Prediabetes Reversed in 3 Weeks
In three weeks this client went from consistent 110+ glucose readings to consistent 70s and 80s. As you can see here, at the beginning of testing, he would get afternoon/evening readings of 140 and up. Now, after eating, he averages below 86. He’s so reversed the trend that within an hour of drinking orange juice (liquid sugar) he’s down to 80.The leading cause of blindness and limb loss in the United States is still insulin resistance and glucose intolerance: two statuses which are reversible in a matter of days. Sadly people still think of diabetes as a disease we’ve caught, rather than an arbitrary point on a grey scale which we shift everyday.
It's not easy. But it's quite simple: get your average blood glucose below 86 if you want to get healthier and fitter. Test before eating and after eating. If your pre-meal test is above 85, you're going to have a slightly more difficult journey ahead of you. Anything that moves that number up is suspect. I should also add that insulin is THE sodium retention pump; thus, as insulin collapses you lose the mechanism for high blood pressure.
Resistance training is the only activity which reliably disposes of glucose independent of insulin. Carbohydrate restriction is the only behavior which reliably reduces the body's capacity to maintain elevated averages of glucose (yes, perceived stress can still induce the liver to dump sugar into the blood; but this capacity eventually runs dry in an environment of dietary carbohydrate restriction).
Did you know that the only way to get a lot faster is to go slower? You have to train low intensity in order to perform high intensity. It's counter-intuitive, which is why people tend to top out really rapidly with distance running speed (and I would argue most skills in life). You see so few people improve year after year. And there are biological laws which govern this; so there is no "bucking the trend." It's a matter of immutable biochemistry.
In 1980 Mark Sisson had one of the top 5 American marathon times. After retiring and discontinuing training, he had a shocking improvement in his sustained running performance. He didn't know the terminology at the time. But what he had unwittingly done was "base" training. Exercise physiology has become a lot more sophisticated in the past 35 years. Thus, even laypeople can actually go and get a metabolic efficiency test performed to find their unique base, anaerobic threshold, VO2 max, and more.
Essentially, what most people do is go out and do something that is too hard. They then proceed to attempt outdoing that already-too-intense effort. Through pain tolerance, people will continue "progressing" for a while. However, what is actually happening is that you are increasingly getting INEFFICIENT and LESS fit. One day, you find that you can no longer muster the mental wherewithal to continue this fool's errand. And you quit.
Even in just the five long runs I did prior to this marathon, I noticed that even really proficient runners on the lakes are clueless about IMPROVEMENT. Everyone's face is just in pain. They are going too fast. They are out of breath. They are suffering. And, ironically, though most weigh 30 to 110 pounds less than me, my feet are silent and theirs are LOUD. People train hard. But they train dumb. Therefore, even if they are running faster than ever, they haven't actually improved athletic capacity. They just are more tolerant of pain.
I'm all for doing hard things. Callous the mind. Be tough. But just punishing yourself is the idiot's way of fitness. And the road is littered with failure. The only "successes" on that road are survival stories of sampling bias. No one kept getting better because of that tough-guy methodology. They survived IN SPITE of it.
There's a much better way. Go slow. Check the ego.
See. Here's the thing. There are energy systems which dictate how this will work. And we can't just toughen our minds past the biochemistry. The inarguable science is that an individual's maximal output ends at 15 seconds. The next-to maximal output ends at 45 seconds. After that, we are in aerobic energy systems, making aerobic enzymes, cleaving energy from fatty acids, ketones, lipids, breaking down adipocytes and stored fat. If you are going to do anything for 30 minutes, 2 hours, 10 hours, you are training precisely incorrectly if you are in pain. Pain is trying to take a max output past 15 seconds or a near-max past 45 seconds. BY DEFINITION, this is a physical impossibility. That's why most people's training is nonsense.
I've explained this to endurance athlete clients with varying outcomes. Most don't listen. They end up training at a non-sustainable intensity, vacillating between a speed that is just inside the 45 second lactate effort and a speed that is just outside of it into the aerobic effort. Those non-listeners get the same lack of results, because they are still failing to train at a low enough intensity to IMPROVE efficiency. They're still going into pain. And they hit a wall.
Many aspiring youth athletes also don't make good progress for the same reason. Their coaches are totally clueless about how biochemistry works and how to actually train for improvement. Less-conditioned youth athletes tend to stay deconditioned, because nobody seems to know that the only way they'll improve is if you STOP PUSHING them. They have to actually train even slower than they currently go in order to reduce stress, progress metabolic efficiency, and thereafter become a more advanced athlete. Technically, the least athletic youth sports participants actually train substantially harder than their more athletic peers. And this results in a reduction in their athleticism. In fact, in Spark, Dr. John J. Ratey's book on exercise and it's positive impact on brain function, he includes an example of this. The Naperville school district began to incorporate heart rate monitoring in their programs. One of the coaches had a reality check one day when he watched a girl in gym class come in dead last, even slowing down in the last stretch while everyone positively cheered her on to push. He felt disappointed. But then, when he checked the data, it turned out that that girl had actually held the highest average heart rate of ALL the students. And, during the period of time he had thought she was slowing down because she was perhaps "giving up," it turned out that she actually was pushing even harder, and her heart rate spiked higher than any of the other students had EVER taken their heart rates. She pushed harder than everyone, by A LOT.
More athletic youths are training so far underneath their pain thresholds and ability that their bodies can recover, adapt and become more efficient. Less athletic youths never train at an easy enough intensity to progress. Since no one knows this, we keep pushing the poor kids too hard, and they actually become LESS fit. Thus, there's a massive bifurcation that occurs over time, only reinforced by archaic beliefs about some kids being "gifted" or "genetically gifted." Actually, we just have to stop making less-conditioned youths train past their redlines; and they'd soon outperform their initially-more-athletic counterparts and peers.
For the very few who do listen, results are incredible. I have one client who HATED this. But he finally relented and religiously trained at 120bpm for 5 full months. At the end, he was so efficient that his sustained effort aerobic work produced more watts than his 5-month-previous sprints. Imagine that. Imagine if you could go harder and faster than your current sprint speed BUT that it were a relaxed pace for you.
So, you can either be very scientific and technical about this (get your zones tested, monitor heart rate and train exactly accordingly) or you can lightly monitor it or you can be a bit more intuitive. OR you can continue ineffectively training foolishly. I won't get into the high level testing. I recommend it if people are interested. It's nice to know. However, even Sisson skips this step with some elite athletes. He just has them keep heart rate under 120 or 130 beats. You NEVER go into pain. Over time your body becomes increasingly efficient. So you can go faster WHILE staying under 120 beats, meaning output increases as perceived exertion DECREASES. This is smart training. What happens with a lot of his athletes is that to stay under 120 beats, they have to keep 12-15 minute mile paces at the beginning. But as they religiously adhere to the heart rate directive, soon they are going 10 minute miles, STILL under 120bpm. He's now got some people running in the 6s. Think about that. Imagine running a 6 minute mile while feeling like most people feel when they're walking or sitting. This outcome CANNOT be achieved by training in pain, pushing it, or playing tough guy. You have to check the ego and work the process.
But then there's an even more intuitive way. Breathe exclusively through the nose and keep asking yourself, "can I keep this pace for 36 hours?" This is what I did. The first run I did 11 miles. I didn't really worry about pace except to go slow and be relaxed and unstressed. Then I did 14. Same thing. Then 20. Then 26. Then, I was aiming to do 30 and push pace a little to see what I'm capable of, but my hands started freezing at mile 17. For the marathon, I knew that I could complete it without issue IF I were to adhere to this ego check. In fact, I feel confident I could've completed an ultra-marathon in the same manner.
I did not train for this; so I did not get to benefit from the increased efficiency one would glean over long-term adherence. That said, I can imagine a novice utilizing this technique for 6-12 months and completing his or her first marathon in the sub-4 hour range. Yes. They will have to put in the time investment for this slow burn to gift them more efficiency. But it pays off. Advanced runners may not be able to check ego. However, for those who can, it's easily imaginable to get sub-3 if they rigorously play this out. It may take 12-24 months, since you do have a number of physiological adaptations which can't be expedited (and this will also be contingent on nutrition, to be discussed next). Maybe more importantly, because we humans are impatient, the biggest challenge to this is the paradigm-challenge: REDUCE training intensity in order to PROGRESS performance. It is at odds with conventional thinking. But the best things come to those who wait.
Stay tuned for Part 3...
Six weeks ago I decided I might show up for the Twin Cities Marathon. I hadn't run in two years. I hadn't trained legs in twelve weeks (as per my pull-ups experiment). It takes three months for any reasonable cardiorespiratory changes. It takes six months to turn over connective tissue. Thus, I knew I did not have enough time to train for it. You must rest as much as possible the week prior to something like this. So, realistically you cannot improve distance running ability in four weeks. I had just enough time to learn my current ability and how to use it to endure the effort without damage. And LEARN, did I ever!
I have no blisters, no toenail damage, no bruises, no excessive pain. I never got winded, out of energy, or "paid the price." I played with my kids the same afternoon I finished the marathon. I went up and down stairs without issue. I worked the next morning and all day. The reason why I was so unaffected comes down to several factors which I’ll cover below. Any beginner can use these to run any distance without hurting themselves. And any avid runner can use these to improve performance beyond anything they’ve previously done.
But first, let me give the history on WHY I did this. I used to think that running distance was somehow a mark of health or fitness. As a result, about twenty years ago, I developed a practice of running over sixty miles per week. Over time, however, I learned that it doesn’t really PRODUCE the results people want. Generally, repetitive motion amplifies people’s muscle imbalances, postural distortions, and orthopedic issues. Risk of injury goes up. Long term results are poor or dangerous. In fact, long bouts of stress and sympathetic nervous system activation are associated with increased risk of heart attack, stroke, and degeneration. With over fourteen years of professional experience in this domain, I can tell you confidently that more often than not “long cardio” makes people fatter and much less healthy.
Consequently, I developed a negative attitude toward running, unless it was sprinting. I have always respected people who do difficult things. I believe in the value of hard work. But from an exercise science perspective, there isn’t a strong case to be made for distance running.
Nonetheless, people really hold it in high esteem. They talk a lot about training to complete a 5k, 10k, half marathon and so on. I would usually retort, “why not just show up?” I genuinely didn’t understand training to complete something. In my mind, training was to improve health and fitness or to outdo oneself or to compete against others. Simply completing a distance, I felt, anyone could do. And in my repeated experience and vast study of physiology, I haven’t seen any evidence that running distance produces good body comp results or improved health markers. In response to my incredulity, many peers and members over the years asked me, “then why don’t you just show up?” Long story short: I did.
My negative attitude definitely softened. For many people it’s a totem of the difficulties they are facing in life. It represents an overcoming. It’s spiritual. I get that. I highly respect the struggle. And being in the marathon on Sunday, I experienced firsthand the incredible positivity and support that participants and spectators alike showcase. It’s legitimate. That, in and of itself, I would say is worthwhile enough that I can recommend the Twin Cities Marathon to anyone, even if you have to walk it. It is quite the event. The people and their energy will astound you.
Now, let’s get down to the takeaways. I only performed five long runs to figure out how not to break myself during the marathon. Those five runs plus the marathon, however, yielded a really substantive education. There’s so much information that I’m breaking this into at least three parts (how to move; how to pace; how to eat):
Part I - How To Move
I know a lot about biomechanics. I have done so many postural and movement assessments and gait analyses over the years. Even really great runners are a mess. No one extends at the hip. Even really great athletes have all kinds of misses in their posture and movement. Few of them can even hit neutral positions. There are many things to work on for people to improve mobility. This takes a lot of time to address, especially with regard to helping someone be a safe runner. Ensuring someone actually dorsiflexes the foot, doesn't drag it, and has stability and mobility at the ankle, activates glutes, and so on is a Herculean effort.
And then there are some people who just shouldn't be running now or perhaps ever, wherein their knee crosses the midline and is under the opposite side hip when their foot hits the ground. But a lot of these issues are far too involved to cover in a post so much as an in-person analysis.
That said, I heard an incredibly beautiful way to summarize some of the best directives on foot strike and proper run form: silence your foot. I have to credit Greg DeNunzio the Director of The Biomechanics Laboratory at Northwestern Health Sciences University for this little gem. It takes all of the various patterns on which one could focus and condenses it into a single practice. Just quiet your run.
Several things happen when you do this. The best thing that happens is you dramatically drop your risk of injury and joint irritation. By silencing your foot strike, you stop counting on locked joint positions. This offloads the beating of the joints on two fronts, both by distributing the force across more area of the tissue (instead of one specific spot) and lowering impact altogether. The downside is that it demands a lot more effort, since you don’t get to just rest on the skeleton anymore. It’ll slow you down in the beginning. However, I have to credit it with the fact that I had no worry about shin splints, IT band issues, low back irritation, knee pain, ankle issues, etc. All of these things were standard procedure for me when I was an avid runner. And keep in mind I weighed EIGHTY POUNDS less. With a much greater mass, and a far less-trained body, I ran farther and suffered no issues. I didn’t even get blisters, for crying out loud.
To practice (and again, I have to acknowledge Greg for this), do a plyometric squat. That is, just jump up and land. Take note of the volume upon impact. Try it again, but quieter. Try it again, but silent. Muscularly, it is much more difficult, isn’t it? When you go out to the treadmill or trail, practice. Get the footsteps as quiet as possible. It takes quite a bit of concentration to begin. Over time, however, it gets embedded in your patterns. It will save your joints. It will reduce irritation by A LOT.
Stay tuned for Part II and III…