The Best Form Of Sugar During Exercise
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝What is the best form of sugar for an energy kick during exercise? Both type of sugar eg glicoae fructose dextrose etc and medium, ie drink, gel, solids etc❞
Great question! Let’s be clear first that we’re going to answer this specifically for the context of during exercise.
Because, if you’re not actively exercising strenuously right at the time when you’re taking the various things we’re going to be talking about, the results will not be the same.
For scenarios that are anything less than “I am exercising right now and my muscles (not joints, or anything else) are feeling the burn”, then instead please see this:
Snacks & Hacks: Eating For Energy (In Ways That Actually Work)
Because, to answer your question, we’re going to be going 100% against the first piece of advice in that article, which was “Skip the quasi-injectables”, i.e., anything marketed as very quick release. Those things are useful for diabetics to have handy just in case of needing to urgently correct a hypo, but for most people most of the time, they’re not. See also:
Which Sugars Are Healthier, And Which Are Just The Same?
However…
When strenuously exercising in a way that is taxing our muscles, we do not have to worry about the usual problem of messing up our glucose metabolism by overloading our body with sugars faster than it can use it (thus: it has to hurriedly convert glucose and shove it anywhere it’ll fit to put it away, which is very bad for us), because right now, in the exercise scenario we’re describing, the body is already running its fastest metabolism and is grabbing glucose anywhere it can find it.
Which brings us to our first key: the best type of sugar for this purpose is glucose. Because:
- glucose: the body can use immediately and easily convert whatever’s spare to glycogen (a polysaccharide of glucose) for storage
- fructose: the body cannot use immediately and any conversion of fructose to glycogen has to happen in the liver, so if you take too much fructose (without anything to slow it down, such as the fiber in whole fruit), you’re not only not going to get usable energy (the sugar is just going to be there in your bloodstream, circulating, not getting used, because it doesn’t trigger insulin release and insulin is the gatekeeper that allows sugar to be used), but also, it’s going to tax the liver, which if done to excess, is how we get non-alcoholic fatty liver disease.
- sucrose: is just a disaccharide of glucose and fructose, so it first gets broken down into those, and then its constituent parts get processed as above. Other disaccharides you’ll see mentioned sometimes are maltose and lactose, but again, they’re just an extra step removed from useful metabolism, so to save space, we’ll leave it at that for those today.
- dextrose: is just glucose, but when the labeller is feeling fancy. It’s technically informational because it specifies what isomer of glucose it is, but basically all glucose found in food is d-glucose, i.e. dextrose. Other isomers of glucose can be synthesized (very expensively) in laboratories or potentially found in obscure places (the universe is vast and weird), but in short: unless someone’s going to extreme lengths to get something else, all glucose we encounter is dextrose, and all (absolutely all) dextrose is glucose.
We’d like to show scientific papers contesting these head-to-head for empirical proof, but since the above is basic chemistry and physiology, all we could find is papers taking this for granted and stating in their initial premise that sports drinks, gels, bars usually contain glucose as their main sugar, potentially with some fructose and sucrose. Like this one:
A Comprehensive Study on Sports and Energy Drinks
As for how to take it, again this is the complete opposite of our usual health advice of “don’t drink your calories”, because in this case, for once…
(and again, we must emphasize: only while actively doing strenuous exercise that is making specifically your muscles burn, not your joints or anything else; if your joints are burning you need to rest and definitely don’t spike your blood sugars because that will worsen inflammation)
…just this once, we do want those sugars to be zipping straight into the blood. Which means: liquid is best for this purpose.
And when we say liquid: gel is the same as a drink, so far as the body is concerned, provided the body in question is adequately hydrated (i.e., you are also drinking water).
Here are a pair of studies (by the same team, with the same general methodology), testing things head-to-head, with endurance cyclists on 6-hour stationary cycle rides:
CHO Oxidation from a CHO Gel Compared with a Drink during Exercise
Meanwhile, liquid beat solid, but only significantly so from the 90-minute mark onwards, and even that significant difference was modest (i.e. it’s clinically significant, it’s a statistically reliable result and improbable as random happenstance, but the actual size of the difference was not huge):
Oxidation of Solid versus Liquid CHO Sources during Exercise
We would hypothesize that the reason that liquids only barely outperformed solids for this task is precisely because the solids in question were also designed for the task. When a company makes a fast-release energy bar, they don’t load it with fiber to slow it down. Which differentiates this greatly from, say, getting one’s sugars from whole fruit.
If the study had compared apples to apple juice, we hypothesize the results would have been very different. But alas, if that study has been done, we couldn’t find it.
Today has been all about what’s best during exercise, so let’s quickly finish with a note on what’s best before and after:
Before: What To Eat, Take, And Do Before A Workout
After: Overdone It? How To Speed Up Recovery After Exercise
Take care!
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Five Advance Warnings of Multiple Sclerosis
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Five Advance Warnings of Multiple Sclerosis
First things first, a quick check-in with regard to how much you know about multiple sclerosis (MS):
- Do you know what causes it?
- Do you know how it happens?
- Do you know how it can be fixed?
If your answer to the above questions is “no”, then take solace in the fact that modern science doesn’t know either.
What we do know is that it’s an autoimmune condition, and that it results in the degradation of myelin, the “insulator” of nerves, in the central nervous system.
- How exactly this is brought about remains unclear, though there are several leading hypotheses including autoimmune attack of myelin itself, or disruption to the production of myelin.
- Treatments look to reduce/mitigate inflammation, and/or treat other symptoms (which are many and various) on an as-needed basis.
If you’re wondering about the prognosis after diagnosis, the scientific consensus on that is also “we don’t know”:
Read: Personalized medicine in multiple sclerosis: hope or reality?
this paper, like every other one we considered putting in that spot, concludes with basically begging for research to be done to identify biomarkers in a useful fashion that could help classify many distinct forms of MS, rather than the current “you have MS, but who knows what that will mean for you personally because it’s so varied” approach.
The Five Advance Warning Signs
Something we do know! First, we’ll quote directly the researchers’ conclusion:
❝We identified 5 health conditions associated with subsequent MS diagnosis, which may be considered not only prodromal but also early-stage symptoms.
However, these health conditions overlap with prodrome of two other autoimmune diseases, hence they lack specificity to MS.❞
So, these things are a warning, five alarm bells, but not necessarily diagnostic criteria.
Without further ado, the five things are:
- depression
- sexual disorders
- constipation
- cystitis
- urinary tract infections
❝This association was sufficiently robust at the statistical level for us to state that these are early clinical warning signs, probably related to damage to the nervous system, in patients who will later be diagnosed with multiple sclerosis.
The overrepresentation of these symptoms persisted and even increased over the five years after diagnosis.❞
Read the paper for yourself:
Hot off the press! Published only yesterday!
Want to know more about MS?
Here’s a very comprehensive guide:
National clinical guideline for diagnosis and management of multiple sclerosis
Take care!
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Stop Using The Wrong Hairbrush For Your Hair Type
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When you brush your hair, you’re either making it healthier or damaging it, depending on what you’re using and how. To avoid pulling your hair out, and to enjoy healthy hair of whatever kind you have and whatever length suits you, it pays to know a little about different brushes, and the different techniques involved.
Head-to-head
Brush shapes and sizes are designed to achieve different effects in hair, not just for decoration. For example:
- Rat tail combs are excellent for parting and sectioning hair with clean lines. The rat tail part is actually more important than the comb part.
- Regular combs are multipurpose but best for use with flat irons, ensuring straighter hair for a longer time.
- Wide-tooth combs should not be used for detangling as they can cause breakage; instead, use a proper detangling brush. Speaking of detangling…
- Detangling brushes are essential for daily use. Whichever you use, start brushing from the bottom to prevent tangles from stacking and worsening. As for kinds of detangling brush:
- The “Tangle Teaser” is a good beginner option, but it may not detangle well for thicker hair.
- Wet Brush (this is a brand name, and is not about any inherent wetness) is the recommended detangling brush for most people. It can be used on wet or dry hair.
- Mason Pearson brush is a luxury detangling brush (see it here on Amazon) that works slightly more quickly and efficiently, but is expensive and not necessary for most people.
- Teasing brushes are for adding volume by backcombing—but require skill to prevent visible tangles. Best avoided for most people.
- Ceramic round brushes are the best for blow-drying, because they hold tension and help hair dry smoother and shinier.
- Blow-dryer brushes are great for easy blow-drying but should not be used on dry hair, to avoid damage.
- Denman brushes are for people with natural curls, enhancing curls without straightening them like a Wet brush would.
For more on all of these brushes, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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How Tight Are Your Hips? Test (And Fix!) With This
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Upon surveying over half a million people; hips were the most common area for stiffness and lack of mobility. So, what to do about it?
This test don’t lie
With 17 muscles contributing to hip function (“hip flexors” being the name for this group of 17 muscles, not specific muscle), it’s important to figure out which ones are tight, and if indeed it really is the hip flexors at all, or if it could be, as it often is, actually the tensor fasciae latae (TFL) muscle of the thigh. If it turns out to be both, well, that’s unfortunate but the good news is, now you’ll know and can start fixing from all the necessary angles.
Diagnostic test for tight hip flexors (Thomas Test):
- Use a sturdy, elevated surface (e.g. table or counter—not a bed or couch, unless there is perchance room to swing your legs without them touching the floor).
- Sit at the edge, lie back, and pull both knees to your chest.
- Return one leg back down until the thigh is perpendicular to the table.
- Let the other leg dangle off the edge to assess flexibility.
Observations from the test:
- Thigh contact: is the back of your thigh touching the table?
- Knee angle: is your knee bent at roughly 80° or straighter?
- Thigh rotation: does the thigh roll outward?
Interpreting results:
- If your thigh contacts the surface and the knee is bent at around 80°, hip mobility is good.
- If your thigh doesn’t touch or knee is too straight, hip flexor tightness is present.
- If your thigh rolls outwards from your midline, that indicates tightness in the TFL muscle of the thigh.
Three best hip flexor stretches:
- Kneeling lunge stretch:
- Hips above the knee, tuck tailbone, engage glutes, press hips forward, reach arm up with a slight side bend.
- Seated hip lift stretch:
- Sit with feet hip-width apart, hands behind shoulders, lift hips, step one foot back, tuck tailbone, point knee away.
- Sofa stretch:
- Kneel with one shin against a couch/wall, other foot forward in lunge, tuck tailbone, press hips forward, lift torso.
It’s recommended to how each stretch for 30 seconds on each side.
For more on all of the above, and visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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Lifespan vs Healthspan, And The Spice Of Life
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Great newsletter. Am taking turmeric for inflammation of hips and feet. Works like magic. Would like to know how it works, and what tumeric is best combined with – also whether there any risks in longterm use.❞
Glad you’re enjoying! As for turmeric, it sure is great, isn’t it? To answer your questions in a brief fashion:
- How it works: it does a lot of things, but perhaps its most key feature is its autoxidative metabolites that mediate its anti-inflammatory effect. This, it slows or inhibits oxidative stress that would otherwise cause inflammation, increase cancer risk, and advance aging.
- Best combined with: black pepper
- Any risks in long-term use: there are no known risks in long-term use ← that’s just one study, but there are lots. Some studies were prompted by reported hepatotoxicity of curcumin supplements, but a) the reports themselves seem to be without evidence b) the reported hepatoxicity was in relation to contaminants in the supplements, not the curcumin itself c) clinical trials were unable to find any hepatotoxicity (or other) risks anyway. Here’s an example of such a study.
You might also like our previous main feature: Why Curcumin (Turmeric) Is Worth Its Weight In Gold
❝This push for longevity is appealing but watching my mother in her nineties is a life I’m not looking forward to. Healthy longevity, yes, but longevity for the sake of a longer life? No thank you.❞
Yes, you’re quite right, that’s exactly the point! Assuming we live to die of age-related conditions (i.e., we do not suffer a fatal accident or incident in our younger years), those unfun last years are coming whether they come at 75 or 95. Or earlier or later, because that can absolutely happen too!
For example: nearly 10% of Americans over 65 have difficulty with self-care
As a rule, and we’ve covered some of the science of this previously, having at least 4 out of 5 of the “big 5” lifestyle factors (diet, exercise, sleep, low-or-zero alcohol, not smoking) not only extends life, but specifically extends the healthspan, i.e. the count of healthy life-years that precedes final age-related decline.
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Adult Children of Emotionally Immature Parents – by Dr. Lindsay Gibson
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Not everyone had the best of parents, and the harm done can last well beyond childhood. This book looks at healing that.
Dr. Gibson talks about four main kinds of “difficult” parents, though of course they can overlap:
- The emotional parent, with their unpredictable outbursts
- The driven parent, with their projected perfectionism
- The passive parent, with their disinterest and unreliability
- The rejecting parent, with their unavailability and insults
For all of them, it’s common that nothing we could do was ever good enough, and that leaves a deep scar. To add to it, the unfavorable dynamic often persists in adult life, assuming everyone involved is still alive and in contact.
So, what to do about it? Dr. Gibson advocates for first getting a good understanding of what wasn’t right/normal/healthy, because it’s easy for a lot of us to normalize the only thing we’ve ever known. Then, beyond merely noting that no child deserved that lack of compassion, moving on to pick up the broken pieces one by one, and address each in turn.
The style of the book is anecdote-heavy (case studies, either anonymized or synthesized per common patterns) in a way that will probably be all-too-relatable to a lot of readers (assuming that if you buy this book, it’s for a reason), science-moderate (references peppered into the text; three pages of bibliography), and practicality-dense—that is to say, there are lots of clear usable examples, there are self-assessment questionnaires, there are worksheets for now making progress forward, and so forth.
Bottom line: if one or more of the parent types above strikes a chord with you, there’s a good chance you could benefit from this book.
Click here to check out Adult Children of Emotionally Immature Parents, and rebuild yourself!
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Topping Up Testosterone?
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The Testosterone Drop
Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.
(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)
This has been called “the male menopause”, or “the andropause”.
Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.
Why “the male menopause” is misleading:
To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).
Why “the andropause” is misleading:
It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.
Is there a better clinical term?
Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.
Terms aside, what are the symptoms?
❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞
…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:
Source: Andropause: Current concepts
Can it be safely ignored?
If you don’t mind the sexual symptoms, then mostly, yes!
However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:
- Depression
- Loss of muscle mass
- Increased body fat
Depression kills, so this does need to be taken seriously. See also:
The Mental Health First-Aid That You’ll Hopefully Never Need
(the above is a guide to managing depression, in yourself or a loved one)
Loss of muscle mass means being less robust against knocks and falls later in life
Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)
See also:
- Resistance Is Useful! (Especially As We Get Older)
- Protein vs Sarcopenia
- Fall Special (How to Proof Yourself Against Falls)
Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.
Will testosterone therapy help?
That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).
See for example:
Testosterone Therapy Improves […] and […] in Hypogonadal Men
(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)
Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:
❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.
The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).
Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞
Source: Effects of Testosterone Treatment in Older Men
We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.
That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).
And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)
Click here to see the results table for the vitality trial
Will it turn me into a musclebound angry ragey ‘roidmonster?
Were you that kind of person before your testosterone levels declined? If not, then no.
Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.
Is testosterone therapy safe?
A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.
As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…
❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development
For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.
Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞
Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:
Risks of testosterone replacement therapy in men
See also: Prostate Health: What You Should Know
Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!
For now, take care!
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