Latest / The Endurance Athlete Journey / Episode 77: The Real Reason You Bonk (And How to Fix Your Fueling Strategy)

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Episode 77: The Real Reason You Bonk (And How to Fix Your Fueling Strategy) · The Endurance Athlete Journey

0:09
SPEAKER_00: Endurance Athlete Journey Podcast, I'm your host, Coach Justin, along with Coach Katie, and this is episode 77.
0:15
SPEAKER_00: And today we're going to be talking about continuous glucose monitoring for athletes.
0:21
SPEAKER_00: So I'm going to actually turn this introduction over to Katie.
0:25
SPEAKER_00: This is her wheelhouse.
0:27
SPEAKER_00: I'm here as supporting cast today and just will ask questions and try and drive the conversation a little bit.
0:34
SPEAKER_00: But this is this is Katie's specialties.
0:36
SPEAKER_00: Uh Katie, can you tell us a little bit about how we're going to approach today's episode?
0:40
SPEAKER_02: Yeah, absolutely.
0:41
SPEAKER_02: Continuous glucose monitors are something that I think are becoming more and more popular with the public.
0:48
SPEAKER_02: Something that's been well used for people with diabetes.
0:51
SPEAKER_02: And now, you know, more and more people are using them.
0:53
SPEAKER_02: They're more accessible.
0:55
SPEAKER_02: I wanted to talk about it in terms of athletes because I think it's something that's becoming more popular with endurance athletes, especially.
1:04
SPEAKER_02: And I wanted to kind of do a deep dive into what is a continuous glucose monitor, like how do they measure glucose, like just a really, a really deep dive into the use of continuous glucose monitors, and then kind of transition right into how they could be used with athletes.
1:23
SPEAKER_02: And then I'm going to actually use some of my own data.
1:26
SPEAKER_02: It's it's sort of data that I've had to change a little bit so it wouldn't give away the company in which I'm using the CGM with.
1:33
SPEAKER_02: So there's several companies that do this, but I want to share a little bit of my own data and my own insights because I mean everybody's individual, but I think it's sometimes helpful to talk about it, you know, in terms of you know what I've experienced and that maybe help people decide whether or not they would want to use a CGM.
1:50
SPEAKER_02: We'll talk about costs.
1:51
SPEAKER_02: I've tried to put in everything that anyone would ever want to know for the most part about CGMs, especially as it relates to uh endurance athlete athletes and performance.
2:00
SPEAKER_02: Yeah, that's it it should be fun.
2:02
SPEAKER_02: I think I'm gonna be doing a lot of talking, and so I apologize ahead of time.
2:06
SPEAKER_02: This is definitely one where it's gonna be a lot of me, and unfortunately, Justin's just gonna be here to learn as well and ask questions.
2:14
SPEAKER_00: Yeah.
2:14
SPEAKER_00: So the one question I'm just gonna ask right off the bat is that why should endurance athletes care about monitoring glucose?
2:22
SPEAKER_02: Right.
2:22
SPEAKER_02: That's a good question.
2:23
SPEAKER_02: So that kind of like dives right in dives right into that piece.
2:27
SPEAKER_02: It doesn't give us every single detail of other substrates like our other or other fuel systems, like how we're burning fat.
2:34
SPEAKER_02: It doesn't really give us any insight into something like lactate.
2:38
SPEAKER_02: I mean, it would almost be amazing if we could have not only just a continuous glucose monitor, but a monitor for all these other things as well.
2:45
SPEAKER_02: But it does kind of help us look under the hood a little bit and what's going on with our metabolism.
2:50
SPEAKER_02: So in general, like glucose changes, it fluctuates up and down a little bit.
2:53
SPEAKER_02: Our body keeps it pretty stable.
2:55
SPEAKER_02: But depending on how active we are, if we're exercising, what we eat, you know, how we're fueling our body, glucose levels change.
3:03
SPEAKER_02: They go up and they go down.
3:04
SPEAKER_02: And so athletes monitoring glucose might be wanting to look at whether or not, especially if they're having symptoms or something going on that they're suspecting there might be like a glucose problem.
3:14
SPEAKER_02: So hypoglycemia, where maybe they're having dips in glucose where their values are their glucose in their blood is going down and they're experiencing symptoms like dizziness, shakiness, lack of energy.
3:25
SPEAKER_02: Maybe they're on a run and they feel pretty terrible, like they're trying to figure out why this is happening.
3:30
SPEAKER_02: That could be a use for a CGM, or even just to see, you know, am I how am I fueling during a race?
3:36
SPEAKER_02: Like, is it adequate?
3:38
SPEAKER_02: Like, or maybe somebody's feeling like they're bonking, it might be a way to determine whether or not they're getting adequate fuel throughout the race, or are are their glucose levels dropping during the race to a point where maybe that's indicating they're not fueling adequately.
3:52
SPEAKER_02: So it's almost like a little bit of a look under the hood.
3:54
SPEAKER_02: It doesn't, there's a lot of stuff it won't tell us.
3:57
SPEAKER_02: Like I said, it doesn't give us any insight into whether we're burning a certain amount of fat or not.
4:02
SPEAKER_02: It can't really tell us like when we hit lactate threshold.
4:05
SPEAKER_02: That would be cool to have a lactate monitor.
4:07
SPEAKER_02: Like you'd have like all these things stuck to your body, measuring all sorts of different things, but it doesn't tell us anything about like ketones, but it does tell us, you know, gives us because glucose is kind of a constant fuel source.
4:17
SPEAKER_02: So we're always our body always has glucose in the bloodstream.
4:21
SPEAKER_02: It's it's a something that our body needs to fuel.
4:24
SPEAKER_02: Even when somebody is on a ketogenic diet, they're always going to still have glucose in their bloodstream.
4:29
SPEAKER_02: It never goes to zero.
4:30
SPEAKER_02: That would be bad.
4:31
SPEAKER_02: So it's it's it's it's an interesting way to monitor things, and I think it can be useful in certain situations.
4:37
SPEAKER_02: I've even used it, I've even noticed situations where maybe I've been overdoing it or over training or a little bit stressed and how that impacts my blood sugar.
4:46
SPEAKER_02: It kind of showed me some interesting things during races or runs when I've had um you haven't gone into it exactly while rested and what that's doing to my body and maybe partially why I don't feel so good during those races.
5:00
SPEAKER_02: So it's it's interesting.
5:01
SPEAKER_02: Yeah.
5:02
SPEAKER_02: I hope that makes it somewhat of a case or so, or kind of gets people thinking about who've never thought about CGM before, maybe thinking, oh, that's interesting.
5:12
SPEAKER_02: But yeah, I don't know.
5:14
SPEAKER_02: Does that make sense?
5:14
SPEAKER_00: Anything it does.
5:16
SPEAKER_00: So anything you just from the basic understanding that I've got based on what you've said here is that glucose monitoring may give us valuable insights into how recovered we are.
5:29
SPEAKER_00: So it's during our the efficiency of our recovery and preparation for future events based on what we've already accomplished.
5:36
SPEAKER_00: So how how we're absorbing our our fitness.
5:39
SPEAKER_00: The second one is going to be it'll help us with our fueling strategy to understand how the body reacts to intakes of certain foods, which may help us determine a proper fueling strategy for an endurance event.
5:53
SPEAKER_00: You know, how often should we be feeding?
5:55
SPEAKER_00: What's going to be the body's reaction to a certain level of of sugar and carbohydrates?
6:00
SPEAKER_00: So is that kind of a basic, a basic understanding on why it would be important or of interest to an endurance athlete?
6:08
SPEAKER_02: Athlete would mostly use it would just be to kind of be monitoring their glucose throughout the day.
6:13
SPEAKER_02: I mean, it monitors it all day, all night to kind of see if there are patterns that might be happening.
6:18
SPEAKER_02: I'll show some visuals of as well at some point.
6:21
SPEAKER_02: But you know, maybe they're going on their long run and they're seeing that their glucose levels are are dropping during that long run.
6:28
SPEAKER_02: Like maybe it starts glucose tends to go up a little bit when we exercise, but maybe as they go, it's starting to drop and drop and drop and getting low.
6:36
SPEAKER_02: That might be an indication that they're not providing enough fuel from exogenous sources like gels.
6:43
SPEAKER_02: And we do have a point in which we run out of glycogen.
6:46
SPEAKER_02: So sometimes you can kind of see that on the monitor.
6:48
SPEAKER_02: You can't actually measure how much glycogen we have using the monitors.
6:53
SPEAKER_02: So it's just kind of like making that assumption that once the glucose levels during like a long run, let's say like two, three hour, maybe longer, you start to see the values drop.
7:03
SPEAKER_02: That might be an indication that the body is starting to run out of glycogen because the glucose levels are now dropping.
7:10
SPEAKER_02: It's it's not going to drop generally, probably to dangerous levels.
7:13
SPEAKER_02: Like the body's gonna do what it needs to do to keep those glucose levels somewhat normal, but it may start to go below, you know, down, down, down.
7:20
SPEAKER_02: And once it's below 70 or even lower than that, it could be a sign kind of hypoglycemia.
7:26
SPEAKER_02: So it might indicate, yeah, you're not fueling adequately for that, you know, during that event.
7:30
SPEAKER_02: And so it's that sort of monitor, or if you're let's see, like maybe afterwards, this is the way I've used it too, is after my um exercise, I've used the CGM to see how much carbohydrate I can kind of take in before it spikes up.
7:47
SPEAKER_02: So it's almost like a gauge for me, a fuel gauge.
7:51
SPEAKER_02: This is where I feel like it could be interesting and used in a in a manner to help athletes figure out sort of that right amount of carb is I'll I've been doing experiments where I'll have a certain amount of carb afterwards, and it maybe doesn't go up very high.
8:06
SPEAKER_02: And I'm like, you know what?
8:06
SPEAKER_02: I could probably have had more carb.
8:08
SPEAKER_02: So I'll eat more carb.
8:09
SPEAKER_02: And it's like a nice gauge.
8:10
SPEAKER_02: And once it starts, once my values start to go up, you know, maybe a little higher than I want them to go, I know, okay, that's probably about the cap, you know, for that type of run.
8:20
SPEAKER_02: So I could probably have, you know, 80 grams of carb after that run, and I and I'm and I'm doing great, you know, and I'm refueling, and that's kind of my limit.
8:29
SPEAKER_02: But if I go too far above that, it starts to go up too high.
8:32
SPEAKER_02: So it's kind of a nice gauge for me, and that's how I've used it.
8:35
SPEAKER_02: And it's almost helped me identify wow, I can I need to consume those carbs around the workout.
8:42
SPEAKER_02: So there's a lot of like insights you can get.
8:44
SPEAKER_03: Yeah.
8:44
SPEAKER_02: If I consume that same amount of 80 grams of carbs later on in the day, it doesn't, it's it's not good because I've waited too long.
8:52
SPEAKER_02: So it's a nice also visual to show people how to fuel adequately and maybe how much they can they need to take in somewhat.
9:00
SPEAKER_02: You know, you have to use other measurements, other other things like subjective feelings and performance metrics as well as the CGM, but it can be a really great way to sort of see, like, oh wow, I can tolerate a lot more carbs after my workout.
9:14
SPEAKER_02: And if I wait and have them later, it doesn't work out so well.
9:17
SPEAKER_02: So I really need to make sure I'm eating my carbs post-workout and I can have more than I thought I could, you know, and so it's just it's just an interesting tool if you know how to use it.
9:27
SPEAKER_02: And I think that's part of the struggle is this not you almost need a skilled practitioner to be able to go through it with you.
9:34
SPEAKER_02: And because there's a lot of things with the CGM that aren't perfect, and we'll talk a little bit about that too.
9:40
SPEAKER_02: There's um errors sometimes, some things that it it's not always getting quite accurately.
9:46
SPEAKER_02: Sometimes the the sensors themselves can kind of malfunction, and you need to be able to spot that.
9:51
SPEAKER_02: Like you need somebody that can actually visually see what's going on with the data and be able to be like, that data point or that thing doesn't seem quite right to me.
9:59
SPEAKER_02: So you know what I mean?
10:00
SPEAKER_02: Or something's going on with the sensor, it doesn't seem to be working quite right.
10:04
SPEAKER_02: But you need to be, you know, skilled to be able to do that.
10:07
SPEAKER_02: And just a little background, had I'm and I'm a bias here.
10:11
SPEAKER_02: So I'm gonna put this out there because I want to be totally, totally um transparent with people.
10:18
SPEAKER_02: But I have been working with a company called Nutrasense for four and a half years, and they do this, they have a app that they use and they use the CGMs.
10:29
SPEAKER_02: And so I've had been working for like yeah, almost five years now with glucose data.
10:36
SPEAKER_02: I have seen thousands of people's data at this point, all sorts of people, pre pre-diabetes, diabetes, like biohacker individuals, athletes, but I have a lot of experience with the data.
10:48
SPEAKER_02: So I'm probably coming at this in a few ways a little bit biased because I do work for a company that uses CGM technology and I uh have used it myself.
10:58
SPEAKER_02: So I just want to put that out there.
11:00
SPEAKER_02: I don't know if people would find that either maybe a little bit biased.
11:03
SPEAKER_02: I'm not telling anyone to use that particular company.
11:06
SPEAKER_02: I do want to put that out there.
11:08
SPEAKER_02: So it's not like I want people to also know that I have a lot of experience too.
11:12
SPEAKER_02: So it's not like I'm just making this up.
11:15
SPEAKER_00: No, no, no, absolutely.
11:16
SPEAKER_02: Yeah.
11:17
SPEAKER_00: So, as we've kind of talked before in some previous episodes where we've talked about, you know, forming a race day strat a fueling strategy and things like that.
11:25
SPEAKER_00: I think that the way that we've described it is almost kind of like it's trial and error.
11:30
SPEAKER_00: It's like you go out for uh a long session.
11:33
SPEAKER_00: This is what I do with my athletes as well when we're testing out new strategies.
11:37
SPEAKER_00: It's just like, okay, in your nutrition bottle this time, we're gonna do, we're gonna go with four scoops of of powder and four gels, and that's what we're gonna consume.
11:46
SPEAKER_00: So we execute that strategy for that day, and then we cut we circle back up.
11:49
SPEAKER_00: It's like, okay, what worked, what didn't work, how did you feel when you got off the bike?
11:53
SPEAKER_00: Do you think that you would have been able to run effectively?
11:56
SPEAKER_00: How did your stomach feel?
11:57
SPEAKER_00: How are your energy levels?
11:58
SPEAKER_00: And so it's really kind of like a fine-tuning iterative process, right?
12:03
SPEAKER_00: That we that we execute.
12:05
SPEAKER_00: I think that the main benefit that I'm hearing about CGMs is that it provides a little bit more concrete information and insight into being able to quantify that iterative process, which can sh which means which means that it can effectively shorten the trial and error period, and we're able to dial in a lot more efficiently on a fueling strategy that works best for a particular athlete under a set specific scenario or situation in which they're going to be racing.
12:40
SPEAKER_00: So it's like, you know, not everybody's digestive system processes nutrients the same in heat versus cold, you know, those sort of nuances.
12:49
SPEAKER_00: And so if you have an idea on what the race day is going to be like, we dial in a nutrition strategy for that particular race.
12:56
SPEAKER_00: Not all race strategies are the same.
12:58
SPEAKER_00: And so this device seems to be able to allow us to shorten that trial and error period and give us a little bit more direction.
13:06
SPEAKER_00: Is that kind of a valuable an accurate assessment?
13:10
SPEAKER_02: Yeah, I think it's like another tool to help you know be able to um see if the fueling strategy is is working and how it may be.
13:19
SPEAKER_02: I don't know if it would shorten the process, but it might help determine, you know, if what someone's doing is enough, you know, fuel or if they're having still low energy, it might give answers to that.
13:30
SPEAKER_02: You know, I think it's just another another tool to be able to determine if fueling, if the fueling is going well and how, you know, just kind of some some other metric to look at almost to see if we're still noticing that there's drops in glucose, maybe even if the athlete isn't feeling terrible or something, but maybe they're just noticing they're really struggling at the end of their workout, um, that might still give us insight into okay, the fueling is not adequate.
13:53
SPEAKER_02: And so we need to continue to work on more fuel.
13:56
SPEAKER_02: But it uh in the other context of maybe the values go up and they're kind of more stable, and there might be like ups and downs, you know, just slightly as somebody's um competing or as they're as they're training.
14:09
SPEAKER_02: Um and and as long as that's pretty stable throughout, that's a pretty good indication their their fuel strategy is starting to starting to work, or they're it's at least adequate to meet their needs for that workout, right?
14:21
SPEAKER_02: But if they're starting to see like drops in glucose or there's like big valleys and peaks and valleys during a workout, maybe there's something else happening.
14:28
SPEAKER_02: So, or even like maybe the fuel source they're using.
14:32
SPEAKER_02: I've had people who are like doing a long run or something and they'll have like a gel and it just causes like a pretty large rise in glucose.
14:39
SPEAKER_02: And then I've, you know, had them try other types of fuel and maybe they don't notice that as much and they just feel better because they have more stable energy throughout.
14:48
SPEAKER_02: Like so they'll do like a UCAM product or a moretin or something like that, and they just feel better because their glucose isn't bouncing up, you know, kind of getting that jolt of glucose in their system and then kind of a drop, and then they take their next gel and and they kind of feel that during a run.
15:03
SPEAKER_02: So maybe like seeing that on the glucose monitor is interesting.
15:06
SPEAKER_02: They kind of corroborates the way they're feeling, and so they're trying different products to have something that's gonna provide more of that lot like energy that's a little more stable.
15:16
SPEAKER_02: And so I think it can be really helpful for that, just almost to visually see it too.
15:20
SPEAKER_02: Because you do have a lot of athletes who are they think they're doing just fine, like, oh, I have one gel for my 15 mile run, um, and that's all, you know, and it's like, well, like this is just visual confirmation that maybe that's not actually the best op like the best way to go about it because your glucose levels are dropping and you know, it's kind of showing someone visually what's happening.
15:41
SPEAKER_02: And some people are a little more visual, and it's helpful for them to actually see it, see something happening, you know, even if it's not giving us the full picture exactly, it's still helpful to kind of see what's happening and get a better picture of oh, okay, maybe my fueling isn't so great after all.
15:57
SPEAKER_02: Or maybe it is, but it's interesting in a visual context to see that if that makes sense.
16:03
SPEAKER_00: Yeah.
16:03
SPEAKER_00: Okay.
16:04
SPEAKER_00: So I answered that question.
16:06
SPEAKER_00: I guess my next question is that some of the research is showing that uh CGMs shouldn't be necessarily described or or characterized as a fuel gauge for athletes.
16:18
SPEAKER_00: And the reason is is because CGMs measure the circulating glucose and don't uh necessarily measure muscle glycogen.
16:27
SPEAKER_00: So let's let's kind of extend this conversation a little bit then and say, okay, given that we know now that it's measuring the glucose that is flowing through our body, not measuring the stores that we have available for uh training.
16:42
SPEAKER_00: How does that change our use of this device to optimize our performance?
16:48
SPEAKER_02: Yeah, I mean, I think it's just that we have to uh keep that in mind.
16:52
SPEAKER_02: Like it's only me it's only measuring what's in our blood.
16:55
SPEAKER_02: Well, the CGM itself isn't that's the other thing, is kind of going back to the very, very basics is a continuous glucose monitor is actually placed generally in the arm.
17:06
SPEAKER_02: And so it's measuring the inner the glucose in the interstitial space.
17:10
SPEAKER_02: Blood glucose, like if you were to take a venous blood draw, is that's you know, that's coming from the blood.
17:18
SPEAKER_02: But when glucose kind of goes from the blood into the interstitial space, and that's sort of the way it's flowing, is from blood first, it goes into the blood and then kind of into the interstitial space in the body.
17:28
SPEAKER_02: So like in the arm, it's like in that space kind of between the skin and the muscle, but it's not exactly placed in the blood, in the in the in the um like veins.
17:39
SPEAKER_02: So it's it's um, you know, so it is measuring blood glucose, but it's just technically it's not directly into the bloodstream, but it's just measuring what's uh happening in the blood.
17:50
SPEAKER_02: It's not measuring, it's actually hard to kind of measure how much glycogen we have.
17:55
SPEAKER_02: I mean, the only I've had a biopsy once where they took a big chunk out of my leg and they measured my, it was like a part of a study, and I still have a scar from it, you know.
18:04
SPEAKER_02: So it's not easy to measure.
18:05
SPEAKER_02: There are some devices that say they can measure glycogen, but it's not very easy.
18:09
SPEAKER_02: So what we don't know in that context is like all we know is what's happening in the blood.
18:13
SPEAKER_02: We don't know how much glycogen we have.
18:15
SPEAKER_02: So it's not a good gauge in that sense.
18:18
SPEAKER_02: And then we also, like I said before, we're not able to measure like how much fat we're using, you know, we're just measuring glucose.
18:24
SPEAKER_02: So it's not giving us every part of the whole picture.
18:29
SPEAKER_02: But when we're looking at the CGM, we can, you know, it can give us insight sometimes into what's happening.
18:35
SPEAKER_02: Like I said, when it's during a run, well, it's dropping towards the end of the run.
18:40
SPEAKER_02: That's probably a good indication you're starting to run out of glycogen.
18:43
SPEAKER_02: Like it may not be able to say exactly how much we have left or how much glycogen is, you know, what amounts being used or any of that, but it tells us, okay, something's happening.
18:54
SPEAKER_02: We're still running at the same rate, but the butt, but the glucose in the blood is starting to drop, it could be an indication that glycogen, because when we're running, when we're working out, the body breaks down glycogen and it sends it into the bloodstream.
19:07
SPEAKER_02: But sometimes if we're starting to go low, there's something going on with glucose regulation.
19:12
SPEAKER_02: And in athletes, that's probably something going on with glycogen starting to decline.
19:17
SPEAKER_02: The next thing that would happen if we didn't fuel our body would be we would hit the wall.
19:21
SPEAKER_02: So at some point, that then also corresponds with some sort of feeling of not feeling good, right?
19:27
SPEAKER_02: But it's that visual being able to see that that's helpful.
19:30
SPEAKER_02: But it doesn't tell us like at the start of the run, we would have no idea where our glycogen levels are and we wouldn't know what percentage of fat we're using.
19:38
SPEAKER_02: And so there are, like in terms of a fuel gauge, yeah, it's not gonna give us like the full picture, but it can give us some insights.
19:44
SPEAKER_02: I just think if people are trying to put the CGM on and thinking like they're gonna learn how to perfectly fuel their body just by using the data, and that's you know, like that's gonna give them all the answers.
19:57
SPEAKER_02: I I think they're gonna be a little bit disappointed because um they might get other insights, but it's not gonna help people like figure out their perfect fueling plan alone.
20:07
SPEAKER_02: Like you obviously have to use other things along with the CGM data, if that makes sense.
20:13
SPEAKER_00: So I think that this this is an important distinction that I want to make sure that that we mention and that we bring up, is because I think it refines this statement that the research is saying is that CGM shouldn't be used as a fuel gauge because I don't find that to be completely accurate.
20:27
SPEAKER_00: What I'm what I'm hearing from you is that since we cannot measure muscle glycogen directly without biopsy, we can use blood glucose as an instrument for measuring the potential for for muscle glycogen.
20:44
SPEAKER_00: So I remember when I was in graduate school and uh I I have a I have a degree in economics, and so we did uh I did a lot of quantitative modeling and things like that, and it's a lot of boring stuff and would put people to sleep.
20:56
SPEAKER_00: But I think the important thing that that I want to tease out is that there are variables that we cannot directly observe, but we can observe variables that are directly or indirectly correlated to those variables that are not able to be observed.
21:12
SPEAKER_00: So that's what we call instrumentation.
21:14
SPEAKER_00: So we we say, well, I can't see this, but I can see this.
21:18
SPEAKER_00: And these two things are related in such a way that if I can just observe what I can see, I can make inferences about what I can't.
21:26
SPEAKER_00: And to me, that's what this is effectively saying is that CDMs can be used as a fuel gauge to a certain extent as long as we understand the relationship between blood glucose and muscle glycogen.
21:39
SPEAKER_00: And as long as we understand that relationship, I can infer where my muscle glycogen is at a particular phase of either a race or a training period based on the data that I'm seeing from from blood glucose, which is measured by the CGM.
21:55
SPEAKER_00: Is that accurate?
21:57
SPEAKER_02: Yeah, another example here with glycogen, like that we can't yeah.
22:00
SPEAKER_02: We can't visually see what's happening with the glycogen, but let's say my example of after the run, right?
22:04
SPEAKER_02: When I'm like trying to experiment with how much or experiment with how much carbs I can eat.
22:09
SPEAKER_02: When I am experimenting with that and I'm seeing that I'm able to consume, you know, 80 grams of carbs and my glucose levels rise, but the but they're not to an extent that it's like a big spike, where it would show me, essentially that's showing me like all of that carb I'm eating is going pretty much, other than maybe some of it going to, you know, um maybe to the other cells of the body, but most of that is going back into glycogen.
22:35
SPEAKER_02: So if you think of glycogen, it's like this is how I describe it, like a bunch of cubby holes that we only have a certain amount of them.
22:42
SPEAKER_02: And when we exercise, we pull from them, and then when we eat, we put them back in.
22:46
SPEAKER_02: We put the glucose back into the cubby holes.
22:48
SPEAKER_02: When I'm doing that experiment post post-run with the carbs, I am essentially seeing how much carbs it is I need that I can top off, or at least mostly top off those glycogen, right?
23:01
SPEAKER_02: So I'm not actually seeing that visually.
23:03
SPEAKER_02: I'm not like measuring the glycogen at the end to see if it's topped off or at least, you know, been restored to a point that's adequate.
23:12
SPEAKER_02: I'm I'm I'm seeing that on the CGM because I'm seeing well, I only eat 30 grams of carb, it's not enough.
23:19
SPEAKER_02: My glucose doesn't change.
23:21
SPEAKER_02: That's showing me that I'm not optimizing that refueling to optimize glycogen repletion.
23:27
SPEAKER_02: So I'm then experimenting with more carb, and then I kind of see that tipping point where now my glucose is spiking.
23:33
SPEAKER_02: And when it's spiking, that usually means I've pretty much topped off most of the glycogen piece, and now it's like into the bloodstream and it's kind of hanging out in the bloodstream a little bit longer.
23:43
SPEAKER_02: So it's telling me, no, then insulin then insulin is involved in that, and then that, you know, that's something else is happening with that glucose.
23:50
SPEAKER_02: But I've pretty much topped off my glycogen or it's pretty well refueled.
23:54
SPEAKER_02: I might still need to eat more carbs later to fully top it off, but it's it that's a fuel, you know, that is essentially kind of like a fuel gauge, right?
24:03
SPEAKER_02: And so the argument, like that's kind of where the researchers argued it's not, but I'm like, based off of my own experience in working with people, it can be used somewhat as a fuel gauge.
24:13
SPEAKER_02: It's just there's probably instances like where you're not like you may not get like, yeah, you're not exactly getting all of the picture with fat and things like that.
24:21
SPEAKER_02: But I'm like, absolutely, I think you can kind of use it in a way, you know, as a way to sort of see what's happening with glycogen, because we do know that once our glycogen is topped off and we are full on the cubby holes, the glucose levels are probably going to be spiking more, higher, more variability with meals.
24:39
SPEAKER_02: That to me indicates, yeah, you probably have a pretty good amount of glycogen stored and your body is now having to deal with that excess glucose.
24:48
SPEAKER_02: And it's not, you know, because when we eat carbs and we need to refill those cubby holes, it goes right into glycogen.
24:54
SPEAKER_02: And so it then the glucose levels don't appear to go up very high because it's all getting right stuffed right into those cubby holes.
25:01
SPEAKER_02: But when those are pretty much full or topped off, the values then rise a little bit higher because the body has to figure out what the heck to do with the glucose, you know, when it's our when the glycogen is full, because that's where we store glucose, right?
25:15
SPEAKER_02: So I think I argue almost that that isn't exact like a yeah, there's it's probably not a perfect fuel gauge, but it sure does, it sure can be helpful in that way.
25:26
SPEAKER_02: You know, and it in kind of like helping us determine have, you know, have we sort of topped off glycogen or could we do a better job at that?
25:33
SPEAKER_02: Should we fuel better during our runs?
25:36
SPEAKER_02: Are we seeing low values?
25:37
SPEAKER_02: And on the other end of the spectrum with the fat, you know, I kind of mentioned does it measure fat, but so when I see an athlete's data and I see that they do a race, for instance, like a half marathon, I have seen data where somebody's glucose spikes to 200 milligrams per deciliter.
25:54
SPEAKER_02: I mean, it's very, very high, the entire race.
25:57
SPEAKER_02: So the entire, you know, this is elite, you know, high performing athletes, their entire hour, you know, to maybe hour and a half at the top end of their race for a half marathon would be in that like very high range for the entire race.
26:11
SPEAKER_02: That to me is showing me that that person is probably burning a huge percentage of fat of carbs and very little fat.
26:20
SPEAKER_02: You know what I mean?
26:20
SPEAKER_02: Like because there's this like their glycogen, they're just maxed, they're just maxed out, right?
26:24
SPEAKER_02: There's like tons and like lots of glucose in their bloodstream.
26:28
SPEAKER_02: I would extrapolate from that, you know, based off my knowledge of the data, that they're probably not burning a whole lot of fat versus if somebody's doing a race or something where their glucose comes up a little bit, but it's fairly stable throughout.
26:41
SPEAKER_02: Um, it's maybe more likely.
26:42
SPEAKER_02: I mean, I can't, I can't tell them how much percentage of fat or anything like that, but it's like maybe more likely that they're burning um a little more fat because they're not so high on the high end of glucose, like a huge like spike that stays up really high for their entire race.
26:58
SPEAKER_02: So yeah, I mean, there's like little things like that again, and so there's like a tons of tons of nuances to that.
27:04
SPEAKER_02: But um I think yeah, it does give us a little bit of insight into those things.
27:08
SPEAKER_02: And it's not perfect, but we don't have any other way of it's like yeah, it's like that we don't have any other way of measuring.
27:15
SPEAKER_02: Better than nothing.
27:15
SPEAKER_02: You know, sure.
27:16
SPEAKER_02: There's better than nothing.
27:18
SPEAKER_02: Yeah, so there's better than something, I think.
27:20
SPEAKER_00: There's one thing that there's actually two things that I want I want to to bring up here.
27:24
SPEAKER_00: The first one is that the way that you've been talking about how you use uh CGMs, you've always referred to it as like post-something.
27:34
SPEAKER_00: So it's always kind of like after the fact.
27:37
SPEAKER_00: So I think the important distinction is that CGMs doesn't provide you live insight.
27:45
SPEAKER_00: This is something that you have to use after something to gain insights like, okay, well, how did that go?
27:51
SPEAKER_00: It's the it that's important in the framing of it is that the frame is how did that go, not how is it going.
27:58
SPEAKER_00: So there's that distinction that I that I want to make that this is not a live, a live insight as to how your body is operating.
28:07
SPEAKER_00: This is something that you use post-event or post-training session or whatever after the fact that you go back and gain a little bit of insight as to what did happen.
28:15
SPEAKER_02: Yeah, let's talk about that.
28:16
SPEAKER_02: Uh, I think since I already mentioned that it's measuring it in the interstitial space and not the blood, the most important distinction to make here is that there is a lag time between what's happening directly in the blood, which is really happening in real time, and what's happening on the CGM.
28:32
SPEAKER_02: And depending on the magnitude of the how quickly the glucose values are changing, that lag time can be up to like 45 minutes.
28:40
SPEAKER_02: So when I've had a CGM, when I had a DEXCOM monitor once and I was able to connect it to my Garmin, it actually showed me the glucose on my Garmin, but it wasn't always exactly at the time.
28:51
SPEAKER_02: Like, you know, so I remember I'm gonna show the data here.
28:54
SPEAKER_02: I had a day where I had something called rebound hypoglycemia.
28:57
SPEAKER_02: I started my run basically after a meal in which I was at the peak of the meal, and I dropped during my run, my glucose levels went whoop right down, dropped really low to like 56.
29:09
SPEAKER_02: But I felt terrible before I saw it on my CGM.
29:12
SPEAKER_02: I felt like I was running in mud and I was like, I need to freaking take a walk.
29:17
SPEAKER_02: Like I I felt like I was gonna pass out on the side of the road.
29:20
SPEAKER_02: And then like maybe five, 10 minutes later, my I look down at my CGM and it says my glucose levels were 56.
29:27
SPEAKER_02: So that's a true sign of hypoglycemia.
29:29
SPEAKER_02: But it took a minute, you know, for what I was feeling to kind of catch up on the monitor.
29:34
SPEAKER_02: So it's not always gonna be in real time.
29:36
SPEAKER_02: You're not, I'm not gonna be able to necessarily even I could maybe see it dropping, but I can't, yeah.
29:41
SPEAKER_02: I mean, you might, but again, it's a lag.
29:43
SPEAKER_02: So you might experience the symptoms before you see it on the CGM.
29:47
SPEAKER_02: And that's that's why it's not great for during.
29:51
SPEAKER_02: I think like there was something I was like, remember the Tour de France, there's some of the cyclists are using CGMs and they I feel like I remember them saying they banned it because they were afraid that the guys, the drivers and the cars that are kind of talking to the athletes would be able to use the CGM and be able to make real-time decisions about fueling.
30:10
SPEAKER_02: Well, honestly, that like I just said, it's sometimes it's too late.
30:13
SPEAKER_02: You know what I mean?
30:14
SPEAKER_02: Like you're you're experiencing it, and then you'll see it on the CGM because of that lag time.
30:18
SPEAKER_02: And also, people, I have a lot of people who use CGMs and they have finger stick devices that measure blood, and they'll they'll be like, my CGM and my blood are like really different.
30:28
SPEAKER_02: Like it's not the CGM's inaccurate.
30:30
SPEAKER_02: It's like, not really.
30:32
SPEAKER_02: It's probably that you're just had there's a lag time between the two, and you have to, it's like a caboose.
30:37
SPEAKER_02: The blood is here, the CGM is here, it's always gonna be behind.
30:42
SPEAKER_02: So you could be at the peak here and down here.
30:45
SPEAKER_02: And like I had, like I was at the draw, I was at the I was dropping, and I was probably still seeing normal glucose until I caught up, you know, on the CGM.
30:55
SPEAKER_02: So it's not as you think of like a train, I guess a visual for people listening would be like the the engine and then the caboose, you know, like the the front of the train is the the blood glucose and the caboose, the end of the train is the CGM.
31:08
SPEAKER_02: So we it's you know, if you're going up and down, it's gonna be different.
31:12
SPEAKER_02: And so just keeping that in mind.
31:14
SPEAKER_02: And it's hard.
31:15
SPEAKER_02: Like I'm thinking of when I'm running, like it had it on, I'd have to have my phone out and I'd have to be looking at my data while I'm running.
31:22
SPEAKER_02: Like I was also, it's also kind of like impractical to unless you can find a way to really easily be able to see it like on a a watch device.
31:29
SPEAKER_02: Like it's a little bit impractical to be like watching your data the entire time.
31:34
SPEAKER_02: Like I'm sure there's a way to kind of get around that, but it's not, it's more of a for me, I've used it more as like a after the fact.
31:42
SPEAKER_02: Like I look at my data after the fact.
31:44
SPEAKER_02: What's what is what did this experiment?
31:46
SPEAKER_02: I did a long run one time without fueling.
31:49
SPEAKER_02: I just was curious.
31:50
SPEAKER_02: Like, I'm gonna do two hours almost of running fasted because it was more of just an experiment, and I had to like I I didn't get to see the data until after the after the run was over to see what was happening.
32:01
SPEAKER_02: You know, it's yeah, that's how I would use it.
32:04
SPEAKER_02: I guess it's not a fuel gauge during and maybe that's the argument.
32:06
SPEAKER_02: It's not a fuel gauge during a good fuel gauge during, but yeah.
32:10
SPEAKER_00: So there's something else that's kind of interested me based on this conversation thus far, is that I know that me personally, sometimes I will overestimate the effort from my or the cumulative effort of my training in order to make nutrition decisions after the fact.
32:29
SPEAKER_00: Here's a scenario that if I go out and I do, you know, a three-hour bike ride and I feel like I I went pretty hard, and I get back home, I'm just like, you know what, that was a that was a hard workout.
32:41
SPEAKER_00: I'm going to treat myself to a cheeseburger, something kind of mentality, feeling like the the food decisions that I'm making are justified because I just did a hard workout.
32:52
SPEAKER_00: It seems to me that we can use these CGMs as a way to really gain more insight into really what kind of intensity we are putting out for our training.
33:03
SPEAKER_00: But it's only it's only from the standpoint of just glucose levels.
33:08
SPEAKER_00: It has nothing to do with with muscular fatigue and the and the accumulation on that side of it.
33:14
SPEAKER_00: But I think that we can make better recovery fueling decisions by using the CGM because we really get valuable insight as to you know what what are our glycogen stores?
33:26
SPEAKER_00: Are we fully stored up?
33:27
SPEAKER_00: Because if we are fully stored up, then we would expect to see elevated glucose levels, you know, during that time period.
33:33
SPEAKER_00: So there's really no justification for coming in and trying to eat more in order to replace what we feel like we've we burned because your body was well stocked.
33:44
SPEAKER_00: Does does that make sense?
33:46
SPEAKER_00: Am I thinking about it right?
33:47
SPEAKER_02: I think sometimes, yeah, I think that's a good way to think about it.
33:51
SPEAKER_02: I I'll give you another little um insight here.
33:54
SPEAKER_02: I think when I put on the CGM myself, I thought, oh, I'm an athlete.
33:59
SPEAKER_02: A can tolerate a lot of carb.
34:01
SPEAKER_02: Like, and I'm not saying athletes shouldn't eat endurance athletes shouldn't eat a lot of carb.
34:05
SPEAKER_02: However, three-hour bike, you know, you're probably burning through quite a bit of glycogen.
34:09
SPEAKER_02: Like you could probably have quite a bit of carb after, like and be, and again, but that's where it's kind of cool to see it is like kind of where what is that looking like after the workouts and is it too much?
34:20
SPEAKER_02: You know, because again, if you're like, oh, I just did this, so I'm gonna just, you know, consume a whole bunch of stuff, you might be overdoing it.
34:28
SPEAKER_02: But what I've noticed is like, um, like, and I don't think, you know, I think as long as I mean, maybe here's what I think.
34:35
SPEAKER_02: I think as long as you're maybe immediately consuming something that's gonna be giving you some carbon protein, you know, whether that's like a smoothie with some good nutrients in it or uh or something like that.
34:45
SPEAKER_02: And then you can have a little treat, you treat yourself a little bit.
34:48
SPEAKER_02: I think there's nothing wrong with that.
34:50
SPEAKER_02: I think that's the beautiful thing of being an athlete.
34:52
SPEAKER_02: But the cool thing is you can kind of see what's happening on the CGM.
34:55
SPEAKER_02: Is that really helping or is it hurting?
34:57
SPEAKER_02: I don't know.
34:57
SPEAKER_02: Like, is it are you are you tolerating that hamburger and some French fries like just fine, or is that causing like some really elevated values?
35:04
SPEAKER_02: Like maybe that's a sign that it's just too too much, or you should try something different, or maybe that's not optim optimal, you know.
35:11
SPEAKER_02: So it is a way to kind of see those things because I do think, like, yeah, I I do the same thing.
35:16
SPEAKER_02: Like I just ran my three-hour run, my long run, like I'm gonna fuel adequately after, like I'm gonna do something right away to kind of start that refueling process, but I might have a little bit of a a treat, you know, like to kind of because I know I have lots of glycogen to restore and all that.
35:32
SPEAKER_02: So it's it's it's not like you want to do that so you can sort of see how much you can get away with, but um, it is a it is a way to use it.
35:40
SPEAKER_02: The other thing I noticed was that um, like I said before, I kind of alluded to this.
35:45
SPEAKER_02: If I don't, if I eat carbs immediately after and I get that right and I fuel and get plenty of carbs, my CGM, my values don't go up a lot.
35:56
SPEAKER_02: Like I can get quite a bit of carbs after workout.
35:58
SPEAKER_02: They don't go up a lot.
35:58
SPEAKER_02: That's telling me I'm refueling pretty well.
36:01
SPEAKER_02: I'm getting that glycogen restored.
36:03
SPEAKER_02: However, like I said, if I decide, hey, I'm gonna save these carbs, I'm gonna, I'm going out to dinner tonight at seven, and I'm gonna save these carbs up and I'm gonna eat them at seven, doesn't work well for me.
36:15
SPEAKER_02: I have huge glucose spikes because it's too late in the day.
36:20
SPEAKER_02: You know, insulin resistance increases for everybody, including athletes, later in the day.
36:25
SPEAKER_02: My body is, it's the window of opportunity is already gone.
36:28
SPEAKER_02: I now cannot optimize glycogen as well because I've waited too long and it shows in my data.
36:34
SPEAKER_02: So it's it's amazing to me, you know, because I thought, oh, well, you know, I did a 10-mile run today.
36:42
SPEAKER_02: I should be fine to be able to have sushi, a big thing of sushi, and whatever later.
36:47
SPEAKER_02: No, it's fine to do it.
36:49
SPEAKER_02: Like I can do that once in a while, but it does not bode well for my glucose data.
36:54
SPEAKER_02: Had I had the sushi more immediately after my workout, it does, you know.
36:57
SPEAKER_02: So it's just that insight to me of like, I need to like really focus on getting these carbs around my workout.
37:03
SPEAKER_02: And if I wait too long, it doesn't, it it I'm not actually putting those carbs into glycogen as well, because there's so many of the glucose that I, you know, from those carbs is going into my bloodstream, it's not being processed well.
37:15
SPEAKER_02: So why don't I optimize for when I'm processing carbs when my body's more um sensitive to carb, right?
37:22
SPEAKER_02: So those are just insights that I think, yeah, it's not showing me how much how much of that glucose is going into fat or exactly how much glycogen and all that, but it's man, that's a very good visual to see.
37:35
SPEAKER_02: And it and it was and it's a good learning process.
37:37
SPEAKER_02: So I think I hope that kind of answers that.
37:39
SPEAKER_00: But I think yeah, I think I think the next question I want to still extend this a little bit more from a post-training session refuel, I'll call it that way.
37:52
SPEAKER_00: So to me, what I'm what I'm understanding is that if I have a workout and let's just say, for instance, for the month of April, I'm going to do the same workout every single week.
38:03
SPEAKER_00: And then each week I'm gonna implement, I'm gonna use the same fueling strategy for each of those sessions.
38:09
SPEAKER_00: So that's been held constant.
38:11
SPEAKER_00: The intensity is gonna be held constant and everything.
38:13
SPEAKER_00: So, you know, I'm gonna do like a trainer session where I can control the environment more than just riding outside, and I know that I'm gonna have you know the same nutrition bottle, the same number of gels and everything else, and the same structured workout, right?
38:26
SPEAKER_00: So I've done the best that I can to implement this Ketter's Paribus assumption that you know all things remain constant.
38:32
SPEAKER_00: What I'm hearing is that what we can do is we can then test the effectiveness of certain post-training meals.
38:42
SPEAKER_00: So if after that session I have, let's say this meal A, and I can look at the glucose data and say, you know, did my did my glucose levels rise?
38:52
SPEAKER_00: So I'm refueling.
38:53
SPEAKER_00: How did they rise?
38:54
SPEAKER_00: At what rate did they rise?
38:56
SPEAKER_00: What time did I did I eat these?
38:58
SPEAKER_00: And so that it was affecting, you know, better, better post uh post-meal timing.
39:02
SPEAKER_00: And then the next week I changed the meal just to and see, you know, what's the impact of that particular meal?
39:09
SPEAKER_00: And then you keep going forward.
39:11
SPEAKER_00: So what I'm getting at is you can almost find the post the most optimal post-training meal for that particular effort level.
39:23
unknown: Yeah.
39:23
SPEAKER_00: Does that is that is that realistic?
39:26
SPEAKER_02: That's a bit yeah, that's a beautiful thing about CGM using the CGM is it's great for like experimenting like that.
39:32
SPEAKER_02: I think that the thing that makes it a little bit complicated though, and this is where I think the it does help to have somebody that is really experienced in CGM data to be able to kind of look at all the variables because there are variables that impact glucose that could make some of those experiments hard to interpret, like, oh wait, which one, you know, what is really going on here?
39:54
SPEAKER_02: So things like poor sleep.
39:56
SPEAKER_02: So let's say you had that same workout, but you didn't sleep well one of the nights before, and that may impact the glucose, you know, potentially during the workout and also after throughout throughout the day, because we do become less sensitive to insulin and therefore can have a little bit higher glucose values the day after, and unfortunately, even one night of poor sleep.
40:17
SPEAKER_02: If you didn't get all the carbs or top-off glycogen the day before, that could potentially impact what's happening during that workout and after the next day.
40:25
SPEAKER_02: Um, so you want to try the best to keep if you're going to be doing these experiments, to try to keep the variables similar.
40:31
SPEAKER_02: So, like, you know, you don't have to be really weird about it and have every meal exactly the same, but maybe the night before try to keep things similar in the morning breakfast.
40:40
SPEAKER_02: And then, you know, if you had a poor sleep making a note of that, you know, if you are using the data and you have a way of kind of noting that so that if you are working with somebody who, you know, is helping you interpret the data that they can kind of see, like I would be able to see that and then be, well, maybe that's why this is happening.
40:55
SPEAKER_02: And we're, you know, we can still get something out of it, but I want to keep this in mind.
41:00
SPEAKER_02: So unfortunately, there are things like our body is a dynamic system.
41:05
SPEAKER_02: There's lots of inputs and things, you know, going on constantly.
41:08
SPEAKER_02: And so it's hard sometimes to feel like we can get a perfect sort of answer.
41:13
SPEAKER_02: But I think it I think for the most part, if you're doing it your best to keep variables the same, that type of experiment can be really fun and can provide some really good insight into what is the optimal fueling foods that you really tolerate well, or how much carb, you know, you experiment with like the amount of carb in each meal and kind of like maybe start at 60 grams or you know, actually kind of keep the experiment pretty scientific.
41:36
SPEAKER_02: Um, and then you kind of know, okay, after my workout, you know, I can tolerate this.
41:40
SPEAKER_02: And then maybe you're you're you experiment a little bit with different kinds of carbs.
41:43
SPEAKER_02: I don't know, you know, you could get really in the weeds potentially.
41:46
SPEAKER_02: And some people who love data, that's great.
41:48
SPEAKER_02: I think sometimes it could get a little bit too.
41:51
SPEAKER_02: We don't want to be, we don't want to get weird with it where it's like, yeah, you know, you just it's supposed to be for fun, it's supposed to be informative, and you don't want to, you don't want to take the data too seriously.
42:00
SPEAKER_02: But yeah, I mean that's a good example.
42:02
SPEAKER_00: I I can see two extensions of that experiment.
42:04
SPEAKER_00: First, we're gonna experiment with trying to find the most optimal meal relative to the selections that we had available to us.
42:10
SPEAKER_00: And then the next extension of that is to say, okay, now that I found the most optimal meal, what happens if I change the the fueling window?
42:20
SPEAKER_00: So let's say that I eat that meal within one hour of the training session, what does my glucose do?
42:26
SPEAKER_00: What happens if I push that into uh that second hour?
42:30
SPEAKER_00: So I wait an hour after I've I've finished the workout and then I eat, what is the effect on glucose?
42:36
SPEAKER_00: And so really what you're doing is you're you're fine-tuning not necessarily the meal selection, but the timing in which you consume that meal for your body in particular.
42:48
SPEAKER_02: Yeah.
42:48
SPEAKER_00: I love those kinds of things just because I mean that's just it fascinates me.
42:52
SPEAKER_02: Yeah, I mean another fun thing here is like I've had people, you know, timing is everything.
42:58
SPEAKER_02: We do want to fuel, you know, I think it's probably more optimal if we can start the fuel refueling process within an hour, but I've had athletes who have literally finished, and this I I have data.
43:06
SPEAKER_02: I'll show you, I'll show you some of my data.
43:09
SPEAKER_02: Well, it's it isn't the exact data, but it's similar because I had it re-remade.
43:14
SPEAKER_02: But where athletes will finish their work race and literally within a couple minutes have a huge glass of gaydrine and a donut.
43:22
SPEAKER_02: I just have an athlete that I recently was working with that this happened, and she actually had a big spike from that immediately.
43:28
SPEAKER_02: It was immediately after her run, like within minutes.
43:32
SPEAKER_02: Um, and so I told her I was like, okay, she's gonna be doing a similar race coming up.
43:36
SPEAKER_02: And I'm like, okay, if they have the same thing at the end, just grab what you need, you know, and then wait about 10 or 15 minutes, do a little bit of a cool down, get your heart rate down, get everything, you know, because you've just stopped the exercise.
43:48
SPEAKER_02: Well, first of all, I want to make sure it's not because you still have glycogen running around in your blood.
43:53
SPEAKER_02: And sometimes at the end of exercise, you can kind of see a little peak because if you've done something intense and you just immediately start.
44:00
SPEAKER_02: Stop, there's still glucose circulating.
44:02
SPEAKER_02: And sometimes that can cause a little spike.
44:04
SPEAKER_02: So it's like, is that that?
44:05
SPEAKER_02: Or is it because you ate something immediately after and maybe because you still had glycogen and because your heart rate was still elevated, it caused a spike.
44:13
SPEAKER_02: So let's wait 10 minutes, do like a walk, cool down, get your heart rate down, try the same thing.
44:18
SPEAKER_02: I mean, I'm not saying that's an optimal refueling strategy, but it was just interesting.
44:22
SPEAKER_02: So she's gonna try to wait to see if that happens again.
44:26
SPEAKER_02: So it's it's just fun, like things like that.
44:28
SPEAKER_02: It's like, okay, well, maybe we don't want to, maybe we don't want to immediately have the carb or the refuel or the donut or whatever, like within a minute after we're done.
44:38
SPEAKER_02: Maybe we need to let our body kind of cool down, go from like sympathetic, that sort of stress.
44:43
SPEAKER_02: Um, you know, when we run and we race, it's kind of in that stress sympathetic state.
44:48
SPEAKER_02: Let's come down a little bit, you know, have a little bit of that parasympathetic, like bring your heart rate down, maybe take some deep breaths, walk, cool down, calm down, and then eat, you know.
44:58
SPEAKER_02: So it could be, you know, and I see that happening after when people are like, I gotta refuel immediately, you know.
45:04
SPEAKER_02: So that's another cool thing too, is just kind of seeing, okay, maybe I don't want to do it immediately.
45:08
SPEAKER_02: I need to take some time to just kind of calm down and get my body back to a good state, and then I'm gonna eat.
45:15
SPEAKER_02: And then it, you know, because actually the way how stressed we are.
45:18
SPEAKER_02: And when we're stressed, if you know, I've seen this with people at lunch, you know, and during work when they're stressed, they eat while they're stressed and they have a spike because that meal maybe didn't cause a spike.
45:28
SPEAKER_02: It was because of there's a huge connection between our physiolog physiology and our gut.
45:34
SPEAKER_02: And so, you know, I don't know, that's just an example.
45:37
SPEAKER_02: I mean, I can think of a million examples, but that it's just fun.
45:40
SPEAKER_02: Like maybe try like immediately, and then maybe you do better when you wait 30 minutes and then eat because your body is now in a better state to be able to utilize that energy.
45:49
SPEAKER_02: So kind of fascinating, you know.
45:51
SPEAKER_00: Yeah, so the the one thing that I do want to clarify that I want to uh I don't want to say clarify, but maybe extend is that you just gave us a few of these uh other variables that can bias the reliability of of glucose data, whether that be uh you know, sleep quality and and those sorts of things.
46:10
SPEAKER_00: And before you you poo-poo on on CGMs, it's just like, oh well, you know, it's just not reliable.
46:16
SPEAKER_00: If you if you train based on heart rate, you are injecting the same kind of biasness into your training metrics under that scenario as well, because heart rate is greatly affected by all kinds of different variables.
46:29
SPEAKER_00: The environment in which you're in, dehydration levels, sleep quality, caffeine intake, stress, all of these factors will buy will affect your heart rate.
46:39
SPEAKER_00: And so if you have training zones that are set by, you know, some kind of like heart rate zone, you are therefore biasing those zones based on those exogenous variables as well.
46:49
SPEAKER_00: So the CGM is no different than if you were to base your training plan on heart rate.
46:54
SPEAKER_02: Right.
46:55
SPEAKER_02: I think the one thing I want to mention with the CGM is that that cut along those lines is that because of the way it's measured, it may not, you know, even if you did like a fasting blood glucose check and then you looked, you know, at the CGM when everything is most stable.
47:10
SPEAKER_02: So there's not going to be as much lag time.
47:11
SPEAKER_02: Sometimes there can be a little bit of difference.
47:13
SPEAKER_02: So the CGM may be running a little like a tiny, I think the FDA allows like a 5% um change a 5% difference from what you see in the um blood glucose.
47:24
SPEAKER_02: So it might be right, there's the whole graph may be running a little bit higher or a little bit lower, but the changes are all precise.
47:30
SPEAKER_02: So for the most part, there can be sometimes like during intense exercise, so we'll talk about this, or when somebody has a really big glucose response, sometimes there can be a little bit of inaccuracies in exactly how much it spiked up, but it's it's not huge.
47:45
SPEAKER_02: I mean, it still gives us a good information, but just keeping that in mind.
47:48
SPEAKER_02: For instance, I know I've had a fasting blood glucose of 85.
47:52
SPEAKER_02: And when I put on one of my CGMs, it was running closer to the high 90s for that fasting level.
47:57
SPEAKER_02: I'm not gonna freak out.
47:58
SPEAKER_02: Doesn't mean that my body is now pre-diabetes range.
48:02
SPEAKER_02: It's just that I that CGM was running high.
48:06
SPEAKER_02: So, you know, there are sometimes some some companies allow you to calibrate it to match the blood glucose, but you just have to kind of not use it as those glucose values.
48:15
SPEAKER_02: You want to really be careful not to be like, oh my gosh, this is exactly where my glucose is right now.
48:20
SPEAKER_02: It's but you what you're measuring is the the changes in glucose um and what's happening in the graph.
48:26
SPEAKER_02: And you know, is the are the values peaking up really high?
48:29
SPEAKER_02: Are they dropping?
48:30
SPEAKER_02: You're measuring those things.
48:32
SPEAKER_02: You just really want to be careful not to take that exact value and and take it to heart.
48:36
SPEAKER_02: Oh, it spiked up to 180.
48:37
SPEAKER_02: Like it must like I'm oh my gosh, I have diabetes.
48:40
SPEAKER_02: No, absolutely not.
48:41
SPEAKER_02: We don't even know if that's 100% accurately at 180, and and it just because it goes up to that amount does not mean you would be diagnosed with diabetes.
48:49
SPEAKER_02: It just means you had a bit of a spike.
48:51
SPEAKER_02: You know what I mean?
48:51
SPEAKER_02: So there's um it's just you want to keep those in mind.
48:54
SPEAKER_02: Those are some of the I mean, I think they're working hard to help get the CGM as accurate as possible.
49:01
SPEAKER_02: I know the technology is improving, but we just have to not be so worried about the exact value as they see it.
49:10
SPEAKER_03: Yeah.
49:10
SPEAKER_02: Because it may not be a hundred percent like it may be off by five points up or down.
49:14
SPEAKER_02: So keep that in mind too.
49:16
SPEAKER_02: I think that's why you want working with someone is helpful.
49:19
SPEAKER_00: So earlier in the conversation, you mentioned the word the the phrase exercise hypoglycemia.
49:25
SPEAKER_00: And so let's let's extend this a little bit more and let's talk about you know what this is, uh why why we should care about it, and what what can a CGM do uh in order to to to fix that.
49:39
SPEAKER_02: Okay, so there's a couple reasons somebody might have like hypoglycemia during exercise.
49:45
SPEAKER_02: And so there's I've mentioned a few scenarios, and so this is where I think showing some of the visuals of my of the data.
49:52
SPEAKER_02: Technically, I mean, I don't know, if you're measuring it, so the CGM measures glucose every like depending on the device vibe to like 15 minute intervals.
50:02
SPEAKER_02: Um, so I suppose this is what it may look like if you were measuring it every minute or something like that.
50:06
SPEAKER_02: It would be like it's on this on the actual data, it doesn't look like this.
50:09
SPEAKER_00: It's clean.
50:10
SPEAKER_02: Yeah, clean.
50:11
SPEAKER_02: It looks a little, this looks less clean, but you can see it.
50:14
SPEAKER_02: Like, okay, so let's say at the start, so where it says blood glucose, um, milligrams per deciliter, and then at the bottom, like the time per minutes, right?
50:23
SPEAKER_02: So you have the start, maybe your glucose.
50:26
SPEAKER_02: This is the same athlete, maybe different scenarios, right?
50:29
SPEAKER_02: So maybe or maybe it's that's how I would kind of describe this.
50:35
SPEAKER_02: So they start at 90 milligrams per deciliter, that's the start of their workout.
50:38
SPEAKER_02: The one in orange goes up, and maybe they're they're properly fueled.
50:42
SPEAKER_02: So it's very common at the beginning of exercise session to see an initial rise in glucose, and then it kind of tapers off a little bit.
50:49
SPEAKER_02: And sometimes it'll go up and down when we're fueling, um, or if we're going up a hill, intensity increases glucose.
50:55
SPEAKER_02: So we'll talk about that as well.
50:57
SPEAKER_02: But so this um goes up, and then you can see the orange, it kind of goes a little bit down, but then it levels off.
51:03
SPEAKER_02: And let's say they were going to continue running and fueling, and it would maybe it would kind of level off for the most part and stay around 110, 120 milligrams per deciliter.
51:13
SPEAKER_02: The other um would be the underfueled scenario.
51:15
SPEAKER_02: So maybe this person isn't fueling during their workout at all, they're just fasted.
51:20
SPEAKER_02: So you can see like they kind of get the blue line, it comes up and then it goes down, and then it drops sort of around um, you know, that 90-minute point, which is technically where glycogen tends to sort of, you know, we sort of have a limitation.
51:35
SPEAKER_02: So you can kind of see that it just drops, drops, drops.
51:37
SPEAKER_02: And by the time they hit two hours, it's like down.
51:39
SPEAKER_02: And then like assumption would be made, it would just continue to drop if they were to continue going.
51:44
SPEAKER_02: Um, that would be something you would maybe see.
51:46
SPEAKER_02: I mean, of course it would be continuously throughout the whole day.
51:48
SPEAKER_02: So this is just like a looking at it from a very from only the time point of the workout, but that would be an example.
51:55
SPEAKER_02: You'd kind of see this like drop, and you know, as soon as the values maybe go below 70, that's kind of more considered hypoglycemia.
52:02
SPEAKER_02: So they might see it in that scenario.
52:04
SPEAKER_00: The other scenario would be So So is the blue is the blue line the visual, the visual of hitting the wall or bonking?
52:12
SPEAKER_02: Bonking, yeah.
52:13
unknown: Okay.
52:13
SPEAKER_02: You see it dropping sort of at the end.
52:15
SPEAKER_02: And then the other side.
52:18
SPEAKER_02: That's just regular like hypoglycemia during exercise.
52:22
SPEAKER_02: That's not really related to how we fueled it before.
52:24
SPEAKER_02: I mean, assuming you that person maybe did fuel before, maybe they we don't know all of the details of that.
52:30
SPEAKER_02: It's just kind of what's happening during exercise.
52:33
SPEAKER_02: But what we eat before exercise can also cause hypoglycemia in certain instances, and it's called re rebound hypoglycemia.
52:41
SPEAKER_02: So this is actually more of what a glucose graph would look like.
52:45
SPEAKER_02: There's a lot, there's a little bit ups and downs always.
52:48
SPEAKER_02: Glucose is never a flat line.
52:50
SPEAKER_02: What we're looking at is the biggest shifts.
52:52
SPEAKER_02: And so what I'm gonna point out here is where it's um where you know, you have this like number two up here.
52:58
SPEAKER_02: I don't know why it, but I don't know.
52:59
SPEAKER_02: It's just that signifies when I started my run.
53:03
SPEAKER_02: I ate right here with this red dot.
53:06
SPEAKER_02: The red dot shows um basically what I remember this day.
53:11
SPEAKER_02: I I was gonna I was gonna run more immediately.
53:14
SPEAKER_02: I had a waffle, like one of those toaster waffles with a little bit of peanut butter and honey and some chia seeds on it.
53:20
SPEAKER_02: And I was gonna literally go running 30 within 30 minutes because I knew that if I waited too long, I would have a glucose spike and then I wouldn't feel good potentially.
53:30
SPEAKER_02: But what I did, I did not do that.
53:31
SPEAKER_02: I waited an hour later because I I think something came up with work or something happened and I had to deal with it, and I couldn't go out on my run at the time I wanted to.
53:42
SPEAKER_02: And I waited and it was more like an hour, and I was here.
53:45
SPEAKER_02: So you see my glucose levels rise.
53:47
SPEAKER_02: Now, when that happens from a meal, you have insulin re-released.
53:52
SPEAKER_02: So you have you eat your meal with carbs and it peaks up like that, and then insulin comes in.
53:57
SPEAKER_02: And insulin is a hormone that helps us drive glucose into our cells, into our cells for fuel, into our liver, or into our um liver or our glycogen sometimes and sometimes even in to fat to be birthed to store it as fat.
54:12
SPEAKER_02: So insulin is a hormone that is very important for getting glucose in out of the bloodstream and into the cells wherever it's needed.
54:21
SPEAKER_02: But I started my run at the peak.
54:23
SPEAKER_02: And then you see I dropped, drop, drop.
54:26
SPEAKER_02: And actually, this doesn't show it on I don't have the glucose levels over here, but it did in reality go to about 56 here.
54:33
SPEAKER_02: And then I ended my run, I think, here.
54:35
SPEAKER_02: So I felt awful.
54:37
SPEAKER_02: I it why it's dropping.
54:38
SPEAKER_02: And why that happened was because I had insulin, which is driving glucose into my cells, and then I started running.
54:45
SPEAKER_02: And when we run, our muscles take up glucose independently of insulin.
54:49
SPEAKER_02: So I had a double whammy.
54:51
SPEAKER_02: I had insulin or acting acting to get blood glucose out of my or glucose out of my bloodstream, and I had muscles directly taking that glucose also out of the bloodstream to fuel.
55:01
SPEAKER_02: And it whoa, like I just you see it, it goes way down.
55:04
SPEAKER_02: And so that's another example, and that's called rebound hypoglycemia when we exercise when we sweat the peak, so we have a larger glucose response.
55:13
SPEAKER_02: So this is why even using this data kind of pre-workout is helpful because you can kind of determine all right, if I have only 30 minutes, what can I eat?
55:23
SPEAKER_02: And then, you know, making sure whatever you're you're not starting your workout, you know, maybe potentially when the glucose levels are peaking.
55:30
SPEAKER_02: So just like it gives you an insight into timing a little bit, right?
55:34
SPEAKER_02: Because if I had just waited another hour, my glucose levels would probably have peaked and then they would have dropped a little bit.
55:40
SPEAKER_02: And when they were back down, I probably could have gone for my run-in.
55:43
SPEAKER_02: I wouldn't have had that because the insulin wouldn't still be in my system as much.
55:47
SPEAKER_03: Yeah.
55:47
SPEAKER_02: My body would have already dealt with that glucose and that, but I I waited and so um I felt bad.
55:53
SPEAKER_02: Um, it's not like a bad thing.
55:55
SPEAKER_02: The body, it's not like you're gonna like crash out and die because your glucose levels, you know, dropped.
56:01
SPEAKER_02: You know, that the people who have type 1 diabetes, I mean, these these data sensors are this glucose data is so important because if that were happening to them, they would probably need to have some sort of gel or something right away to bring their levels up because it could be dangerous.
56:16
SPEAKER_02: But for uh, for for people with normal um pancreatic function and normal insulin function, um, they you know, uh the body will kind of have mechanisms to like bring those glucose back levels back to normal.
56:29
SPEAKER_02: And you kind of see that here it dropped and then it comes back up.
56:32
SPEAKER_02: But it didn't feel good.
56:33
SPEAKER_02: And so it could be interesting.
56:35
SPEAKER_02: Like so, those are two examples of like where hypoglycemia might occur.
56:39
SPEAKER_02: The other might be like outside of the exercise window, like if you're not fueling, if you didn't refuel adequately post-long run.
56:46
SPEAKER_02: You know, you might see like the remainder of the day.
56:48
SPEAKER_02: I had one of these scenarios once where I don't know what happened.
56:52
SPEAKER_02: I had like a long run and then life happened.
56:54
SPEAKER_02: I don't know.
56:55
SPEAKER_03: Yeah.
56:55
SPEAKER_02: Life happened.
56:56
SPEAKER_02: I'll just say that.
56:56
SPEAKER_02: And I didn't get what I needed to eat right after.
56:59
SPEAKER_02: And I saw these dips the rest of the day, just like low like blood glucose, low blood glucose, just kind of showing me that I didn't eat adequately after.
57:08
SPEAKER_02: And so the rest of the day my my body was kind of hitting these lows, and I finally ate and um was able to get food.
57:15
SPEAKER_02: It was just that that wasn't optimal, right?
57:17
SPEAKER_02: Because I'm seeing these dips in glucose.
57:19
SPEAKER_02: So it it there's a lot of, you know, with hypoglycemia, there's a few scenario scenarios you could look into, but those are two examples.
57:27
SPEAKER_02: Hopefully that's helpful.
57:28
SPEAKER_01: That is, that actually uh helps visualize it a little bit more.
57:33
SPEAKER_02: Yeah, I was like, I have visuals this time.
57:35
SPEAKER_01: Yeah.
57:36
SPEAKER_02: Maybe unfortunately the people who are listening can't see them.
57:40
SPEAKER_02: It's kind of like if I I will I'm gonna try, I have so much content here, just kind of creating this.
57:45
SPEAKER_02: I'm gonna try to make like I really think some blog posts with visuals would be a helpful thing to Yeah, I was just about to say that is maybe this this is a good topic to extend the conversation into a blog format.
57:59
SPEAKER_00: And you know, we'll we'll post that whenever you get to it.
58:02
SPEAKER_00: We'll post it within the the closed Facebook group for the podcast as some of that additional content that we've talked about before uh that we're releasing into that area.
58:11
SPEAKER_00: So let's hit on maybe like one more topic before before we kind of wrap this thing up a little bit, and that relates to what is the role of CGM in terms of improving athletic performance.
58:27
SPEAKER_00: What does the research say?
58:28
SPEAKER_00: Is that well, what does it say?
58:30
SPEAKER_02: Yeah, I mean, this so it's I think the research doesn't directly say that.
58:33
SPEAKER_02: So, you know, the CGM can't all out its own improved athletic performance.
58:39
SPEAKER_02: Yeah, like you can't put a CGM on alone and just expect your performance to improve, right?
58:44
SPEAKER_02: Like that's not an performance enhancing tool.
58:47
SPEAKER_02: It's the data you get from it and what you do with it.
58:49
SPEAKER_02: That's that makes the research tricky, right?
58:51
SPEAKER_02: Because they're looking at does the CGM enhance performance?
58:55
SPEAKER_02: And that's a tricky thing to be able to figure out and do a research study on, because you would have to like assume that each athlete was then using that and maybe having someone they were working with that was able to interpret the data and help them make adjustments to their fueling plan to like, and then you'd have to like somehow, somehow like see if that helped with their performance.
59:16
SPEAKER_02: But it's probably the adjustments they're making based off the data that's helping their performance, right?
59:21
SPEAKER_02: So directly no, like having a CGM on your arm and saying, I'm gonna go put one on, and no, that's not gonna, that's not gonna do anything for you other than maybe just be uncomfortable in your arm potentially.
59:32
SPEAKER_02: That's kind of uh that's my answer.
59:34
SPEAKER_02: Is the data says like the research says no, but I think the problem is it's not like a creatine or some kind of supplement, or it's like heart rate monitoring.
59:44
SPEAKER_02: Like you have to like know how you're using it and and know the nuances of it and and then be able to like use that to improve your performance.
59:52
SPEAKER_02: But is monitoring your heart rate alone just gonna help you perform better?
59:56
SPEAKER_02: Not really.
59:57
SPEAKER_02: You have to know how to use that data and then change your training and or fueling strategy in this case appropriately to get the outcome, right?
1:00:06
SPEAKER_02: So yeah.
1:00:07
SPEAKER_00: I like that I like that you that you made that analogy of relating the CGM to like what we would use just a standard heart rate monitor, because I think that that that's a it's a valuable uh piece of information that I think is because when I talk to certain athletes, they'll come to me, and especially if they're new to the sport, and they get on this kick, it's like, okay, well, I've heard that I'm supposed to be running in zone two, and like 80% of my training should be done in zone two.
1:00:37
SPEAKER_00: But when I when I look at my heart rate, my heart rate spikes up into like the 160s when I start running, and so there's no way that I can keep my heart rate into this prescribed zone two range.
1:00:47
SPEAKER_00: What do I do?
1:00:48
SPEAKER_00: And I I think that this is valuable because that is something that is completely common for new runners, is to find these as soon as you start running, you'll see that heart rate spike up.
1:00:58
SPEAKER_00: And I think it's just an indication of just base fitness.
1:01:01
SPEAKER_00: You know, the body is overreacting to the activity that you're that you're doing in that moment because it's anticipating that need.
1:01:11
SPEAKER_00: So I did this in my own training years and years ago.
1:01:14
SPEAKER_00: I was trying to figure out why my heart rate, as soon as I start running, it spikes up to like 150, 160, but the effort feels easy.
1:01:22
SPEAKER_00: I was like, I don't understand it.
1:01:23
SPEAKER_00: And this is the way that was kind of explained to me was that your body, your heart is overreacting because it's trying to be preemptive.
1:01:30
SPEAKER_00: And so I I think that this is important because when we look at the CGM stuff, there's there's no kind of like optimal range for endurance athletes versus quote unquote normal people.
1:01:42
SPEAKER_00: It's not that their ranges are any different, it doesn't mean that, oh well, my glucose is stable, so that means that I'm that I'm in my optimal range, or that fluctuating glucose levels doesn't necessarily mean that I'm performing poorly.
1:01:58
SPEAKER_00: So I think that there's that that important distinction is that these I think that's where it could be dangerous.
1:02:08
SPEAKER_02: Yeah, if people don't know about glucose, maybe their assumption would be that they have to keep it pretty flat throughout the whole day, and there can't be ups and downs.
1:02:16
SPEAKER_02: Um, and that itself could be very dangerous because they might underfuel in an effort to keep their glucose levels super flat, or they might decide to restrict carbohydrates.
1:02:26
SPEAKER_02: So I think in this sort of like using the continuous glucose monitor, that is why I highly recommend you do so and work with the skilled practitioners like someone like myself or somebody who has a lot of experience with CGM data, because it could actually be used negative, it could actually be a negative thing.
1:02:47
SPEAKER_02: Because I think without that knowledge and it, you know, maybe you're hearing someone like Peter Tia and I not have any problems with him, but he doesn't work with endurance athletes.
1:02:56
SPEAKER_02: He's he's he's like a longevity expert, but he'll say, keep your glucose, don't go above 120, you know, or something like very tight, a tight glucose range.
1:03:05
SPEAKER_02: Well, if you're somebody that's athletic and you're listening to this stuff, you could then be like, oh my gosh, my value spiked up to 140, and I'm like, I'm gonna start restricting carbs and not, you know, and then your performance really suffers because athletes inevitably will have a little bit more variability.
1:03:22
SPEAKER_02: In fact, with exercise, glucose rises, and that's completely normal.
1:03:25
SPEAKER_02: It's a different mechanism than from food.
1:03:28
SPEAKER_02: So if you're seeing that your glucose spikes a bit from exercise and you're thinking, oh, that's bad, like you might do things that would not knowing why that's happening or what the mechanism is, it could cause someone to worry, you know, a little bit when they don't need to be.
1:03:42
SPEAKER_02: So I think that's the thing is there's isn't really at this point enough research to establish any kind of optimal level.
1:03:49
SPEAKER_02: In fact, we don't even know exactly what, you know, like I said, glucose levels spike with exercise.
1:03:55
SPEAKER_02: We don't know at what point that spike becomes dangerous yet.
1:04:00
SPEAKER_02: There are a lot of people that have differing opinions.
1:04:03
SPEAKER_02: I know at, you know, um some of the research that we found through Nutrasense, it was like we were kind of determining maybe around 180 is that cutoff of like when our glucose spikes during exercise above 180, it's kind of becoming more concerning.
1:04:16
SPEAKER_02: You know, that scenario of that athlete who's in the 200s the entire race, that's probably not yeah.
1:04:22
SPEAKER_02: I mean, well, arguably elite athletes doing a lot of things that aren't exactly healthy, right?
1:04:27
SPEAKER_02: So you could be wearing it and somebody might be like, oh, you can't go above one, you know, 180, or somebody else might be like, it doesn't matter because exercise is different, you know, because you're gonna get differing opinions on that.
1:04:38
SPEAKER_02: So we don't really have enough yet to say, oh, athletes need to stay, even is the 70 to 140 optimal range that we've sort of determined for normal people, is that even really optimal for athletes?
1:04:51
SPEAKER_02: We just don't know that.
1:04:53
SPEAKER_02: So we have to keep that in mind.
1:04:55
SPEAKER_02: There's not, it's not like the heart rate where we have sort of these zones and we've been able to sort of determine how to get there, and there's more data behind that.
1:05:01
SPEAKER_02: There's not that with the CGM.
1:05:04
SPEAKER_02: Um, and I do think that I think that helps I think that alone, like the exercise spikes.
1:05:09
SPEAKER_02: I I do want to talk a little bit about that before we're done because I think that's another thing you can kind of use the CGM for.
1:05:15
SPEAKER_02: And I just want to, I think this is helpful to mention.
1:05:18
SPEAKER_02: But yeah, I want people to understand that, you know, because you're gonna get, you know, you go on and you follow the glucose goddess on Instagram or something, and she's got all these tips and tricks for keeping glucose stable.
1:05:29
SPEAKER_02: That's great.
1:05:30
SPEAKER_02: I think a lot of the tips are fantastic, especially for people who are longevity people or really wanting to optimize glucose and keep it pretty even and low variability, meaning low fluctuations throughout the day.
1:05:43
SPEAKER_02: But for an athlete, that might not be realistic because we're trying to also fuel.
1:05:47
SPEAKER_02: So we're going to need more carb.
1:05:48
SPEAKER_02: We're probably going to see a little more variability.
1:05:51
SPEAKER_02: And the other thing we don't know is like what variability is too much.
1:05:55
SPEAKER_02: So, someone with diabetes, that variability, which is essentially just like the standard.
1:06:00
SPEAKER_02: Or deviation.
1:06:00
SPEAKER_02: It's basically just how much we're going up and down and up and down throughout the day.
1:06:04
SPEAKER_03: Yes.
1:06:05
SPEAKER_02: They're that 35 or 36, I think, is sort of the cutoff of what's acceptable.
1:06:09
SPEAKER_02: So anything below that, you know, is the goal.
1:06:12
SPEAKER_02: For people who are more optimal, like below 20 might be okay, and below 14 is optimal.
1:06:17
SPEAKER_02: But we don't know what that variability goal should be for athletes either.
1:06:21
SPEAKER_02: Because athletes probably, because their glucose levels are rising more with workouts, their variability is going to be higher potentially.
1:06:29
SPEAKER_02: So, and you know, maybe 14 or less is too low of a variability for athletes who are trying to optimize fueling.
1:06:35
SPEAKER_02: Maybe we need to have more um more of a goal of less than 20.
1:06:39
SPEAKER_02: I don't know, but it we don't know that yet.
1:06:41
SPEAKER_02: So the danger is, you know, you're listening to these experts in glucose who are really more like longevity people, or or, you know, maybe they're trying to help people who have prediabetes or other conditions optimize glucose.
1:06:55
SPEAKER_02: And I think you can kind of actually get yourself into trouble with as an athlete because we're a little different, you know.
1:07:02
SPEAKER_02: We need we have different needs, we have different goals.
1:07:04
SPEAKER_02: And sometimes those goals of optimizing performance do not jive well with goals of longevity and health.
1:07:10
SPEAKER_02: And that's just the reality.
1:07:12
SPEAKER_02: I would say, like when I was carb loading, I had the CGM on and I like wish I didn't, because I had crazy spikes.
1:07:19
SPEAKER_02: It was going up all over the place because I'm carb loading and I'm trying to optimize that.
1:07:23
SPEAKER_02: And it's definitely in direct opposition to like having perfectly lovely glucose values that have low variability.
1:07:30
SPEAKER_02: But it's that contradiction of what you need to do for performance versus so that's the other part of the glucose CGM.
1:07:37
SPEAKER_02: I think that's maybe more could be detrimental to an athlete is when they're too worried about optimizing all these values and not really thinking of, oh, well, I also want to optimize performance.
1:07:48
SPEAKER_02: So they kind of butt heads a little bit.
1:07:51
SPEAKER_00: That makes sense.
1:07:52
SPEAKER_00: Yeah.
1:07:52
SPEAKER_00: It's completely the reason because this the same could be said on the reliance of of carbohydrates.
1:07:58
SPEAKER_00: You know, you hear a lot of experts saying, well, you know, you should really try and minimize carbs if if your goal is for weight loss.
1:08:05
SPEAKER_00: But you know, when it comes to a carb minimization methodology for for athletes, that's really kind of performance detrimental.
1:08:12
SPEAKER_00: And so, you know, it doesn't seem to be any different for for CGM monitoring as well.
1:08:18
SPEAKER_00: So the same methodology applies.
1:08:20
SPEAKER_02: Yeah, and I do want to mention the the the sky.
1:08:22
SPEAKER_02: Yeah, go ahead.
1:08:23
SPEAKER_02: I just want to talk about that.
1:08:24
SPEAKER_02: So the rise in glucose, just one last little bit, and then I think I think that people probably uh, you know, we could I could talk for a while on this, but I am gonna share again um just a few examples.
1:08:34
SPEAKER_02: One is just a basic example of like a rise during exercise.
1:08:39
SPEAKER_02: So here we go.
1:08:40
SPEAKER_02: Okay, so this one's in black.
1:08:42
SPEAKER_02: It's just a black background.
1:08:43
SPEAKER_02: But the start of the runs in yellow.
1:08:45
SPEAKER_02: I had breakfast, I had the start of the run, or it's the this arrow in blue, and then it the finish of the run is for some reason an orange.
1:08:53
SPEAKER_02: But um, you can see there was a rise during that run.
1:08:56
SPEAKER_02: Totally normal.
1:08:57
SPEAKER_02: It's very common to see a little bit of a rise, and then I actually we it kind of actually peaked up a little bit right after the run, likely because I had some glycogen still in my bloodstream, and so it just took a minute to take a minute to clear that up.
1:09:10
SPEAKER_02: Sometimes you'll get a little bump in glucose, and then I ate and it actually kind of came down.
1:09:14
SPEAKER_02: So I didn't even go up.
1:09:15
SPEAKER_02: So that might show me maybe I didn't eat enough carb because it actually like bopped down.
1:09:20
SPEAKER_02: Like you'll see that there was a meal here or something, and then it kind of came down.
1:09:23
SPEAKER_02: And then the I don't know if these are actually accurate these, but the the some of the little dots might correspond with meals or something like that.
1:09:30
SPEAKER_02: So some of the different, there's different companies out there, and a little apps are similar, and a lot of times they have people logging meals and stuff, and so it kind of comes across on the in the glucose with the dots, but um you can kind of see that like it it was actually pretty stable than the rest of the day.
1:09:46
SPEAKER_02: So the biggest movement of the day was just around the exercise.
1:09:50
SPEAKER_02: So my variability otherwise would have maybe been less than 14, but who knows?
1:09:54
SPEAKER_02: Maybe on this day it was higher because of the exercise.
1:09:57
SPEAKER_02: So that's why we have to be kind of careful with that variability metric and just know it's normal to have a little bit of a rise, and it's a different mechanism.
1:10:05
SPEAKER_02: There's no insulin being released during exercise.
1:10:08
SPEAKER_02: It's a it's all just glycogen being released, and the whole mechanism for that rise is different.
1:10:14
SPEAKER_02: It's very dynamic, lots of glucose fluctuating in and out of cells.
1:10:17
SPEAKER_02: Whereas from a meal, the glucose kind of sticks in the bloodstream a little longer.
1:10:21
SPEAKER_02: It's not as dynamic, it's just a different scenario.
1:10:24
SPEAKER_02: So we don't want to be worried too much.
1:10:26
SPEAKER_02: But there's another scenario.
1:10:28
SPEAKER_02: This one, now don't pay too much attention.
1:10:30
SPEAKER_02: The side here, these are supposed to be glucose and milligrams per deciliter.
1:10:35
SPEAKER_02: So that um don't be too worried about that.
1:10:37
SPEAKER_02: But this uh particular graph shows the start of the run, and then you see it actually went into the red.
1:10:44
SPEAKER_02: It actually in reality went above 200.
1:10:47
SPEAKER_02: Um, and this particular day was interesting.
1:10:50
SPEAKER_02: This is my uh uh example from some of my data that I created.
1:10:53
SPEAKER_02: I just kind of recreated it.
1:10:55
SPEAKER_02: It that day I was stressed.
1:10:57
SPEAKER_02: I was so stressed.
1:10:57
SPEAKER_02: I had to like, I don't know, that night before I didn't sleep well.
1:11:01
SPEAKER_02: I was just experiencing some anxiety and some stress, and I had this like race that I was gonna do, and I'm like, well, I signed up for it.
1:11:07
SPEAKER_02: I don't feel that good.
1:11:08
SPEAKER_02: I probably should take the day easy, but I signed up for this race and I'm gonna go do it because I didn't want to waste my money and I already signed up, right?
1:11:16
SPEAKER_02: Everybody knows that scenario.
1:11:18
SPEAKER_02: I started and you can see my glucose just goes up.
1:11:21
SPEAKER_02: Like it's this is like an 8k or a 12k, kind of a little over like a 10K race distance, and it just goes up and up and up, and it actually spiked like above 200 during the race.
1:11:32
SPEAKER_02: So this the the the this was for whatever reason, chat GB messed that up a little bit, but it actually goes up above 200, so a big rise.
1:11:41
SPEAKER_02: And then I did that.
1:11:42
SPEAKER_02: I actually finished immediately had orange juice.
1:11:44
SPEAKER_02: So I was talking about that scenario with that other woman, and it spiked up even more to like 220, and then it comes crashing down after, like kind of comes crashing down, and the rest of the day it looks fine.
1:11:54
SPEAKER_02: But that's an interesting scenario where I would argue, and this is my argument was I probably should not have done that race.
1:12:02
SPEAKER_02: That level of glucose over 200 was just too much.
1:12:05
SPEAKER_02: That's that's that's indicating to me my body was stressed to begin with.
1:12:09
SPEAKER_02: And then I did because I've had other scenarios where I've done races and it has not done that.
1:12:13
SPEAKER_02: It goes up maybe to 160, maybe, maybe 180, pretty normal.
1:12:18
SPEAKER_02: Um sixty and during exercise glucose level is pretty normal, but above 200, that's kind of where I'm like, whoa, that was too much.
1:12:27
SPEAKER_02: Uh and so that indicates to me my body was under a little too much stress.
1:12:32
SPEAKER_02: The whole scenario of the poor sleep, and I knew it even going in, I felt it in the morning and I didn't listen.
1:12:37
SPEAKER_02: And this is what happened, and it was like this is this is a learning experience for me because it's like, okay, I'm if I'm going to do that, this is what I'm going to have to put my body through, is this additional, it's signaling to me I'm a little bit stressed.
1:12:51
SPEAKER_02: Um, but like I said, other scenarios where I haven't had it, where I've slept well, where I'm not stressed, where I feel great and I do the race and it doesn't do that.
1:12:59
SPEAKER_02: So this this is interesting.
1:13:01
SPEAKER_02: And I've actually seen scenarios where people go fasted running, intense, fasted workouts, intense, high intensity, huge spikes.
1:13:10
SPEAKER_02: To me, I'll tell that individual that is too stressful for your body.
1:13:14
SPEAKER_02: You are your body is like releasing a lot of glycogen.
1:13:18
SPEAKER_02: There's a lot of stress, norepinephrine, epinephrine, the stress hormones that are happening that kind of happen when we start exercise, or for whatever reason, it's just like, whoa, that's too much.
1:13:29
SPEAKER_02: Try eating something.
1:13:30
SPEAKER_02: Do not do those high-intensity workouts fasted.
1:13:34
SPEAKER_02: This is like this is your body saying, This is not good.
1:13:37
SPEAKER_02: You're going way high.
1:13:39
SPEAKER_02: So I, and then they'll eat.
1:13:40
SPEAKER_02: Yeah, sure enough, they eat something before those, like a interval workout or something, much, much better, you know, glucose.
1:13:47
SPEAKER_02: And generally, probably they feel better too.
1:13:49
SPEAKER_02: So that is another fun example.
1:13:51
SPEAKER_02: Not every scenario is sometimes it goes up during a race, and it's just because of that you're working so hard, higher intensity workouts generally mean you have higher levels.
1:14:01
SPEAKER_02: And and again, we don't know exactly what cutoff is, but for me, it was being able to compare that result to like other similar situations where it didn't go that high, and every other piece of the puzzle of how I was feeling that morning, that to me was my body.
1:14:14
SPEAKER_02: Yeah, it's too much.
1:14:15
SPEAKER_02: Um, I think that's another great example of how we can kind of use the data during exercise, putting the pieces together.
1:14:21
SPEAKER_02: I think I even did an HRV.
1:14:23
SPEAKER_02: I I don't remember.
1:14:24
SPEAKER_02: It was it wasn't good.
1:14:25
SPEAKER_02: So it was like all these little other things are telling me today is your body's uh your body it needs a rest.
1:14:33
SPEAKER_02: And then I did that anyways, and that's what happened.
1:14:35
SPEAKER_02: So it's just kind of I think there's um yeah, lots of little other scenarios that you can use this CGM stress, like looking at how stress impacts glucose, how sleep impacts glucose.
1:14:45
SPEAKER_02: So just be even beyond just the the endurance performance alone.
1:14:49
SPEAKER_02: There's a lot you can kind of get from the CGM.
1:14:52
SPEAKER_02: And so my argument is I think it's it's a helpful tool if you use it the right way.
1:14:58
SPEAKER_02: I think that's where I would want to end it.
1:15:00
SPEAKER_02: I hope, unless you have any, I don't know.
1:15:02
SPEAKER_00: No, I I think that that's a great that was a great way to kind of end it to show to show the body's the body's reaction to to to working out.
1:15:11
SPEAKER_00: And you know, when you start to you're trying to interpret these signals that your body is sending you, and sometimes it gets hard to interpret the signals and to parse out what's really causing it.
1:15:20
SPEAKER_00: So I think a lot of people could have seen that same graph and they would have said, Well, you just didn't you didn't feel properly.
1:15:27
SPEAKER_00: You know, rather than trying to interpret, no, you know, poor sleep, too hard of a workout, overly stressed, you know, because I I have athletes coming to me too and they say, you know, my performance wasn't very good today.
1:15:40
SPEAKER_00: It just, you know, it felt heavy and just my legs were just feeling off.
1:15:43
SPEAKER_00: And rather than rather than say, well, you know, we need to take a step back from training, I always approach this like, okay, well, what are the other factors that you have going on in your life?
1:15:52
SPEAKER_00: You know, has the last few days been particularly stressful?
1:15:55
SPEAKER_00: You know, what has work been like?
1:15:56
SPEAKER_00: What are what are your relationships like?
1:15:58
SPEAKER_00: These other factors, how are you eating, how are you sleeping?
1:16:01
SPEAKER_00: There's more to it than just what's my training volume.
1:16:05
SPEAKER_00: It's a system.
1:16:06
SPEAKER_00: We can't approach this stuff from a siloed perspective and and think that we can interpret it that way.
1:16:13
SPEAKER_00: And I think that this did a really good job of illustrating that as well.
1:16:17
SPEAKER_02: Yeah.
1:16:17
SPEAKER_00: I think that this polishes off polishes off the episode.
1:16:21
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1:16:33
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1:17:26
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1:17:28
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SPEAKER_00: As I mentioned earlier in the podcast, I made a brief mention of it.
1:17:32
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1:17:42
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1:17:55
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1:18:00
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1:18:02
SPEAKER_00: This is episode 77 of the Endurance Athlete Journey Podcast.
1:18:06
SPEAKER_00: We hope that you've enjoyed uh this episode, and we look forward to talking with you guys again next time.
1:18:12
SPEAKER_00: So thank you for joining us.
1:18:14
SPEAKER_00: Happy training, everyone.
1:18:15
SPEAKER_02: Yeah, thanks.
1:18:16
SPEAKER_02: Bye, Justin.
1:18:27
SPEAKER_00: That wraps up today's episode of the Endurance Athlete Journey Podcast.
1:18:31
SPEAKER_00: Endurance sports have a way of teaching us patience, humility, and resilience.
1:18:36
SPEAKER_00: Lessons that carry far beyond the workout.
1:18:40
SPEAKER_00: Progress in endurance sports doesn't come from shortcuts.
1:18:43
SPEAKER_00: It comes from consistency, discipline, and doing the work when it's not glamorous.
1:18:48
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1:18:55
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1:19:02
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1:19:10
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1:19:14
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1:19:25
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1:19:28
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1:19:34
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1:19:44
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