- A new study suggests that logging high weekly totals of moderate to vigorous physical activity can reduce the risk of developing chronic kidney disease in people with type 2 diabetes who are also living with overweight or obesity.
- The research indicates that people who tallied 329 to 469 minutes per week of moderate to physical activity were significantly less likely to develop chronic kidney disease than their peers who logged under 220 minutes.
- Health experts say physical activity doesn’t need to be limited to movement typically associated with exercise.
Getting exercise is standard advice for preventing and managing type 2 diabetes. It’s based on years of research that indicates that physical activity helps manage blood sugar levels.
Now, a new study indicates another potential benefit: Reducing the risk of chronic kidney disease in patients who have type 2 diabetes who are also living with overweight or obesity.
The study was published online on February 7 in the British Journal of Sports Medicine and indicated that participants with type 2 diabetes who were living with overweight or obesity had a lower chance of developing chronic kidney disease than those who did not.
People with diabetes are at a higher risk of chronic kidney disease.
About 1 in 3 people living with diabetes also have chronic kidney disease, according to
The CDC does not separate between type 1 and type 2 diabetes, but a
Experts say that research like this study is pivotal in providing patients and providers with tools and insights to prevent this common co-existing condition.
“A lot of patients who have diabetes end up having kidney disease, and on dialysis, so anything that can decrease the risk of being on dialysis is going to be good for the patient’s quality of life,” says Dr. Kenar Jhaveri, MD, the associate chief in the Division of Kidney Diseases and Hypertension at Northwell Health.
The eight-year study of 1,746 people evaluated the effects of moderate to vigorous physical activity on the progression of chronic kidney disease in people who were living with overweight or obesity.
Researchers tracked activity levels with an accelerometer rather than subjective measures like questionnaires or journals.
Dr. Jewel Osborne-Wu, of Revolution Medicine, Health & Fitness, says this method added objectivity to the reporting and results.
Participants who got 329 to 469 minutes per week of moderate to vigorous physical activity were at a lower risk of progressing to chronic kidney disease than those who tallied less than 220 weekly minutes. The more physical activity minutes a person averages weekly, the lower their risk of chronic kidney disease.
“This means that those who participated in moderate to vigorous physical activity for longer periods of time or increased the duration of activity over time were less likely to experience the progression of renal disease and therefore were able to keep their kidneys healthier for longer,” Osborne-Wu says. “This improvement was found to be linear, meaning that the more activity performed, the healthier the kidneys became long term. There also seemed to be no plateau effect.”
Osborne-Wu says that this indicates that a person can continue to log more and more moderate to vigorous physical activity each week and see a more significant risk reduction of chronic kidney disease.
Moreover, people who upped their weekly physical activity minute tally by a little more than one hour (63 minutes) over the course of the first four years of the study saw their risk of developing chronic kidney disease fall by 33%.
Researchers noted effects for individuals who got this activity in bouts of more or less than 10 minutes.
“This is encouraging for those who are not able to perform an activity for longer than 10 minutes at a time but can do it often and frequently,” Osborne-Wu says.
Jhaveri was impressed and encouraged by the results.
“More and more, people are sedentary,” Jhaveri says. “Keeping yourself active and not just sitting on the couch changes the way your body metabolizes some of the sugar and cholesterol. When that happens, your insulin is better tolerated by the body and cannot start damaging the heart and the kidney.”
Still, the study has some limitations.
“The study does not show a direct causal relationship between exercise and reduction of kidney disease…because there is no strict control of other variables,” says Dr. Felix Spiegel, a bariatric surgeon with Memorial Hermann, Houston, Texas. “For example, someone who exercises a lot could have also made other lifestyle and diet changes that affect kidney disease.”
Spiegel adds that researchers didn’t control for weight loss.
“For example, some of the participants could have had weight loss surgery in addition to exercise and prevented kidney disease because of the weight loss-associated benefits to their kidneys,” Spiegel says.
The study indicates no ceiling to how much exercise to get.
However, Spiegel and Osborne-Wu say getting about an hour per day, seven days per week, offers the most benefits for patients with type 2 diabetes who are also living with overweight or obesity and want to reduce their risk of chronic kidney disease.
These numbers are significantly higher than the American Heart Association’s commonly cited recommendation to get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week, which doesn’t surprise Osborne-Wu.
“Diabetes causes an increase in inflammation, reduction in effective blood flow through the kidneys, and scarring,” Osborne-Wu says. “Exercise is known to promote anti-inflammatory markers, increase blood flow, and carry healing biomarkers to areas of damage. It makes sense that a [person with diabetes] may require more exercise than the average person in order to compensate for the damage that has already been occurring.”
Intensity also matters, but “moderate” and “vigorous” can be vague.
“Moderately intense activity can be described as an activity that increases the heart rate and body temperature and causes a person to breathe fast enough that they can talk in short sentences or phrases only,” Osborne-Wu says. “Vigorous activity is harder and faster, usually resulting in the inability to say more than a word or two at a time.”
The high numbers of physical activity may seem overwhelming at first. However, experts shared ways to make it more manageable (and safer).
Consult a doctor
Since type 2 diabetes can affect organs within the body, it can lead to other underlying conditions like cardiovascular disease.
For example, people with diabetes are two times as likely to develop cardiovascular disease,
Jhaveri says discussing a new workout routine with your care team, such as a cardiologist, is always a good idea before proceeding.
Start small and slow
High amounts of exercise can be beneficial, but people don’t need to sign up for a marathon or try to start logging 369 minutes per week when they’re getting started.
Remember, the study indicates that even 10 minutes of physical activity at a time can add up and provide benefits. Additionally, long and intense exercise right out of the gate can increase injury risk. Jhaveri says low impact activities can provide benefits.
“Think brisk walking, simple biking, and just swimming for a few minutes for like half an hour at a time,” he says.
Think outside the box
Physical activity isn’t limited to exercise.
“You can walk up the stairs at the office instead of taking the elevator,” Spiegel says. “You can do yard work and house cleaning yourself instead of paying someone to do it…You can park far away at venues or stores so you can walk more.”
In other words, you have options — it’s not one-size-fits-all.
People with type 2 diabetes are at a greater risk of developing chronic kidney disease.
Research indicates that high weekly totals of moderate to vigorous intensity physical activity can reduce a person’s risk if they have type 2 diabetes and are living with overweight or obesity.
Experts say that physical activity helps manage blood sugar, increases blood flow, and has an anti-inflammatory effect, which may contribute to its benefits for people with type 2 diabetes.
The research and experts suggest that getting an hour of physical activity daily, seven days per week, offers the most benefit.
However, people who log higher amounts might see even more significant benefits — the study did not note a plateau.
Speak with a healthcare professional before starting a new workout routine.