Exercise and Diet with a Chronic Disease

Chronic disease

Chronic disease affects roughly 100 million Americans. Overwhelming evidence in modern studies link most chronic diseases to physical inactivity and inappropriate diet. One of the most effective ways of battling chronic disease is by engaging in physical activity. It is critical that you enjoy your exercise regimen so that it becomes a source of pleasure for you, giving you a positive feeling of well-being as well as a positive outlook on life. Exercising effects muscle tone, blood pressure, and many other factors that are important to everyone, especially to individuals with a chronic disease. Exercise effectively reduces weight, overall body fat and intra-abdominal fat, a hidden risk for many chronic illnesses.5 Below are diet and exercise tips for some of the most common chronic diseases.

*Note: These are just recommendations and it is important to talk to your doctor about your health prior to following a long-term diet or exercise plan.

Diabetes: Type 1 & Type 2
Healthy eating, along with physical activity and, if needed, diabetes medicines, helps keep blood glucose in the target range. Below are diet and exercise recommendations to help achieve this goal.

You can take good care of yourself and your diabetes by learning what to eat, how much to eat, and when to eat. (If you are taking diabetes medicine, what you eat and when you eat affects how your diabetes medicines works. Talk with your doctor about when to take your medications).

Here are some dietary guidelines:6

If you are a small woman who exercises, a small or medium-sized woman who wants to lose weight, or a medium-sized woman who does not exercise much, eat about 1,200 to 1,600 calories a day.

Eat the following servings from each food group:

  • Six starches
  • Two milks
  • Three vegetables
  • Four to six ounces of meat and meat substitutes
  • Two fruits
  • Up to three fats

If you are a large woman who wants to lose weight, a small man at a healthy weight, a medium-sized man who does not exercise much, or a medium-sized to large man who wants to lose weight, eat about 1,600 to 2,000 calories a day.

Eat the following servings from each food group:

  • Eight starches
  • Two milks
  • Four vegetables
  • Four to six ounces meat and meat substitutes
  • Three fruits
  • Up to four fats

If you are a medium-sized or large man who exercises a lot or has a physically active job, a large man at a healthy weight, or a medium-sized or large woman who exercises a lot or has a physically active job, eat about 2,000 to 2,400 calories a day.

Eat the following servings from each food group:

  • Ten starches
  • Two milks
  • Four vegetables
  • Five to seven ounces meat and meat substitutes
  • Four fruits
  • Up to five fats

What are healthy ways to eat starches?
Buy whole grain breads and cereals and eat fewer fried and high-fat starches such as potato chips, french fries, or pastries, and instead try pretzels, fat-free popcorn, baked potatoes, or baked tortilla chips. Eat cereal with fat-free or low-fat milk and use low-fat or fat-free substitutes (i.e., low-fat mayonnaise, light margarine).

What are healthy ways to eat vegetables?
Eat raw and cooked vegetables with little or no fat, sauces, or dressing and steam vegetables using water or low-fat broth. Try using low-fat or fat-free salad dressing on salads.

What are healthy ways to eat fruits?
Eat fruits raw, cooked, as juice with no added sugar, canned in their own juice, or dried. Choose pieces of fruit more often than fruit juice, as whole fruit is more filling and has more fiber.

What are healthy ways to have milk?
Drink fat-free (skim) or low-fat (1%) milk, eat low-fat or fat-free fruit yogurt and use low-fat plain yogurt as a substitute for sour cream.

What are healthy ways to eat meat and meat substitutes?
Buy cuts of meat that have only a small amount of fat on them and trim off the extra fat, eat chicken or turkey without the skin, limit the amounts of nuts, peanut butter, and fried foods eaten (they are high in fat), and cook meat in low-fat ways: broil, grill, steam, and stew.

*Talk with your diabetes specialists about how to make a meal plan that fits the way you usually eat, your daily routine, and your diabetes medicines.

Physical Activity
Sometimes, it may seem easier to pop a pill or even have a shot than to put on your walking shoes and walk in the park. But the truth is that exercise, in combination with a healthy diet, is one of the best things you can do to take care of yourself if you have diabetes.

Why is it important for people with diabetes to be physically active?

  • Physical activity burns calories, which will help you lose weight or maintain a healthy weight.
  • Regular exercise can improve the body’s ability to use insulin and is known to be effective in managing blood glucose. Exercise can lower blood glucose and possibly reduce the amount of medication you need to treat diabetes, or even eliminate the need for medication all together.
  • Exercise can improve your circulation, especially in your arms and legs, where people with diabetes have the most problems.
  • Exercise can help reduce your cholesterol and high blood pressure. High cholesterol and high blood pressure can lead to a heart attack or stroke.
  • Exercise helps reduce stress, which can raise your glucose level.
  • In some people, exercise combined with a meal plan, can control Type 2 Diabetes without the need for medications.

How much and how often should people with diabetes exercise?
If you’re out of shape and have recently been diagnosed as having diabetes, see your doctor before you begin an exercise program. Your doctor can tell you about the kinds of exercise that are good for you depending on how well your diabetes is controlled and any complications or other conditions you may have. Moderate-intensity physical activity for at least 30-minutes on five or more days a week is recommended. However, you will see improvements if you exercise at least three times a week. Examples of moderate-intensity exercise are walking briskly, mowing the lawn, dancing, swimming, or bicycling. Try to do some physical activity everyday; it is better to walk for 10 to 20 minutes each day than one hour once a week.

What are quality types of physical activity for people with diabetes?

  1. Be extra active every day (i.e. walk around while you talk on the phone, take the dog for a walk, get up to change the channel instead of using the remote control, clean the house, wash the car).
  2. Aerobic exercise (i.e. walk briskly, hike, climb the stairs, dance, swim).
  3. Strength training with hand weights, elastic bands, or weight machines two to three times a week to build muscle. When you have more muscle and less fat, you’ll burn more calories because muscle burns more calories than fat.
  4. Stretching increases flexibility, lowers stress, and helps prevent muscle soreness.

Are there any safety precautions for physical activity for people with diabetes?

  • Build up the time you spend exercising gradually. If you have to, start with five minutes and add a bit of time each day.
  • Physical activity can lower your blood glucose too much, causing hypoglycemia, especially in people who take insulin or other oral medications. To help prevent hypoglycemia, check your blood glucose before you exercise. If it’s below 100, have a small snack prior to exercise.
  • Bring food or glucose tablets with you while you exercise, just in case. On the other hand, you should not exercise if your blood glucose is too high because exercise could make it go even higher. Do not exercise if your blood glucose is above 300.
  • Drink plenty of fluids before, during, and after physical activity.
  • Always wear your medical identification or other form of ID while exercising.
  • Stretch for five minutes before and after your workout regardless of the intensity of your exercise.
  • Avoid lifting heavy weights as a precaution against sudden high blood pressure.

*Talk to your diabetes specialist about a safe exercise plan for you.


  • Fauci, A., M.D. National Inst. of Allergy and Infectious Diseases, “Exercise and Chronic Disease.”
  • Woodward, K. (2007). Exercise reduces chronic disease risks. Center News Weekly.
  • Campbell, S. PT. (2009). Diabetes and Exercise. PT Northwest.
  • Roberts, C.K., & Barnard, R.J. (2005). Effects of exercise and diet on chronic disease. Journal of Applied Physiology, 98, 3-30.