Weight Loss with Risk Prevention: Exercise Contraindications and Safety Guidelines for People with High Blood Pressure, High Cholesterol, and High Blood Sugar

What precautions should be taken when exercising?

(1) Five things to avoid when exercising for the elderly

"Three highs" patients are mainly middle-aged and elderly people. Due to their special physical condition, they have many requirements in choosing exercise methods, exercise time and exercise intensity. The elderly must pay attention to the following five aspects when exercising:

① Avoid intense competition: Some intense sports competitions are not suitable for the elderly. This is mainly because: on the one hand, the function of various organs of the elderly declines, their coordination and reaction ability is poor, and they are prone to sports injuries; on the other hand, intense competition can easily cause excessive emotional excitement and easily induce accidents.

② Avoid holding your breath and exerting force: When the pressure in the pleural cavity is lower than atmospheric pressure, it is called negative pressure in the pleural cavity. This is conducive to the return of venous blood to the heart. However, when holding your breath, the pressure in the pleural cavity will suddenly increase, making it difficult for blood to return to the heart, reducing cardiac output, and thus reducing the blood supply to the brain. Therefore, dizziness and vertigo are likely to occur, and in severe cases, even fainting may occur. When the breath-holding is completed, a large amount of blood suddenly returns to the heart, which will cause a sudden increase in cardiac output, a rise in blood pressure, and a sudden increase in blood supply to the brain. At this time, cerebrovascular accidents are likely to occur. Therefore, older adults must ensure their breathing is smooth and natural during exercise, and avoid sudden breath-holding or straining.

③ Avoid weight-bearing exercises: Older adults often experience some muscle atrophy and a significant decrease in muscle strength; their nervous system reacts more slowly, coordination is poorer, and reaction time to stimuli is prolonged. Therefore, older adults should choose slow, gentle exercises that promote muscle relaxation and full-body activity, such as Tai Chi, walking, and jogging.

④ Avoid rushing: Excessive activity or rapid increases in intensity are often a cause of accidental injuries in older adults. Due to decreased physiological function, older adults have a lower capacity to adapt to physical exertion, thus requiring a longer adaptation period during exercise. For people over 30, the adaptation time increases by approximately 40% for every 10-year increase in age. Therefore, exercise should be gradual, increasing the intensity only after the body has adapted to a certain level of activity, avoiding excessive exertion.

⑤ Avoid changes in head position: Movements such as bending forward and backward, tilting to the side, various rolls, head-down and feet-up inverted positions all involve head movement, causing blood to flow to the head. Elderly people have hardened blood vessel walls and poor elasticity; if they cannot withstand the pressure, blood vessels may rupture, causing cerebral hemorrhage, which can be life-threatening in severe cases.

(2) Pay attention to the influence of environmental and weather factors

① Pay attention to the surrounding environment and climate: In summer, avoid the midday sun to prevent heatstroke; in winter, pay attention to keeping warm to prevent stroke. If outdoor environmental pollution is severe and air quality is poor, outdoor exercise should be avoided.

② Wear comfortable, sweat-absorbent clothing and shoes: Choose high-quality cotton clothing and athletic shoes. Prevent foot injuries by wearing elastic shoes with slightly thick soles and moderately firm uppers, such as athletic shoes. Regularly check shoes for foreign objects and remove them promptly to prevent injury. Athletes who have previously been injured should also pay attention to protecting vulnerable areas, ideally by wearing protective gear such as knee pads and wrist guards. ③ Choose a safe location: such as a park or school. Do not exercise in alleys or along roadsides. It is best to exercise in a partner, not alone. To prevent accidents, carry a medical card with your name, age, home address, and contact number while exercising.

④ Do not exercise on an empty stomach to avoid hypoglycemia: Exercise should be done 1.5 to 2 hours after a meal. Carry some candy with you to replenish sugar in case of hypoglycemia.

⑤ Avoid exercising too early in the morning: In the early morning, flowers, grass, and trees release less oxygen and have a higher concentration of carbon dioxide. At night, the ground temperature drops, and pollutants not only fail to disperse upwards but tend to sink. With deeper and faster breathing in the morning, pollutants, dust, and bacteria can easily enter the body through the respiratory tract. This is especially true for diabetic patients, whose resistance is weak, making them highly susceptible to lung and tracheal infections, which can worsen their condition. In addition, the lower morning temperature, exposure to cold air, or fatigue can easily lead to sudden illness. Diabetic patients with chronic complications such as cardiovascular disease should especially avoid exercising in the morning. Clinically, we often encounter diabetic patients who faint during morning exercise on an empty stomach. Diabetic patients (especially those with cardiovascular and cerebrovascular diseases) should use the period from early morning to 9 a.m. as their "warning line" for exercise. During this time, they should avoid being impatient, tense, or angry, and should not participate in strenuous activities.

⑥ Precautions before and after exercise: It is best to have a 5-minute warm-up before exercise, such as twisting the neck, shoulders, and waist, and doing some high knees. Besides walking, even after relatively strenuous exercise, continue with some cool-down activities such as walking or jogging for about 5 minutes. After exercise, it is not recommended to take a shower immediately, sit down immediately, or lie down to sleep immediately. Instead, maintain a standing posture until your heart rate returns to normal before starting other activities. Remember, this is very important.

⑦ Pay attention to the intensity of exercise and do what you can: The simplest way to measure exercise intensity is whether you can talk naturally during exercise, feel warm and sweaty but not profusely, be breathless, and be able to talk but not sing. For young and middle-aged patients without heart disease, a heart rate of 120-130 beats per minute during exercise is generally safe. Follow the three-part exercise routine: 5-10 minutes of warm-up, 20-30 minutes of exercise, and 5-10 minutes of cool-down.

⑧ Before implementing any exercise program, it is best to have a comprehensive and systematic examination at the hospital, including blood pressure, blood sugar, glycated hemoglobin, electrocardiogram, fundus examination, and kidney function tests. Sometimes, cardiac function tests are also necessary. Patients should establish a good relationship with their doctor and have the doctor develop a reasonable exercise plan. All diabetic patients receiving exercise therapy should undergo a comprehensive medical history inquiry and examination. For elderly patients or those with lung disease, if possible, lung function tests, blood pressure measurements, and fundus examinations should be added. Those with severe cardiopulmonary dysfunction or a history of fundus hemorrhage should not participate in exercise. If blood pressure rises, fundus hemorrhage occurs, or myocardial ischemia occurs after exercise, exercise should be stopped or reduced.

⑨ Each exercise session should last about one hour, and it is important to stay hydrated. Furthermore, if you expect to exercise for 1 hour, it's best to hydrate beforehand to avoid dehydration and its adverse effects on the body. For exercise exceeding 2 hours, consider having a snack to prevent excessive consumption of glycogen in the liver and muscles, which could lead to hypoglycemia.

(3) Who is unsuitable for exercise?

① Severe type 1 diabetes: In cases of absolute insulin deficiency, exercise not only fails to promote muscle glucose utilization but also increases liver glucose output, leading to increased fat breakdown and a higher risk of ketoacidosis.

② Diabetic patients with kidney complications: Exercise reduces renal blood flow, lowers glomerular filtration rate, increases proteinuria, and worsens diabetic nephropathy. These patients are not suitable for exercise therapy.

③ Patients with cardiovascular complications: For those with severe hypertension or coronary heart disease, exercise increases the burden on the heart, raises blood pressure, and can easily trigger angina or even myocardial infarction. Patients with these conditions should undergo a thorough physical examination before exercising. Even if moderate exercise is permitted, the amount and type of exercise should be strictly controlled, and all indicators of exercise response should be closely monitored. Exercise should be conducted under the supervision of a doctor, and patients must never exceed their physical capacity.

④ Patients with severe diabetic retinopathy: Exercise can worsen retinal lesions and increase the risk of bleeding.

⑤ Patients with diabetic foot: Exercise can exacerbate ischemia and hypoxia in the extremities, worsening foot lesions.

⑥ Patients with acute metabolic disorders: Such as diabetic ketoacidosis, exercise can exacerbate the degree of metabolic disorder.

⑦ Elderly diabetic patients with the following conditions are relative contraindications: worsening arrhythmia after exercise, left or right bundle branch block; pacemaker implantation; recent history of cerebral ischemia; severe varicose veins; history of thrombophlebitis; neurological, muscular, or joint dysfunction; taking certain medications such as digitalis and beta-blockers.