Diabetes Forecast

Take Your Favorite Exercise Outdoors


As naturalist and essayist Henry David Thoreau put it, “An early-morning walk is a blessing for the whole day.” Although he wrote that more than 150 years ago, modern science suggests he was onto something: Moving your body outside makes you healthier.

Exercise is great for all aspects of health, including blood glucose management. But being in the great outdoors has added benefits. A 2011 review of 11 studies in the journal Environmental Science and Technology concluded that, compared with indoor exercise, outdoor activity was associated with feeling more energized and positive, and with decreases in anger and depression. “Outdoor exercise is a full-body reset,” says Marcey Robinson, MS, RD, CSSD, BC-ADM, an exercise physiologist and diabetes educator in Basalt, Colorado. “It’s good for the soul and mind as well as for [managing] blood sugar.” Here are a few of the many ways that being active outdoors, especially in a natural environment, can improve your health: 

  1. It boosts mental health. A 2012 study published in the Journal of Affective Disorders showed that a walk in an arboretum lifted the spirits of people suffering from depression, even though they were asked to think about a painful memory before the walk. “There’s something about the acoustic and visual properties of being outside,” says Marc Berman, PhD, an assistant professor of psychology at the University of Chicago, who led the study. “Interacting with nature gets you into this good mindset. You’re part of a system, and there are things out there bigger than yourself.”

  2. It might help your body image. A study published in January in the journal Body Image found that spending time in nature—in this case, city parks—for as little as one hour per day gave people more appreciation for their bodies. Researchers think that may have to do with participants’ focus on the beauty of their surroundings  rather than how they compared with the person on the treadmill next to theirs.

  3. It can make you more alert. A dose of sunlight, especially in the morning, signals to your brain that it’s time to wake up and can help you feel more alert throughout the day. “You’re getting the morning light you need to train your circadian system, the hormonal body clock that tells you when it’s time to wake and sleep,” says Mariana Figueiro, PhD, director of the Lighting Research Center at Rensselaer Polytechnic Institute in Troy, New York. A circadian system that’s out of step, on the other hand, can lead to too little sleep, which can result in higher blood glucose levels the next day. Over time, irregular or too-short sleep can raise the risk for obesity and cardiovascular disease and, for people without diabetes, the risk for type 2. Another reason to get your daily dose of sunlight: Exposing your skin to the sun’s rays can boost your body’s production of vitamin D, which is important for bone and heart health. Some research suggests that an adequate intake of the vitamin—your doctor can test your blood levels—is associated with better blood glucose levels.

  4. It can make you work out longer. A 2012 study published in the International Journal of Behavioral Nutrition and Physical Activity showed that older adults who exercised outdoors at least once a week did 30 more minutes of vigorous activity each week than those who exercised indoors only. That may be because sunshine, fresh air, and the variety of activities available make exercise more fun. “Usually when people exercise outdoors, they’re more likely to stick with a program,” says exercise physiologist Guy Hornsby, PhD, director of the Human Performance Lab at West Virginia University in Morgantown.

Activity Awaits

Let’s be clear: Indoor exercise is better than no exercise. But when it comes to motivation, the great outdoors can be another draw. You can jump-start an outdoor exercise routine just by walking the long way home, playing catch with your pooch, or taking a lunchtime stroll. Step up the fun factor by trying a new activity. “People think, ‘I have to exercise; my doctor told me to,’ ” says Robinson. “But being outside is really about enjoyment and play and breathing the fresh air. Find an activity that’s a motivator for you.”  

Not sure where to begin? Steal these ideas:

Day Hiking. Walking helps strengthen bones and muscles, lowers your risk of heart disease, improves balance, burns calories, and reduces blood glucose levels. Aim to stride briskly for at least 2½ hours per week for optimal health benefits. Try day hiking for a full-on nature experience. New to hiking? Start with shorter distances and flatter trails. Some trails are even paved and accessible to people using walkers or wheelchairs. Paved trails are also a good option for anyone with a loss of sensation in the feet due to nerve damage (neuropathy), because uneven ground can pose risks. You can find a nearby trail and see its difficulty level at alltrails.com.

Disc Golf. Instead of using a golf ball and clubs, you toss a flying disc at targets along a trail course that’s usually in a natural environment. The idea is to complete each “hole” in the fewest throws. “It’s a fun game and a stress release,” says Robinson. “Playing reminds me of being a kid.” There are thousands of courses nationwide; see pdga.com to find one near you.

Paddling. Canoeing, kayaking, and stand-up paddleboarding—which is easier than it looks!—build arm strength and aerobic capacity. Find a boathouse nearby at paddling.com.

Water Workouts. Aqua Zumba, water aerobics, and underwater cycling are all great for burning calories and toning muscle. And buoyancy takes pressure off joints and feet, which is helpful if you have arthritis or neuropathy, or are very overweight. There’s also the fun factor: “We did a study and found that people who did aerobic and resistance activities in water enjoyed it more than those who did the same exercises on land,” Hornsby says. Look for classes at a YMCA, recreation center, or swim club, many of which feature outdoor pools.

Biking. Pedaling is another great low-impact activity. If you have balance issues, consider a step-through bike, which has a low interior frame so it’s easier to mount. A three-wheel recumbent bike is more stable than a traditional model and eases pressure on your back and joints, making it a good choice for people with arthritis and nerve damage.

Play it Safe

Outdoor activities require a few extra precautions. Here’s a checklist.

  1. Plan ahead. Physical activity can lower your blood glucose, and not just during the workout itself. Your levels may be low for up to 24 hours after exercising. “It’s always good to bring in your diabetes management team because, depending on medications, there may need to be an adjustment before you embark on a new exercise routine,” says Jennifer Smith, LD, RD, CDE, a triathlete and certified diabetes educator in Madison, Wisconsin. “You may need to take less insulin or have a snack ahead of time.” Track how you respond to a new exercise by monitoring blood glucose before, during, and after it, noting what you ate and the time of day. 

  2. Pack water. Dehydration can drive up your blood glucose levels. Hot weather can increase the risk, and older adults are particularly prone. If you’re thirsty, it means you’re already a little low on hydration, Smith says. Signs of more serious dehydration include feeling dizzy or fainting, rapid heartbeat and breathing, and dark yellow urine. It’s important to hydrate before, during, and after a workout. Drink 17 to 20 ounces of water two hours before you exercise. How much fluid you’ll need during a workout depends on your age and weight, the outdoor temperature (you’ll lose more fluids sweating on a hot day), and what you’ll be doing, but as a general rule of thumb, Smith suggests drinking a 16-ounce bottle of water for every hour you’re exercising.

  3. Wear the right shoes. Footwear is important for all people with diabetes but doubly so for those with nerve damage and a loss of sensation in the feet. Poorly fitting shoes can rub skin into a blister or cause cuts, which can progress to hard-to-treat ulcers if you don’t notice and treat them right away. A cushy, supportive walking shoe helps prevent the chafing that causes blisters, while a water shoe protects your feet when swimming and paddling. Go to here for more information on picking the right shoe for you.

  4. Dress the part. When buying workout wear—including socks—look for synthetic fabrics that are advertised as sweat wicking to help avoid chafing and blisters from damp material, Smith says. Sunscreen and clothing with UV protection help ward off sunburn, which not only raises your risk of skin cancer, but can also raise blood glucose levels. And don’t forget your medical ID, which alerts strangers of your diabetes in an emergency.

  5. Carry a location device. Most established park trails are well-marked, but you’re on your own in the backcountry. No matter where you go, use an old-fashioned compass or a hiking app such as Gaia GPS to help you stay on your route, and tell someone where you’re heading before you set out.

  6. Bring supplies. Take your blood glucose monitoring tools, diabetes medication, and fast-acting carbohydrates in case your blood glucose goes low. Pack extra in case you’re out longer than you planned, your device runs out of batteries or breaks, or your workout is more strenuous than you anticipated. If you need insulin, make sure it doesn’t overheat; its chemical composition will change, making it less potent. Smith suggests storing insulin in a water-activated cooling bag, which can keep it cool for days.

  7. Buddy up. Your outing might be more enjoyable, as well as safer, if you bring a friend. Or look for like-minded fitness seekers near you at meetup.com. “It makes it easier to stick to a routine if someone is depending on your being there,” Smith says.

New to Biking?

Skip roads and trails, and stick to paved bike paths. Find one near you at railstotrails.org.



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