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Short-Duration, High-Intensity
Interval Training Dramatically
Improves Insulin Sensitivity
    Heath Extension Salon, 2012.09.13
    Paper: Babraj, Timmons et al., 2009
    Presented by: Maximus Peto
Format of This Presentation
1.   Review the aspects of disease that insulin is
     involved in (e.g. athero, cancer)
2.   Mention a paper (Timmons, 2009) showing
     HIIT improves insulin sensitivity
3.   Discuss an exercise intervention I
     developed to replicate Timmons’ insulin
     sensitivity enhancements, but with much
     less time/effort
Why talk about insulin sensitivity?
        Insulin signaling relates to many aspects of
         health and longevity, including:
    1.    Cholesterol synthesis
    2.    Cell division
    3.    Substrate utilization (oxidation (“burning”) of fat
          or carbs, depending on insulin status, among
          other things). This will then strongly influence
          body fatness, which influences inflammation and
          other disease factors
         Others (not discussed today)
[Insulin] and Cholesterol Synthesis
   Insulin + insulin sensitivity enables glucose to
    enter cells; insulin resistance prevents it
   High glucose (e.g. via insulin resistance)
    activates HMG-CoA Reductase
   HMG-CoA Reductase is the rate-limiting
    enzyme involved in cholesterol biosynthesis,
    and the target of cholesterol lowering drugs
    like statins
   I.e. Statins are largely prescribed for people
    with insulin resistance – DON’T BE!
[Insulin] and Cell Division (Specifically:
Cancer Proliferation)
   Insulin is an anabolic hormone – required for
    cell growth and division
   Type 1 diabetics, despite high glucose, have
    metabolic and wasting problems due to lack
    of insulin production (glucose can’t get used)
   Many (most? all?) cancers need insulin
    signaling for cell division – this is one big
    reason why calorie restriction has been
    shown to inhibit cancer (CR enhances insulin
    sensitivity
[Insulin] and Substrate Utilization (What
Macronutrients are Used as Fuel)
   Low insulin = burn fat; high insulin = NOT
   Insulin decreases autophagy (i.e. its lack
    enhances it!)
   Insulin increases lipid esterification
    (preparation for storage of lipids in fat cells –
    i.e. you get fatter)
   Insulin decreases proteolysis (which is why
    many bodybuilders eat high-glycemic diets –
    to retain muscle mass)
Measuring [Insulin] Indirectly – The
OGTT
   OGTT = “Oral Glucose Tolerance Test”
   75 g glucose, dissolved in water
   Fast for 12 hours, drink glucose water
   Measure blood glucose every 30 mins for 2
    hours (5 data points: 0, 30, 60, 90, 120 mins)
Measuring [Insulin] Indirectly – The
OGTT
   High glucose during OGTT most likely
    illustrates poor insulin action (e.g. secretion,
    sensitivity)
   Low glucose during OGTT suggests poor
    digestion (e.g. high fiber/low glycemic) or
    excellent insulin sensitivity, or both
Max’s Personal Experiments – Lowering
the OGTT and Postprandial Glucose
   I have tried many, many, many things to
    enhance insulin sensitivity (as measured by
    both OGTT, and fasting insulin), for all the
    reasons I’ve described before
   E.g. intermittent fasting, calorie restriction,
    low-carb diet, low-glycemic diet, exercise
    (low, moderate, and high-intensity),
    combining fat w/ meals (lowers glycemic
    index) among others. Lost 65 lbs back in
    2007 (effective, yay!)
Max’s Personal Experiments – Lowering
the OGTT and Postprandial Glucose
   Achieved much better body fat and fasting
    insulin, but OGTT won’t change much (damn
    it!)
   Tried many things to change it
   Only found a single way to improve
    OGTT reliably – HIIT, the topic of
    today’s paper
Experimental Parameters in Timmons,
et. al 2009
   Take a group of healthy people, test OGTT
    before experiment
   Do exercise protocol: HIIT: bicycle sprint 30
    sec, rest 4 min, repeat 4-6x in one session.
    Do 3 sessions/week for 2 weeks
   Wait 2 or 3 days (washout acute effects)
   Take OGTT again
Max Developed His Own Protocol
   Fast 12+ hours (e.g. overnight)
   Before breakfast, sprint as long as possible
    (15-30 sec), rest 60 seconds, sprint as long
    as possible (10-20 seconds)
   Rest until you feel like eating (~2-4 mins;
    you’ll be really out of breath, and maybe
    nauseous)
   Have breakfast; go about your day as normal
   Perform 3-5x per week
Max, Pre-HIIT
180
                            Postprandial OGTT

160




140




120




100
m
G
d
u
o
L
e
g
/
c
s
)
(
l




 80




 60
      0   0.2   0.4   0.6    0.8       1          1.2   1.4   1.6   1.8   2

                                   Time (hours)
Max, Post-HIIT
180
                            Postprandial OGTT

160




140




120




100
m
G
d
u
o
L
e
g
/
c
s
)
(
l




 80




 60
      0   0.2   0.4   0.6     0.8      1           1.2   1.4   1.6   1.8   2

                                    Time (hours)
A Few Notes
   I measured glucose, NOT insulin. So this is
    actually representative of enhanced
    GLUCOSE DISPOSAL, which is related to,
    but not identical to, insulin sensitivity
   My glucose AUC findings were similar to
    what Timmons et. al found, so I'm
    ASSUMING my insulin sensitivity is ALSO
    enhanced (I will be testing soon)
   I would like to do actual scientific study
Disclaimers! If you are trying this...
   Be sure you are in decent cardiac/vascular
    health. This is very strenuous, and you could
    give yourself a stroke or heart attack if you
    have current cardiac/vascular issues
   Jog 30 mins/day, 3x/week for 2 weeks before
    doing this, to get muscles ready
   EXPECT to be sore the next few days when
    starting (this goes away with training). I was
    sore in abs & hip flexors, but not now
QUESTIONS?

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Max Peto at Health Extension Salon #1

  • 1. Short-Duration, High-Intensity Interval Training Dramatically Improves Insulin Sensitivity Heath Extension Salon, 2012.09.13 Paper: Babraj, Timmons et al., 2009 Presented by: Maximus Peto
  • 2. Format of This Presentation 1. Review the aspects of disease that insulin is involved in (e.g. athero, cancer) 2. Mention a paper (Timmons, 2009) showing HIIT improves insulin sensitivity 3. Discuss an exercise intervention I developed to replicate Timmons’ insulin sensitivity enhancements, but with much less time/effort
  • 3. Why talk about insulin sensitivity?  Insulin signaling relates to many aspects of health and longevity, including: 1. Cholesterol synthesis 2. Cell division 3. Substrate utilization (oxidation (“burning”) of fat or carbs, depending on insulin status, among other things). This will then strongly influence body fatness, which influences inflammation and other disease factors  Others (not discussed today)
  • 4. [Insulin] and Cholesterol Synthesis  Insulin + insulin sensitivity enables glucose to enter cells; insulin resistance prevents it  High glucose (e.g. via insulin resistance) activates HMG-CoA Reductase  HMG-CoA Reductase is the rate-limiting enzyme involved in cholesterol biosynthesis, and the target of cholesterol lowering drugs like statins  I.e. Statins are largely prescribed for people with insulin resistance – DON’T BE!
  • 5. [Insulin] and Cell Division (Specifically: Cancer Proliferation)  Insulin is an anabolic hormone – required for cell growth and division  Type 1 diabetics, despite high glucose, have metabolic and wasting problems due to lack of insulin production (glucose can’t get used)  Many (most? all?) cancers need insulin signaling for cell division – this is one big reason why calorie restriction has been shown to inhibit cancer (CR enhances insulin sensitivity
  • 6.
  • 7. [Insulin] and Substrate Utilization (What Macronutrients are Used as Fuel)  Low insulin = burn fat; high insulin = NOT  Insulin decreases autophagy (i.e. its lack enhances it!)  Insulin increases lipid esterification (preparation for storage of lipids in fat cells – i.e. you get fatter)  Insulin decreases proteolysis (which is why many bodybuilders eat high-glycemic diets – to retain muscle mass)
  • 8. Measuring [Insulin] Indirectly – The OGTT  OGTT = “Oral Glucose Tolerance Test”  75 g glucose, dissolved in water  Fast for 12 hours, drink glucose water  Measure blood glucose every 30 mins for 2 hours (5 data points: 0, 30, 60, 90, 120 mins)
  • 9. Measuring [Insulin] Indirectly – The OGTT  High glucose during OGTT most likely illustrates poor insulin action (e.g. secretion, sensitivity)  Low glucose during OGTT suggests poor digestion (e.g. high fiber/low glycemic) or excellent insulin sensitivity, or both
  • 10. Max’s Personal Experiments – Lowering the OGTT and Postprandial Glucose  I have tried many, many, many things to enhance insulin sensitivity (as measured by both OGTT, and fasting insulin), for all the reasons I’ve described before  E.g. intermittent fasting, calorie restriction, low-carb diet, low-glycemic diet, exercise (low, moderate, and high-intensity), combining fat w/ meals (lowers glycemic index) among others. Lost 65 lbs back in 2007 (effective, yay!)
  • 11. Max’s Personal Experiments – Lowering the OGTT and Postprandial Glucose  Achieved much better body fat and fasting insulin, but OGTT won’t change much (damn it!)  Tried many things to change it  Only found a single way to improve OGTT reliably – HIIT, the topic of today’s paper
  • 12. Experimental Parameters in Timmons, et. al 2009  Take a group of healthy people, test OGTT before experiment  Do exercise protocol: HIIT: bicycle sprint 30 sec, rest 4 min, repeat 4-6x in one session. Do 3 sessions/week for 2 weeks  Wait 2 or 3 days (washout acute effects)  Take OGTT again
  • 13.
  • 14.
  • 15. Max Developed His Own Protocol  Fast 12+ hours (e.g. overnight)  Before breakfast, sprint as long as possible (15-30 sec), rest 60 seconds, sprint as long as possible (10-20 seconds)  Rest until you feel like eating (~2-4 mins; you’ll be really out of breath, and maybe nauseous)  Have breakfast; go about your day as normal  Perform 3-5x per week
  • 16. Max, Pre-HIIT 180 Postprandial OGTT 160 140 120 100 m G d u o L e g / c s ) ( l 80 60 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2 Time (hours)
  • 17. Max, Post-HIIT 180 Postprandial OGTT 160 140 120 100 m G d u o L e g / c s ) ( l 80 60 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 2 Time (hours)
  • 18. A Few Notes  I measured glucose, NOT insulin. So this is actually representative of enhanced GLUCOSE DISPOSAL, which is related to, but not identical to, insulin sensitivity  My glucose AUC findings were similar to what Timmons et. al found, so I'm ASSUMING my insulin sensitivity is ALSO enhanced (I will be testing soon)  I would like to do actual scientific study
  • 19. Disclaimers! If you are trying this...  Be sure you are in decent cardiac/vascular health. This is very strenuous, and you could give yourself a stroke or heart attack if you have current cardiac/vascular issues  Jog 30 mins/day, 3x/week for 2 weeks before doing this, to get muscles ready  EXPECT to be sore the next few days when starting (this goes away with training). I was sore in abs & hip flexors, but not now