Exercise, weight no guarantee against diabetes

DEAR DR. ROACH: I have heard that endurance athletes may be at increased risk for Type 2 diabetes. What is the evidence behind this, and what do you recommend to prevent it?

ANSWER: A small study and some anecdotal evidence have shown endurance athletes are not immune to developing Type II diabetes.

People often think of Type 2 diabetes as a condition related to obesity and inactivity, but many people with Type 2 diabetes are of normal weight, and indeed exercise is not a guaranteed protection.

It is possible some of the apparent link may be due to people who know themselves to be at risk for diabetes due to family history taking up exercise.

In fact, large studies have shown that regular exercise significantly reduces the rate of diabetes, even if it doesn’t eliminate it. However, many of the nutrition products sold to endurance athletes are very high in sugar.

One rule of thumb is that it’s not possible to outexercise a poor diet. You can take in far more grams of sugar and far more calories than you can burn, so prevention of diabetes ideally includes exercise and reducing simple sugars and processed carbs.

That definitely includes sports drinks, some of which are no better than soda.

DEAR DR. ROACH: Are prunes better than OTC remedies for constipation?

ANSWER: Some over-the-counter constipation drugs used to contain phenolphthalein, which is not safe for long-term use. Occasional use of senna or docusate (the active ingredients in most OTC brands) is fine.

Prunes are a very effective treatment for constipation for many people.

They are a fruit, but being dried, are higher in sugar than many others.

Three to four prunes a day seems reasonable to me, and is effective for many people to treat constipation.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Email ToYourGoodHealth@med.cornell.edu.