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Study: Exercising at the start of fast can help people reach ketosis 3.5 hours faster

Exercise made a big difference: when participants exercised, they reached ketosis on average three and a half hours earlier in the fast and produced 43% more BHB. The theory is that the initial exercise burns through a substantial amount of the body’s glucose, prompting a quicker transition to ketosis. Without exercise, the participants hit ketosis about 20 to 24 hours into the fast.

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Photo by Meghan Holmes from Unsplash.com

A new Brigham Young University study published in the journal Medicine & Science in Sports & Exercise finds that exercising intensely at the start of a fast may help maximize health benefits of temporarily foregoing food.

“We really wanted to see if we could change the metabolism during the fast through exercise, especially how quickly the body enters ketosis and makes ketones,” said BYU Ph.D. student Landon Deru, who helped design the study for his thesis.

Ketosis occurs when the body runs out of glucose — its first, preferred fuel — and begins breaking down stored fat for energy, producing chemicals called ketones as a byproduct. In addition to being a healthy energy source for the brain and heart, ketones combat diseases like diabetes, cancer, Parkinson’s and Alzheimer’s.

For the study, the researchers asked 20 healthy adults to complete two 36-hour fasts while staying hydrated. Each fast began after a standardized meal, the first fast starting without exercise and the other with a challenging treadmill workout. Every two hours while awake, the subjects completed hunger and mood assessments and recorded their levels of B-hydroxybutyrate (BHB), a ketone-like chemical.

Exercise made a big difference: when participants exercised, they reached ketosis on average three and a half hours earlier in the fast and produced 43% more BHB. The theory is that the initial exercise burns through a substantial amount of the body’s glucose, prompting a quicker transition to ketosis. Without exercise, the participants hit ketosis about 20 to 24 hours into the fast.

“For me, the toughest time for fasting is that period between 20 and 24 hours, so if I can do something to stop fasting before 24 hours and get the same health outcomes, that’s beneficial,” said study coauthor Bruce Bailey, a BYU exercise science professor. “Or if I do fast for my usual 24 hours but start with exercise, I’ll get even more benefits.”

There are a few caveats to the proposed strategy, however.

“If you carb load or eat a huge meal before you fast, you may not reach ketosis for days, even if you do exercise, so you should eat moderately before fasting,” Bailey said. “We also don’t know the ideal frequency for fasting. There are definitely certain people who shouldn’t fast, such as those with Type 1 diabetes, and obviously it’s detrimental to fast 24/7. But for most people it’s perfectly safe and healthy to fast once or even twice a week for 24 or more hours.”

The study, which required participants to run on a treadmill for an average of 45 to 50 minutes, also didn’t establish an ideal amount or type of exercise for every person. Overall, though, the researchers believe the more energy a person can burn, the better.

“You can get a pretty good estimation of how many calories you’re burning in most exercises, and the more carbohydrates you burn off (without overdoing it or injuring yourself), the better you set the stage for starting ketosis early in your fast,” Deru said.

Also important to note is that, according to the participants’ reports, exercise didn’t seem to aggravate hunger or affect moods during the fast.

“Everyone’s going to be a little grumpier when they fast, but we found that you aren’t going to feel worse with the intervention of exercise — with exercise, you can get these extra benefits and be the exact same amount of grumpy as you would be if you didn’t exercise,” said Deru.

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Fitness

Treatment options to help overcome knee pain for sports enthusiasts

“Sports-related pain should be evaluated quickly, especially when it’s difficult to put weight on the knee, swelling occurs or there is restricted range of motion,” said Dr. Alexander Meininger, orthopedic surgeon and MACI consultant.

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Millions of people experience chronic pain, with knee pain among the most common. Athletes and active adults know the impact activities like running and skiing can have on their knees, but when chronic knee pain makes it difficult to do those activities, or even day-to-day tasks like walking up the stairs, people may often face challenges.

According to the journal “Cartilage,” unlike other tissues, cartilage does not repair itself and, without proper treatment, can worsen over time and become more difficult to treat. However, options like FDA-approved knee cartilage repair surgery MACI (autologous cultured chondrocytes on porcine collagen membrane) uses a patient’s cells to help repair cartilage defects and may help alleviate knee pain.

“Sports-related pain should be evaluated quickly, especially when it’s difficult to put weight on the knee, swelling occurs or there is restricted range of motion,” said Dr. Alexander Meininger, orthopedic surgeon and MACI consultant.

Justin Keys, a former patient of Meininger and avid skier, knows that the long-term outcomes of knee cartilage surgery can be worth the short-term sacrifices. After several injuries, including an ACL injury, Keys struggled with most activities except walking on flat, paved surfaces. After consulting with Meininger, Keys chose knee cartilage repair to help get back to his active lifestyle.

Keys considered whether to manage the injury as-is or choose MACI and undergo rehabilitation to potentially get back to his favorite activities in the future. He knew he could no longer use short-term relief methods and had to address his pain with a treatment to help provide lasting relief.

For athletes like Keys who want to fix knee pain, it’s important to consider these steps:

Discuss Options with Your Doctor

Patients should talk to their doctors and undergo an MRI to help assess the internal structures of the knee. Meininger recommends patients and their doctors discuss options for long-term knee restoration health, preserving function for future decades and recognizing the short-term sacrifice.

Set Yourself Up for Success

Experts like Meininger suggest patients take steps ahead of surgery to help their recovery.

“The important thing is to be as fit as possible and use the preseason months to undergo surgery and rehab,” Meininger said.

Patients can take steps to prep their home for recovery, which may include:

  • Bringing necessities down from hard-to-reach shelves
  • Moving furniture to ensure clear pathways
  • Installing shower safety handles to minimize potential falls

The Road to Rehab and Recovery

Rehabilitation takes time and everyone’s experience is unique. It can be as much of a mental challenge as it is physical. Committing to a physical therapy regime, staying hydrated and eating well are important aspects to support recovery. Patients should talk to their doctors with questions and before starting any exercises.

IMPORTANT SAFETY INFORMATION

Do not use if you are allergic to antibiotics such as gentamicin or materials from cow or pig; have severe osteoarthritis of the knee, other severe inflammatory conditions, infections or inflammation in the bone joint and other surrounding tissue or blood clotting conditions; had knee surgery in the past 6 months, not including surgery for obtaining a cartilage biopsy or a surgical procedure to prepare your knee for a MACI implant; or cannot follow a rehabilitation program post-surgery.

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Fitness

6 Exercise safety tips

Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.

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In the wake of the COVID-19 pandemic, many Americans are more aware of their health and wellness. Now, as social restrictions ease, you may find yourself stepping up your workouts, whether you’re training for an event or working to improve your game in a recreational league.

Sprains, strains and injuries can happen to even the most seasoned athletes. When you’re testing your limits, even a minor injury can alter your performance. Consider products and supports like these from the CURAD Performance Series product line, available at Walmart and Amazon, to help you get back in the game quickly and safely.

Find more resources to support your fitness journey at CURAD.com.

Keep Dirt and Germs Away

The more active you are, the harder it can be to find a bandage that stays with you all day or all game long.

Spray Away Sore Spots

Controlling mild pain can help keep you at the top of your game, and a topical analgesic works fast to heal common pain brought on by fitness and exercise, such as pain in knees, feet, shoulders and backs.

Put Pain in the Past

When recovery becomes the name of the game and pain relief is needed after daily workouts or bodily injuries. Cold packs work to heal bruises, reduce swelling and relieve headaches and general pain points while microwavable heat packs provide satisfying heat therapy to address sore and stiff joints, muscle cramps and tension.

Reduce Impact of Knee Strain

Weak, injured or arthritic knees can come from many sources, including tendonitis and a wide range of conditions that result in strain or overuse. An adjustable band can provide support for on-field sports and during workouts or everyday activities.

Manage Pain and Relieve Pressure

If you participate in endurance and strength exercises or certain sports, you may ask a lot of your joints. Kinesiology tape can be configured a multitude of ways to help reduce pain and improve blood circulation, as well as relieve tension and pressure.

Control Back Strain

When your back is strained, your body and performance can suffer. A mild or moderate sprain can benefit from strong support and compression.

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Fitness

Exercise can provide relief for dry, itchy eyes

A significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes.

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Photo by Quinten de Graaf from Unsplash.com

A team led by researchers from the University of Waterloo discovered that a significant increase in tear secretion and tear film stability after participating in aerobic exercise can be another remedy for relieving dry, itchy eyes. 

Every time we blink, our eyes are covered in tear film—an essential protective coating necessary for maintaining healthy ocular function. Healthy tear film comprises three layers–oil, water, and mucin–that work together to hydrate the ocular surface and protect against infection-causing irritants like dust or dirt.

When any part of the tear film becomes unstable, the ocular surface can develop dry spots, causing eye symptoms like itchiness or stinging and burning sensations.

“With so much of our activity tied to screen usage, dry eye symptoms are becoming increasingly common,” said Heinz Otchere, a PhD candidate in vision science at Waterloo. “Instead of having to use eye drops or other alternative treatments, our study aimed to determine if remaining physically active can be an effective preventative measure against dryness.”

Fifty-two participants were divided into two groups—athlete and non-athlete—to participate in an exercise session. Participants in the athlete group exercised at least five times per week, while non-athlete participants exercised no more than once per week. Researchers, which included experts from the University of Cape Coast in Ghana, performed visual examinations before and five minutes after each exercise session, where tear secretion and tear break-up time were assessed.

While participants in the athlete group showed the largest increase, Otchere says all participants experienced a meaningful boost in tear quantity and tear film stability after the exercise session. 

“It can be challenging for people to regularly exercise when the demand is there to work increasingly longer hours in front of screens,” Otchere said. “However, our findings show physical activity can be really important for not just our overall well-being, but for our ocular health too.”

The study, Differential effect of maximal incremental treadmill exercise on tear secretion and tear film stability in athletes and non-athletes, was co-authored by Otchere, the University of Cape Coast’s Samuel Abokyi, Sekyere Nyamaah, and Michael Ntodie, and Ghana’s Our Lady of Grace Hospital’s Yaw Osei Akoto. It was recently published in the Experimental Eye Research journal.

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