Johns Hopkins Diabetes GuideManagementLifestyle and Education

Physical Activity and Exercise

Mariana Lazo, M.D., Mimi Huizinga, M.D.
Physical Activity and Exercise is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Physical activity: bodily movements produced by the contraction of skeletal muscle that requires energy expenditure beyond resting energy expenditure
  • Exercise: planned, structured physical activity performed to develop or improve one or more components of physical fitness.
  • Physical fitness: includes cardiorespiratory fitness, muscular fitness and flexibility (see below).
  • Intensity of exercise: refers to the level of effort or physiological demand required to perform the activity
  • Metabolic equivalent (MET): unit to estimate the level of effort (oxygen consumption) of the physical activity. It indexes the intensity of exercise. E.g. sleeping (0.9 MET), walking 2.5 mph (2.9 MET), bicycling < 10 mph (4.0 MET), jogging (7 MET), rope jumping (10 MET). Often expressed as MET per minute or MET per hour
  • Classification of physical intensity: light (35-54% maximum heart rate, or 1.1 to 2.9 METs); moderate (55-69% maximum heart rate or 3.0 to 5.9 METs); vigorous or high (70 - 89% maximum heart rate or ≥6 METs).
  • For most people with type 2 diabetes, brisk walking is a moderate-intensity exercise.
  • Aerobic exercise: Rhythmic, repeated, and continuous movements of the same large muscle groups for at least 10 min at a time (e.g.walking, bicycling, jogging, and swimming). Increases cardiorespiratory fitness and energy expenditure. Resistance exercise: Activities that use muscular strength to move a weight or work against a resistive load (e.g. weight lifting and exercise using weight machines). Increases muscular fitness and whole body glucose utilization.
  • Maximum heart rate = 220 - age, preferably determined by graded exercise testing (GXT).

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Last updated: October 4, 2015