Type 2 Diabetes and HIIT

05/11/2015 09:15 am ET | Updated May 11, 2016

There has been a lot of talk, interest, hype, etc. lately about the benefits of what is called HIIT, which is an acronym for High Intensity Interval Training. When the term high intensity is used in regards to exercise training, it usually means exercising at a high percentage of a person's maximal heart rate. Interval training is when that person performs exercise for a specified period of time then stops and rests for a specified period of time and then repeats this sequence repeatedly.

HIIT is not new

This type of training is not new, in fact coaches, athletes and even casual athletes have used this method of training for many years. I first was introduced to interval training when I was only ten years old swimming on the country club swimming team. The coach would have us swim 50 yards, rest 30 seconds and repeat until we had completed it 10 times. This was known as 10 x 50s with a 30-second rest.

There are many, many variations of doing interval training, but what they all have in common and what makes it interval training is alternating periods of work with periods of rest. The beauty of interval training is that it allows the person doing the training to accomplish greater amounts of work then if they were doing what is called steady state training. Steady state training is just as the name implies where the person runs, bikes, swims, performs the elliptical or rowing machine at the same pace without speeding up or slowing down for the entire duration of the exercise. Because there is no change in speed once the person's heart rate gets acclimated to the work load the heart rate will generally stay constant or steady (hence the term steady state) during the entire duration of the exercise. It is well known by true professionals in the exercise industry that interval training can produce the greatest gains in fitness and conditioning when used appropriately.

No, don't stop doing cardio

It has been suggested recently by some supposed fitness experts (none of which I have ever heard of) that cardio, or what we have traditionally referred to as aerobic conditioning, where someone exercises at a steady state for an extended period of time, is not the way to go if you want to lose weight fast, regain vitality and get "ripped." I saw yesterday where one "fitness expert" (does having a body builder physique make you a fitness and weight loss expert?) suggested that you should stop doing cardio exercise, implying that it was hurting you. Now is a good time to remember what your parents taught you about not believing everything you hear or read.

First of all, not everybody is looking to get "ripped," and there are greater risks involved when doing high intensity exercise vs. cardio. This is particularly true with people that are obese, have heart disease, high blood pressure and diabetes. Depending on the duration of someone's diabetes and how well they have cared for it they may already be experiencing diabetes-related complications which in that case HIIT would be definitely contraindicated whereas a lower level of intensity might be acceptable.

At this particular time, any disparaging comments made about any type of exercise that is safe to do is not productive. I say this during a time when most people are not getting anywhere near the amount of exercise they need and many people are not regularly engaging in any regular exercise.

For some people the increased health risk associated with performing high intensity exercise training may be of less concern due to their age, fitness level, genetic history, etc. For them burning more calories in a shorter period of time, the greater cardiovascular conditioning and the discomfort involved while doing HIIT is not too much to be a deterrent, great. For others the promoted benefits of HIIT may not be worth the risk. This does not mean that I would necessarily shy away from interval training altogether as it is a great way to do exercise but I would definitely avoid recommending HIIT for the majority of the population I see.

Interval training at ALFs

Interval training, the act of alternating periods of work and rest can be implemented for almost anyone as long as they are capable of handling even minimal stress. Even people in assisted living facilities that can lift their leg 10 times in front of them and then rest for one minute and then do it again, these people are doing intervals but at a low, far less intense level.

It's not the interval training that I take issue with, it's the high intensity half of the high intensity interval training that concerns me. Interval training can be very beneficial and provide sometimes quicker and greater fitness gains than long sustained cardio, however that in no way should demean the many benefits of cardio training regimens. Any time increased workloads are placed on the heart the heart is more vulnerable to what is referred to as a cardiac event. There is a relationship between the amount of stress placed on the heart and circulatory system and the risk of suffering a cardiac event, that is the greater the workload placed on the heart the greater the risk of suffering a cardiac event during the time the heart is under that increased stress. So then why do people that want to be healthy subject themselves to this increased risk even for a short time? Because it is believed that due to training adaptations that occur as a result of high intensity training the likelihood of suffering a cardiac event during non-exercise times is reduced to a level that is less than those that do not exercise at high intensity levels.

Long, slow to moderate cardio still the way to go for many

Lower intensity cardio exercise performed at a steady state or even intervals performed at a lower intensity can provide significant health and fitness benefits for the largest majority of people that are exercising today and there is no need to switch to an intensity of exercise that may be more risky in terms of injury and less pleasant. Countless people over the past 40-50 years have changed their lives for the better doing lower intensity steady state exercise and it pains me when it is suggested that people stop doing it in favor of more difficult, less comfortable and for many people more risky type of exercise.

Granted HIIT may burn more calories quicker and provide a higher level of fitness and is appropriate for some I suggest that it is a minority of the exercising population.

There is truly an exercise for everyone out there and slower less intense exercise whether it is incorporating low level intervals or not is a valuable one.