branches and grumpy voters could be pushed into neutralizing flashpoint judges at either end of the political spectrum with recalls, subpoenas, impeachment and defunding.  Hes not only consistent, he has a point. (A 12/22 addendum - A point which Newt is provocatively willing to to back up with U.S. Marshals.  Of course, he could just sandbang them during State of the Union Addresses.  Whats next: pieing?)

2)  Being too incendiary, zany and mercurial to be President

This was best portrayed by Peggy Noonans December 10 Wall Street Journal "Declarations"  description of Newt as a human "hand grenade" who delights in being to ready "watch this!" pull the pin at a moments notice. 

Good point, but there is also something stubbornly dysfunctional in many parts of the health care system.  If Obamacare doesnt work out as planned, there may be merit to the notion rejecting the Republican mainstream and applying a heavy dose of creative destruction.  Newt certainly has the "creative" and "destruction" chops.  Absent anyone else with this particular skill set, Newts biggest problem may be that were just not ready for him to combine them... yet.

Newts problem is that hes still far ahead of the curve.

Let the games continue.

Joslin Diabetes Center posted a great, easy-to-read table on the different insulins (rapid-, short-, intermediate-, long-acting), and the time periods in which they work (onset, peak, duration):

Click table to enlarge.________