#173 - AMA #26: Continuous glucose monitors, zone 2 training, and a framework for interventions
whatshot 13 snips
Aug 23, 2021
This discussion dives into continuous glucose monitors (CGMs) and their role in managing blood sugar. They explore how different fruits affect glucose levels and the psychological impact of using CGMs. The hosts highlight insights on Zone 2 training and how it influences exercise performance, especially referencing the incredible cyclists of the Tour de France. Peter shares a foundational framework for evaluating health interventions, emphasizing the need for personal accountability in dietary choices and the importance of understanding insulin's role.
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volunteer_activism ADVICE
Framework for Interventions
Consider the potential harm, benefit, and opportunity cost of any intervention.
These questions are crucial, especially when randomized controlled trials (RCTs) are lacking.
insights INSIGHT
Intervention-Based RCTs
RCTs on interventions like exercise address opportunity cost, unlike pharmacological RCTs.
This framework is helpful for evaluating CGM use in non-diabetics, where RCT data is limited.
volunteer_activism ADVICE
CGM Trial and Considerations
Consider a three-month CGM trial for insight and behavior modification, but avoid it for patients with eating disorders.
CGM's can cause anxiety and obsession, so use cautiously.
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In this “Ask Me Anything” (AMA) episode, Peter and Bob answer numerous follow-up questions to recently discussed deep-dive topics such as the use of continuous glucose monitors and getting the most from zone 2 exercise. They also discuss the incredible feats of cyclists in the Tour de France through the lens of the amazing performance physiology required from these athletes. Additionally, Peter ties the conversation together by sharing his foundational framework when considering different interventions, even in the absence of data from a randomized controlled trial. If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #26 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss:
Peter’s foundational framework when considering different interventions [1:30];
Applying Peter’s framework to the idea of using a CGM [8:00];
Why certain fruits have a bigger impact on glucose, and the limitations of a CGM can tell you [16:00];
Importance of paying attention to insulin, and the prospects of a continuous monitor for insulin levels [20:00];
How exercise impacts glucose and peak glucose numbers to stay under [24:15];
Impact of anxiety on stress on glucose, and why it’s important to calibrate your CGM [26:30];
The five main tools for managing blood glucose numbers [33:45];
Benefits of moving or exercising after a meal, and where ingested carbohydrates get can be stored [37:15];
How to make decisions about an action or intervention in the absence of data from a rigorous, randomized controlled trial [40:30];
The incredible athletic feats of Tour de France cyclists [48:30];
Different modalities for doing zone 2 exercise: running, rowing, cycling, and more [1:00:15];
Proxies for knowing your in zone 2 short of using a lactate monitor [1:07:30];
Monitoring lactate for zone 2 exercise [1:10:00]; and
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