Mitochondrial damage from hiit

ali

Level 6 Valued Member
And there was I thinking diabetes was a common problem, trying, in vain, to suggest a greater risk of acidosis in unqualified hands than swinging a kettlebell and getting a little bit too sweaty and avoiding those nasty bananas.
 

North Coast Miller

Level 7 Valued Member
The reason you’re “taking a kicking” is you keep equating harmless, widely utilized, widely studied, effective low carbohydrate/ ketogenic dieting with the uncontrolled, unmodulated, chronically super-
deranged metabolic environment created by a serious disease state.

Rather like trying to warn people about the dangers of Disney World fireworks displays by invoking the Bikini Atoll H-Bomb test.


I think he's using it as an example/comparison of the overblown dangers from HIIT on mitochondrial health.
To be fair, more people will likely have trouble adapting to a ketogenic diet than will getting used to 3x week HIIT session.
Both options are very effective for type 2 diabetes.
 
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Steve A

Level 5 Valued Member
And there was I thinking diabetes was a common problem, trying, in vain, to suggest a greater risk of acidosis in unqualified hands than swinging a kettlebell and getting a little bit too sweaty and avoiding those nasty bananas.

I think I see what you are getting at. I think it takes some doing to get to those extreme levels, but given the variation in people's responses, and some people wanting to be "hardcore" or something, monitoring should be the norm. However unlikely, the consequences of getting this wrong could be severe (as opposed to overdoing HIIT, which for most people will be more along the lines of "we'll that's not ideal). Yes?

There are a bunch of graphics on this at levels of ketosis - Pesquisa Google - don't know which one is most correct, but they all tell the same general story.
 
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Steve A

Level 5 Valued Member
To be fair, more people will likely have trouble adapting to a ketogenic diet than will getting used to 3x week HIIT session.
Both options are very effective for type 2 diabetes.

While both options are effective, the magnitude of improvements noted in research is greater for the KD than for HIIT. But in most the research they seem to use subjects that are in fairly bad shape (blood markers, weight, etc.) and for such people the KD diet is probably much easier than HIIT.
 

North Coast Miller

Level 7 Valued Member
While both options are effective, the magnitude of improvements noted in research is greater for the KD than for HIIT. But in most the research they seem to use subjects that are in fairly bad shape (blood markers, weight, etc.) and for such people the KD diet is probably much easier than HIIT.

Yes, but are the improvements only good while on the diet?
HIIT qualitatively improves insulin sensitivity very rapidly. In fact it improves glucose uptake immediately following exercise pretty much independent of insulin.
Even in healthy people, ROS formation is directly responsible for improved insulin sensitivity from exercise.
 

Steve A

Level 5 Valued Member
Yes, but are the improvements only good while on the diet?
HIIT qualitatively improves insulin sensitivity very rapidly. In fact it improves glucose uptake immediately following exercise pretty much independent of insulin.
Even in healthy people, ROS formation is directly responsible for improved insulin sensitivity from exercise.

There are both acute and chronic benefits of exercise on insulin sensitivity. The acute benefits tend to fade after a few days. The chronic ones seem to stem from mitochondrial biogenesis (ROS may contribute to AMPK activation; ATP consumption does result in AMPK activation. AMPK activation is an activator of mitochondrial biogenesis.) Any resulting improvement in peripheral tissues can last on the order of weeks, depending on the extent of the improvement and on lifestyle. The classic "use it or lose it." So as a practical matter, for somebody with T2D, whatever solution is implemented has to be maintained or replaced with another solution. Even with folks who can simply lose to get below a threshold level of fat, they will need to stay below that threshold.

If we invert our viewpoint, we see that while the insulin sensitivity in elite endurance athletes can be literally multiples of that of ordinary folks, some overpower those mitochondrial adaptations with diet and end up with T2D. Diet has the bigger hammer potential in either direction. Certainly it is to our advantage if a bigger hammer isn't needed.

Wow, this has really gotten off on tangents from the original. Oops.
 

ali

Level 6 Valued Member
That scenario, weight loss, elevated ketones.


"The 62-year-old has lost almost three stone in recent months and was urged to visit doctors by his wife Catherine and other family members.

Sir Lindsay said the symptoms were so severe that doctors wanted him to stay in hospital, but he refused to miss the election campaign.

He said he is “more or less 100% sure” that his diabetes is type 1, and said the ketones in his body were “off the scale”, adding: “The fact that suddenly I go in, and then I’ve got to start injecting insulin came as a real shock.”

So, yes, it'll never happen. A totally different population than health conscious low carbers armed to the teeth with keto sticks and diabetes is very rare these days anyway.

Do you see my point?

Weight loss, elevated ketones ....the sweet spot of a fat burning beast OR diabetes.

Yes, of course, *uck sake, see a doctor and if that doctor is an expert in applied ketogenic dietary interventions then good luck. God speed.

Personally, my theory why he caught diabetes was due to Brexit. Still, another story.

So back to ph . Not a problem in a healthy population. Homeostatic systems have your back. A big problem when they don't.

On balance, the active pursuit of reaching high levels of blood ketones is a big *ucking stupid idea.

But exercise isn't. My point, on a strength training forum, lost in the world of introspective keto lifestyle bollocks.

Because what's the point? Fat loss? Well that's all about physics, thermodynamics and eating less.
If you eat less, during times of not eating, you will produce ketones.

And if you are on a mission, maybe posting your daily levels on instagram, then go ahead do that. Shout it from the rooftops. But at the same time if you are backing off exercise because you are worried about ph levels then that's *ucked up.
 
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randyh

Level 2 Valued Member
This post should have been for Ali, maybe Steve can adjust.
I still think your arrow of causality needs adjusting. Ketones don’t cause diabetic ketoacidosis nor cause weight loss. In the former, they are present in excess as a result of the pathology of uncontrolled diabetes, in the latter they are a byproduct fat oxidation. In healthy individuals the body makes and uses what it needs, including glucose. Like water soluble vitamins, the ketones you don’t use get peed out, which may be the biggest complaint regarding exogenous ketones: waste of money.
I have recommended my distance runners take MCTs or Coconut oil with cream or butter in their coffee in the winter prior to runs because the it helps them recover. Shiver response (while pro MT biogenesis) shreds glycogen, perhaps it is the ketones which seem to moderate that effect (and also support MT biogenesis) and also provide some quick energy during warmup miles. Hard to say. Three Oly Trials qualifiers in marathon, no ketoacidosis or diabetes caused yet.
 

ali

Level 6 Valued Member
There is nothing there I disagree with at all. Applied to a defined population, managed appropriately, it would be patronising of me to praise your results and puerile to criticise. I do not wish to point score or fault your, or anyone's, training philosophy.
In the depths of applied sports science and applied clinical practice, supported by evidenced based science, the application of it is nuanced, both in performance and pathology/health, as there are many, many variables in real life data gathering and controlling variables in studies concluding with 'more evidence is needed'.

SO TO BE ABSOLUTELY CLEAR. The ketogenic diet as a medical intervention should be supervised, as is recommended by diabetic associations and accountable professionals. And if in consultation with medical practitioners a ketogenic diet is selected to treat and manage an individual under the care of a qualified practitioner using evidence based practice then that is the way to go. Equally if a practitioner was to recommend a non ketogenic diet, then that is a clinical decision based on evidence again. But a medical decision based on information and need, nonetheless, patient by patient, or athlete by athlete. Even with expert opinion, the ketogenic diet may be appropriate, or entirely inappropriate and other experts warn against it.

The problem of course is when all this is applied to a general population, chewed up and spat out by the multi-layered business bonanza of wellness portals, trends and lifestyle tittle-tattle.
The science becomes science-y, science-y becomes paranormal and it all gets in a right mess with people getting so attached to a belief that food becomes an identity. And from that an anti carb mentality appears, that all carbs are bad etc lah-de-dah.


Many people are diabetic however. Low carb can help. Recommended for some people. It works. Good.
The ketogenic diet, however, is not the same thing as the catch all term 'keto' and low carb.

Diabetes is really *ucking complicated. Generally it is assumed type 2, generally a result of lifestyle. But not always. Definitely not always. Because of the prevalence of it, and an increase in percentage of population, diabetic profiles can be mixed and misdiagnosed - hence why the ketogenic diet should only be ever used in consultation with a medical team. So various levels of insulin resistance, insulin dependence with a mix of genetic and epigenetic factors.
Signs and symptoms of type 1:
*weight loss
*increased urination
*fatigue
*elevated ketones

Those symptoms are the same as a keto dieter seeks. If, as is the model in the keto world, a person should prolong a stay in ketosis whilst foregoing some nasty, nasty carbohydrate, then diabetic complications result overtime at the very least. Equally, were they to have some carbs with elevated ketones and forget or not realise they need insulin then that is a problem.

Am I being obtuse? Especially extreme for point scoring? No. Outside the bubble of keto lifestyle craziness where all carbs are bad, it probably is.
The very reason why a ketogenic diet should be supervised.

And, it follows, such as is the idea promoted within the keto club that having the presence of ketones is a good thing for those wanting to burn fat, people seek them. And disappointed that they are not appearing in their piss, reduce carbs even more and up their fat when all they really want to do is to lose some chubber. It's a dangerous game for many people who will be unsupervised and possibly - given the levels of diabetes in today's society - affecting many that no one will ever know about or care.

So, put those symptoms to a keto mindset; good for you, bro. Keep those ketones up, weight loss is good, you're peeing a lot, getting rid of all those toxins caused by sugar and feeling tired is good, you're getting in zone, we call it keto flu.....

Or get a call from a diabetic type 1.....a friend of mine, in his 50s. Had it since he was a kid. He gets anxious, and when he does, receives a dump of glucose from his liver and then forgets his insulin. Picked him up from hospital 2 weeks ago. DKA. Bad s*** happens. He exercises, you know. Still cannot get on top of his illness despite the years he's dealt with it. It's a difficult thing to manage and understand. He's thought about keto.....his specialist advised him not to.

Oh, rare, you say.....diabetes does not happen....the predominant model is type 2 with an overlap to the complex multi-factorial disease of obesity. Yes, excess energy issue but it isn't that simple.

The Peter Attia Drive: #85 - Iñigo San Millán, Ph.D.: Mitochondria, exercise, and metabolic health on Apple Podcasts

A thoroughly good dive....

quoting...."exercise intensity....the biggest improvement in fat burning and biggest improvement in lactate clearance capacity. Therefore that means the mitochondria is where you see the biggest improvement. We see also the biggest improvement in performance."

Now, it goes into layers of nuance with the ketogenic diet and why and how that may be applied with the overall view that it is all possible of course with appropriate training time but it is the glycolytic pathways that give an edge for performance. In endurance cyclists, anyway. Also, insulin. He suggest to that exercise itself is very powerful for its control....especially type 2 diabetes and in type 1 reduces the need for insulin due to non insulin dependent transporters.

And then....double diabetes, a mix of the 2 types, as above. As mentioned. I'm not raising this to point score, told you so. My point is just genuine. It is an issue. The figures were mentioned, it's more common than many realise.

So it looks like, on balance, big picture, that exercise is very much a good thing. As we know, anyway. And we also know that it is dose dependent and we also know that spending too long at too much intensity produces a global fatigue response and stresses the system within broad and varied athletic history and training goals. And a steady build up toward appropriate levels is a fine way to go.

So no, I don't think my argument, or point is misplaced. Yes, fairly specific but if it raised or broadens out the thinking behind the narrow view of keto which, I believe, dominates much of the food nonsense then good.

Now.....if people fall to fat down the rabbit hole of keto, the place it sits on the scale of science to science-y is to the latter. Many keto wellness nonsense portals pursue a business agenda and exaggerate views and beliefs for profit above all else. A certain Dr (not a doctor) for instance is anti vaccine and a big proponent of keto lifestyle and toxin cleaning remedies based on utter bollocks. Anti science creeps in. Don't trust the experts creeps in. And you know....
ahem.

And, is mainstream scientific consensus wrong?
Is a diet of 40% calorie from carbs wrong? Leaving aside Big Sugar conspiracies, everyone absolutely shares the need to cut back on refined sugars and er, fats. For the general population, that is.

I think people should start there rather than pissing on an overpriced piece of paper in search of the promised land or something or other. Due keto extremism, a radicalised subversion of food. A healthy relationship with food is the aim, if you have that and you eat a diet more towards the fatty end of the spectrum then great. I just don't think peeing on sticks is a healthy relationship when there is no need to do so. And if there is a need to do so, get a doctor.

We all have different views on food, different tolerances, different beliefs and cultural influences, there's room to manoeuvre, give and take but no need to go to extremes for the general population.

If no one had a health problem, if diabetes did not happen, if genetics were not to inflict its fate on people at any time regardless of their health status then my argument would be obtuse.

And to re-iterate, if anyone goes on a ketogenic diet do so with assistance, I have no beef with applied science, just applied bollocks. There's a difference, at least I hope you think there is.
 

Van Der Merve

Level 2 Valued Member
Unfounded? Really?

"Diabetic Ketoacidosis (DKA) is a condition in which the blood becomes highly acidic as a result of dehydration and excessive ketone (acid) production. When bodily fluids become acidic, some of the body’s systems stop functioning properly. It is a serious condition that will make you violently ill and it can kill you "


Now clearly there is a population issue here. I'm not saying, in anyway, that a healthy, exercising person will go on to develop ill health due to skipping breakfast and going for a run or a spot of Q&D. No. To be clear.
However, let's get real. Many people seek advice about diet, possibly from a position of ill health with possibly some food issues and the prevailing wind is from the direction of keto this, keto that. And from that there is a sub culture of ketone chasing. If healthy, personal choice etc....I have no judgement on that, do what you want. But there is a crossover, a very real one, that of testimony and anecdote. Some people clearly do well going some sort of keto version of something or other.
There is very little, if any, discussion of the dangers. And there are very real dangers.
My point is if someone is overly concerned about creating an acid bath at the cellular level due to lactate but is unaware perhaps that ketone bodies are themselves acidic, then is that not a point worth mentioning?
Is it a worry for healthy people? No. For diabetics, well....what do people think?
And here, probably, people will say that they've gained their health back via keto/low carb....and good for them. Do you hear of the people who don't? And then there is the full, proper ketogenic diet.
And yes, differentiate between type 1 and type 2. There are so many variables in a general discussion - but the variable being discussed here is acid. Ketones are acidic and when uncontrolled, in excess, can kill you.

You are comparing carrots and pencils. Diabetic ketoacidosis is multifactorial condition caused by lack of insulin. That leads to high levels of glucose in plasma, glycosuria (excretion of glucose in the urine) and dehydration caused by so called osmotic diuresis. Also, DKA usually occurs on the background of some significant event in the body, an infection, trauma etc.

In healthy individuals with normal glucose levels acidosis caused by elevated ketones is easily compensated by the buffering systems.

Signs and symptoms of type 1:
*weight loss
*increased urination
*fatigue
*elevated ketones

Classical symptoms of type 1 diabetes are: polyphagia (eat a lot), polyuria (urinate a lot) and polydipsia (drink a lot). It was coined "diabetes mellitus" (mellitus - honey-sweet in Latin) because patients' urine tasted sweet. As opposed to "diabetes insipidus", characterised by polyuria, but tasteless urine. Weight loss and other symptoms depend on the severity of the disease, i.g. if pancreas is still producing some of it, albeit inadequate amount, or there is zero insulin.

Before insulin was synthesised the only hope for T1D patients was "the Allen plan", the diet of very low calories and practically zero carbs. it did improve diabetics' life expectancy somewhat, but was very hard to follow. Later some physicians acknowledged that starving patients is not necessary and that carb restriction works just as well. Brief review here: Why were "starvation diets" promoted for diabetes in the pre-insulin period?
 
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Van Der Merve

Level 2 Valued Member
Coming back to the original post, there is no research demonstrating the destruction of mitochondria by acidosis. Or, rather, I have not been successful searching for it on PubMed. Mitochondria develop from any stimulus that cause muscle to utilise more oxygen. Any variation of both HIIT or LSD. Muscle cell may be damaged by excessive loading (like any other cell), but mitochondria don't specifically get destroyed by acidosis.
 

Steve Freides

Staff
Senior Certified Instructor
Elite Certified Instructor
Ladies and gentlemen, may I humbly suggest that we resist commenting on "diabetic ketoacidosis" because that is the domain of medical professionals which we are not. Anyone with a diagnosis of diabetes (of any form or type) is strongly advised to follow their doctor's advice. We should refrain from giving them any medical advice at all. Where we can help is when they have been given permission to exercise without restrictions or if they understand and can explain to us what restrictions they are under to us. Let's leave the doctoring to the doctors.

Let's also be careful not have a war of words between those who favor a ketogenic diet in healthy individuals and those who don't. "We don't say you're wrong" to adherents of either camp. In healthy individuals, we don't want to demonize any food nor do we want to demonize the people who choose to demonize some foods.

As long as you're not demonizing swinging a kettlebell, you're welcomed here. :)

-S-
 

ali

Level 6 Valued Member
Thank you @Steve Freides ....., nicely put, as always.
It's a thing I don't understand, really but try to understand and explore (multi-faceted that it is, belief/psychology) why there is such fervour, anger, intolerance and strongly held beliefs about food. It is odd, isn't it? And all a bit silly.
 

Steve Freides

Staff
Senior Certified Instructor
Elite Certified Instructor
Thank you, @ali.

Whenever discussions like this come up, I remind myself that a large percentage of the world's people go to bed hungry every night, and that's usually enough to shut me up right there. Being able to be overweight, to have access to more food than you need, is a blessing.

People have survived for a long time on all manner of less-than-optimal eating. I not only can afford enough food for my comfortable survival, I can afford to shop at Whole Foods, affectionately known in some circles as Whole Paycheck. I do the best I can with what I have. If I can pick up heavy things and I like the number I see on the scale, I'm pretty content.

-S-
 

Eyetic

Level 4 Valued Member
Diabetes T1 here, started on Keto 2 years ago while on Crossfit training, god damn the difficulties I faced where a lot, specially cramps! So started with just a Low carb diet (lets say less than 60g a day) and indeed improved overall.
To compensate the lack of vitamin I was getting normally from fruits I did have to include a bunch of vegs in my diet as well as extra pills with different vitamins.
Did all this hand by hand with my wife (Biology & Chemistry degree, Phd Phisiology, Master in Sports nutrition and also Crossfit CFL1 coah) so we took it very seriously, did I improve overall?

Yes, my HbA1c went from 8.5 to around 6.2 meaning my glucose lvls were on good lvls almost the whole day, other marks were already good before taking this path but that was because my lifestyle was already healthy and my diet was well balanced as well as my workout routine. I did check my ketones urine levels every time I went to the bathroom and tried always to avoid HIIT exercises if high (the same I do if my BG are high).

Reduced my overall insulin intake (money savings), improved my insulin sensitivity, more "jacked" but that was not the main point here and overall I feel good.

Regarding the medical advises...I tried to speak with my Endo dr. about this and he didn't even try to listen me, he wanted me just to take more insulin and eat more carbs as that was what people do... so I preferred to follow my wife's criteria and here I am healthy and alive (not a single diabetic related complication after 22 years with it, Im 33 now)

Would I recommend it to other diabetics? maybe but its just better to start changing the lifestyle, add some exercise and then improving your overall intake of healthy food, avoid some nonsense carbs and see where that goes...listen your doctor but if you feel he's an old fashioned one (like mine was) try to consult some others.
 

Anna C

Level 9 Valued Member
Elite Certified Instructor
Diabetes T1 here, started on Keto 2 years ago while on Crossfit training, god damn the difficulties I faced where a lot, specially cramps! So started with just a Low carb diet (lets say less than 60g a day) and indeed improved overall.
To compensate the lack of vitamin I was getting normally from fruits I did have to include a bunch of vegs in my diet as well as extra pills with different vitamins.
Did all this hand by hand with my wife (Biology & Chemistry degree, Phd Phisiology, Master in Sports nutrition and also Crossfit CFL1 coah) so we took it very seriously, did I improve overall?

Yes, my HbA1c went from 8.5 to around 6.2 meaning my glucose lvls were on good lvls almost the whole day, other marks were already good before taking this path but that was because my lifestyle was already healthy and my diet was well balanced as well as my workout routine. I did check my ketones urine levels every time I went to the bathroom and tried always to avoid HIIT exercises if high (the same I do if my BG are high).

Reduced my overall insulin intake (money savings), improved my insulin sensitivity, more "jacked" but that was not the main point here and overall I feel good.

Regarding the medical advises...I tried to speak with my Endo dr. about this and he didn't even try to listen me, he wanted me just to take more insulin and eat more carbs as that was what people do... so I preferred to follow my wife's criteria and here I am healthy and alive (not a single diabetic related complication after 22 years with it, Im 33 now)

Would I recommend it to other diabetics? maybe but its just better to start changing the lifestyle, add some exercise and then improving your overall intake of healthy food, avoid some nonsense carbs and see where that goes...listen your doctor but if you feel he's an old fashioned one (like mine was) try to consult some others.

You might enjoy this podcast...They talk specifically about diabetes after the 1 hr 30 min mark. Fascinating.
 

Eyetic

Level 4 Valued Member
You might enjoy this podcast...They talk specifically about diabetes after the 1 hr 30 min mark. Fascinating.

Gosh they are just describing what I've been through....what an interesting point about the Zone 2, I did already realized that somehow I was lowering my BG (specially when running barefoot which I do pretty slow) but never heard about this glucose absorption due to muscle contraction....
 

Anna C

Level 9 Valued Member
Elite Certified Instructor
never heard about this glucose absorption due to muscle contraction....

Yes, that was new to me, too! I wonder if "active rest", "fast & loose" figures in there...? Seems like it could.
 

Eyetic

Level 4 Valued Member
I'm surely start, which I already did with the "rucking" commutes, to improve the Zone 2 training and see if I reduce my insulin intake, he talk about that T1 guy which brisk walk for 3 hours a day taking 10 units of insulin a day...he doesn't talk about his calories intake though, weight and height as that also affect the units you need per day. (i'm taking less than 50 a day between basal and bolus insulin)
 
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