What sort of exercise should I do on Mounjaro?

Trial participants were advised to get 150 minutes of cardiovascular/aerobic exercise per week. That breaks down to 30 minutes, 5 days a week. 40 minutes, 4 days a week also gets this accomplished. It’s surprising how easy it is to reach “cardio” when you start to try this out. A brisk walk where you can still talk, slightly out of breath, maybe – but you couldn’t fully sing without some breath interruptions, is about the right exertion level. Cardio is the most effective way for a person with Type 2 Diabetes to drive the glucose from a meal into their cells.

 

American Heart Association has these estimates for target heart rates by age:

45 years: 88 to 149 beats per minute
50 years: 85 to 145 beats per minute
55 years: 83 to 140 beats per minute
60 years: 80 to 136 beats per minute
65 years: 78 to 132 beats per minute
70 years: 75 to 128 beats per minute

“Lower-intensity zone: You’re exercising at 50% to 60% of your max heart rate. At this point, 85% of the calories you burn are fat. The downside? You’re burning fewer calories overall than you would if you were exercising at a higher intensity. You’re generally able to sustain this zone the longest amount of time.
Temperate zone: You’re exercising at 60% to 70% of your max heart rate. Roughly 65% of the calories you burn are fat.
Aerobic zone: Working at 70% to 80% of your max heart rate puts you in the aerobic zone. About 45% of the calories you burn are fat. But you’re burning a higher number of overall calories compared to the other heart rate zones. You generally sustain this zone the shortest amount of time.

Why do you burn less fat the harder you work out? Once your heart rate increases, you’re not taking in as much oxygen. You can’t oxidize fat fast enough. Your body turns to another, more readily available energy source to provide fuel for you — glycogen, also known as carbohydrates.

From: https://health.clevelandclinic.org/exercise-heart-rate-zones-explained/

There’s ample research about what good resistance training can do for diabetes as well.

“exercise stimulates your muscles (which like to be fed glucose) to produce more insulin receptors – including receptors that do not require insulin to transport sugar into the muscle. Thinking about this in terms of the “lock in the door” analogy I have used in previous articles, insulin fits into the insulin receptor like a key fits into the lock in a door. The key fits, turns and you pass through the door. Imagine insulin is the key, the insulin receptor is the lock and sugar is you – insulin fits into the receptor and sugar passes through the door. In diabetes it is as if someone stuck gum into the lock- the key no longer fits or functions properly. Now imagine if there was a way to make more doors – including some without locks! This is exactly what exercise, and especially resistance exercise, appears to do. Your body has the potential to make doors for glucose to be absorbed that do not require insulin to work – however exercise is the trigger for this process to occur.” 

RESISTANCE ISN’T ALWAYS FUTILE: STRENGTH TRAINING IN DIABETES, 2008 https://diabetesaction.org/article-exercise 

Here is a great article about exercise and how it affects people’s bodies who have diabetes:

Ask DMine: Can Exercise Make Blood Sugar Spike?  Diabetes Mine, 2019 https://www.healthline.com/diabetesmine/ask-dmine-diabetes-exercise-blood-sugar-spikes 

Precision Nutrition (or Personalized Nutrition)

There’s a line of thinking that’s newer than the typical “universally applicable dietary guidelines” which is developing. This is called Precision Nutrition, and Harvard’s website gives a great explanation of what this means, why it’s being investigated and what for. A snippet is below, with link at the bottom.

Precision Nutrition is an “emerging area of research supported by the National Institutes of Health under the umbrella of precision medicine. [1,2] Precision medicine seeks to improve the personalized treatment of diseases, and precision nutrition is specific to dietary intake. Both develop interventions to prevent or treat chronic diseases based on a person’s unique characteristics like DNA, race, gender, health history, and lifestyle habits. Both aim to provide safer and more effective ways to prevent and treat disease by providing more accurate and targeted strategies. Precision nutrition assumes that each person may have a different response to specific foods and nutrients, so that the best diet for one individual may look very different than the best diet for another. How often are we tempted to follow a flashy diet that a celebrity or friend promoted in helping them to lose 20 pounds or “cure” their diabetes? The concept of precision nutrition would discourage this practice, as our individual blueprint might require a unique dietary plan to be successful. Precision nutrition also considers the microbiome, trillions of bacteria in our bodies that play a key role in various daily internal operations. What types and how much bacteria we have are unique to each individual. Our diets can determine which types of bacteria live in our digestive tracts, and according to precision nutrition the reverse is also true: the types of bacteria we house might determine how we break down certain foods and what types of foods are most beneficial for our bodies…

…the PREDICT 1 trial focus on individual responses to food, they have found substantial variations in blood responses of glucose and triglycerides even if individuals are eating identical meals. [3] The person’s microbiome was found to cause variations in blood triglycerides after a meal. Non-food factors like sleep, physical activity, and time of meals also played a role in causing variations in blood levels of glucose and triglycerides after meals. [3] Therefore, an individual may see additional benefits if following personalized nutrition guidance beyond general health recommendations. Precision nutrition evaluates one’s DNA, microbiome, and metabolic response to specific foods or dietary patterns to determine the most effective eating plan to prevent or treat disease.”

The Nutrition Source – Harvard T.H. Chan School of Public Health https://www.hsph.harvard.edu/nutritionsource/precision-nutrition/