Can you manage Coronary Heart Disease through physical activity?

The standard explanation of how Heart disease and stroke are caused is pretty well understood. In short the idea is that high levels of the wrong kind of cholesterol

I’m not covering the standard stuff we all know about. I’m looking at different angles. The stuff that rarely gets covered. I want to discuss the value of these insights. (more…)

Why walking is good for you

I was inspired by this excellent tweet from CDCObesity


Learn how walking is good for your body.

I’ll expand on this in time. For now they’ve done such a great job I don’t feel I have to.

Enjoy and thanks  @CDCObesity for sharing.

How white blood cells are transported could explain heart disease

The article Nanoparticles cause cancer cells to die and stop spreading is a fascinating explanation of a very exciting discovery but I got even more out of it. I love it when I take something from an article that wasn’t quite what it intended. What I found was a key insight into circulatory function and how red and white blood cells differ in the way they are transported through the body.

This is critical because we know a lot about blood but mainly that is about red blood cells and plasma. We know something about white blood cells and very little about how they move around the body. Read through this excerpt from the article to see what I mean.

When attempting to develop a treatment for metastases, King faced two problems: targeting moving cancer cells and ensuring cell death could be activated once they were located. To handle both issues, he built fat-based nanoparticles that were one thousand times smaller than a human hair and attached two proteins to them. One is E-selectin, which selectively binds to white blood cells, and the other is TRAIL.

He chose to stick the nanoparticles to white blood cells because it would keep the body from excreting them easily. This means the nanoparticles, made from fat molecules, remain in the blood longer, and thus have a greater chance of bumping into freely moving cancer cells.
There is an added advantage. Red blood cells tend to travel in the centre of a blood vessel and white blood cells stick to the edges.

This is because red blood cells are lower density and can be easily deformed to slide around obstacles. Cancer cells Have a similar density to white blood cells and remain close to the walls, too. As a result, these nanoparticles are more likely to bump into cancer cells and bind their TRAIL receptors.

Did you notice the clear difference in how white blood cells travel through the body and the obvious relationship with damage occurs to the circulatory system in cardiovascular diseases. Damage occurs in the walls of blood vessels. Red blood cells travel through vessels but white blood cells travel by moving along the vessel walls themselves. They stick to the edges.

The implication here is not that the immune system is causing the problem. Though that could be the case. Instead I feel that disease and injury really is the cause of heart disease. The white blood cells may make things worse by being sticky but I have read that sugar harms both blood vessels and the immune system.

It seems pretty clear that vascular disease revolves around fights that break out inside vessels damaging their walls. So I’m just hunting down the parties involved and trying to piece together the events leading up to the fight. For now the evidence is pointing to sugar and fat having a party in the blood network and causing trouble. The white blood cells are closest to hand and try to contain the situation. Cholesterol gets involved because it is the bodies building and haulage system. Cholesterol brings building blocks to make new cells and takes away waste. That’s why it gets the blame. It’s going to be at every site of damage and the worst damage will have the most cholesterol.

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How activity and exercise improves your health

For years we have been told that exercise is good for us. Now the evidence is becoming indisputable.  Being inactive is as bad as smoking or drinking too much alcohol. It could even be more serious than that.

Over the years I’ve found so much information I didn’t know what to do with it. I mainly shared it through my original blog or kept it private hoping to share it when I found the right approach. For many of these articles I’ve now been waiting years which just isn’t helping anyone.

I recently realised my blogs are the perfect medium on which to share because I’m most interested in the discussions and debate around this topic. I don’t feel I have the answers, I share because I’m interested in learning and using what I learn to help me on my journey through life.

I have now started to organise all I have found and it’s re invigorating my dreams because the message really is about living your life. The act of living itself is what we must do. Moving is living. Activity to me isn’t just physical it is mental and emotional. Thinking about things makes your brain active, experiencing emotions involves both your brain and your body.

For now most information will be about physical activity because that is what is most available. Though I am looking for and finding interesting articles in all three areas. Over time this and all the other posts will grow as I continue this life journey.


For now I’m creating a series of articles covering the various topics related to activity and health. So far I have published:

Key articles

Activity is so useful throughout life that I’ve also compiled a list of the main articles worth reading to build your general knowledge.

Useful Reading

Here is more useful information

What factors make us kick the bucket?

I hear so much about what risk factors there are to make us die sooner and all the things we should do or not do but because I like to research both sides of the story I always find things that contradict each other.

I’m coming round to the view that the overall risk really depends on where we are in our lives at any particular time. I don’t know if I can put this concept across well enough but I’ll try. (more…)

Feast and Famine: Is that what our bodies expect?

I was in the Open University library a couple of weeks back. I had the urged to pop down the human biology section and see what caught my eye. I know I shouldn’t admit to that because it’s far too sad, but that’s how much this stuff fascinates me.

Anyway I picked up a book named ‘Human Biology and Health: An evolutionary approach‘ and I was hooked at the first. I can’t remember every detail but basically began forming a few theories based on what I have already read. I also used other references but can’t for the life of me find them. So I’ll just have to launch in.

What does it do?

The theory I was working on is basically a way toxins can build up in the body and how they can be got rid of. With this knowledge we can adjust our lifestyles to take advantage of this. Eliminating toxins from our body should be a great way of minimising their bad effects. Much like taking out the trash.

How does it work?

The way this works is because the body has certain mechanisms in place to get energy from cells that aren’t needed by the body or are marked as dangerous. This mechanism is not used if you eat plenty. Thus those who eat less than others are more likely to use it and thus get rid of bad things from their body. I think I’ve held off putting this out there in case anyone reads this too literally. You still need to eat enough high quality food to thrive. My approach is through using intermittent fasting so I flush my body with great food regularly so I’m always healthy. Then when I think it’s full of nutrients I fast for a day or so to encourage my body to break up the bad cells for food and get rid of their contents.

More detail please!!!

Ok, here I’ll explain this in a little more depth.

From human biology and health I came across a possible explanation why people who eat little could live longer.  The theory began with how toxins build up in the liver and ultimately cause it to fail. The process would work like so:

  • Toxins in food get absorbed in the gut and sent to the liver.
  • The liver doesn’t get rid of toxins so they get more concentrated.
  • Toxin build up causes problems and these mount up.
  • Organs start failing.
  • Then you die.

Then I came across research that showed that our body actually obtains energy from devouring its own cells. It’s also not a random act. The immune system is constantly patrolling our body through killer B and T cells. Any bad cells that can’t be devoured on the spot are marked for deletion. Since we’ve normally lived in periods of feast and famine you body seems to assume that during the next period of famine these cells will be lost and the body will be cleaned.

The main problem these days in western societies is that few of us have problems getting enough to eat all year round. Thus it’s entirely possible that we’re all slowly building up bad pollutants and cells in our bodies and over time their effects show as all the diseases and problems that affect western society. Before modern times our lifestyles got rid of these toxins. These days they don’t and they build up and cause problems.

What’s the evidence?

Obviously that’s a big claim and I can’t vouch for exactly how much it all stacks up. It does make sense in a logical way though. That our bodies mark up cells for deletion is something I’ve heard a lot before. That they’d be the first to go if we couldn’t get enough food. That makes sense too. That only recently has there been enough food for all. That’s well known. That all those who reach truly exceptional ages over a hundred are all on the thinner side and seem to eat frugally in general. That seems to be the case too.  I have noticed many times that while larger people can be very healthy there seem to be less and less of them that make it to an older age. That said I’m not sure if they just get thinner as they get older so maybe they were larger when younger but not when older.

What also makes sense is that cells that have become cancerous would, in theory, be ejected from the body in this way reducing the likelihood that a cancer could take hold. It also implies that without this mechanism the risk of all related diseases would be higher. That seems to be the case according to health statistics.

I do wonder if our bodies are essentially well adapted for feast and famine and thus our constant feast is something we’re not suited to. If that’s the case then coming up with safe ways to implement a famine (I’d prefer just a simple fast of a morning or a day) could be useful. As long as we’re aware of the risks and don’t get carried away. Don’t forget just living your life according to hunger. That often works for me. If I’m not hungry I don’t eat. If I am I do.

Another easy and useful way to create a famine like situation is being active which helps for two main reasons.

  1. Firstly, moving makes your body work the way it’s supposed to. Exercise creates a demand for energy within the body forcing the food from the famine to be put to use and forcing the cells to use the food properly to get stuff done.
  2. Secondly, being active every day burns a few more calories. It doesn’t mean much in the short term but adds up to a lot over the long term.

This sounds like a very simple answer to a complex problem. The beauty is it that it uses what is currently known to explain how we could survive in the tough conditions we’ve faced over the years. There could easily be a lot that I haven’t thought of or I could have misinterpreted things. Either way I look forward to your comments and seeing if this theory holds water over time.

Learn more about the effect of physical inactivity on disease worldwide and what you can do to help prevent obesityinsulin resistanceheart disease and Diabetesdementia and alzheimers and even Cancer through exercise.
Feast and Famine: Is that what our bodies expect? first appeared on my original blog. Cell Your Sole is my new focus for health posts so I’m re posting relevant articles here.

Can you reverse insulin resistance

I read an article Insulin resistance and pre diabetes and just had to report the findings of the major study they refer to.

‘lifestyle changes reduced the risk of diabetes by 58 percent’

The main recommendation is to be active and eat well.

I just wanted to make the point that insulin resistance can be reversed. They also found that many people with pre-diabetes, symptoms that often lead to diabetes, returned to normal.

So anyone out there who’s worried about or has been told they have or are likely to get diabetes. There are options for you and they don’t all involve medicine. Simple approaches like looking at the balance in your life and including activity and adjusting your foods can make a big difference

These days diabetes type 2 is generally considered a self inflicted disease. The up side is that it means you can help fix it yourself with the right advice.


If you’re in a rush here is the take home message in one paragraph.

Insulin resistance occurs because your body forgets how to deal with sugar. This leaves sugar flowing through your body causing lots of damage. Exercise creates a big demand for sugar forcing your body to remember how to deal with it. Making sure sugar doesn’t get to flow where it shouldn’t, minimising the damage sugar can do. Improving your health in the process.

What is insulin resistance?

Insulin resistance is a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes

Insulin resistance means that the cells start losing their natural response to the presence of insulin and so sugar is no longer used properly within the body. This is because the levels of a cell component named Glucose Transporter 4 (GLUT4) fall. GLUT 4 responds directly to the presence of insulin and encourages cells to take up sugar. GLUT4 is the glucose transporter found in (skeletal) muscle and fat (Adipose) cells

This can lead to sugar shortages within the cell and an inability to clear sugar from the blood. Both situations can have serious consequences. This is often compounded by the pancreas secreting more insulin in an effort to trigger great uptake of glucose within cells. Over time this feedback loop can overload the pancreas and create problems in producing any insulin at all.

How important is insulin resistance?

The size of the problem can be large because insulin resistance affects two thirds of the human body since it effects both muscle and fat cells which account for around two thirds of an average humans weight.

Why does insulin resistance develop?

The reason insulin resistance occurs is because the body is constantly adapting to our lifestyle and looking for ways to save precious resources. When you lead an inactive life you rarely create a big demand within your cells for carbohydrate. So the GLUT4 receptors are lost by the cell. There seems no need for them.

How can you reverse insulin resistance?

What is not commonly known is that regular exercise can reverse insulin resistance by increasing the number of GLUT 4 receptors within cells. Research shows that exercise places a high demand on the bodies carbohydrate (sugar) stores. It tests its ability to mobilise and use carbohydrate to power the muscles to create movement. Most of the adaptations that happen when you get fit are designed to conserve carbohydrate by using it efficiently. As a result the body will increasingly prefer fat as a fuel. Small amounts of exercise have been shown to have a big impact on the bodies ability to regulate carbohydrate.

Benefits of reversing insulin resistance

It is becoming increasingly clear that insulin resistance causes obesity and diabetes. Not the other way around. If you consider How exercise combats Heart Disease, Insulin Resistance and Diabetes then you will find that learning how to move more can tackle insulin resistance. In turn this can help tackle:

  • Obesity
  • Coronary Heart disease
  • Diabetes
  • Stroke
  • Cancer

Often because all these problems are strongly linked to an inability to handle sugar properly.

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Can you reverse insulin resistance first appeared on my original blog. Cell Your Sole is my new focus for health posts so I’m re posting relevant articles here.

How exercise combats Heart Disease, Insulin Resistance and Diabetes


It may surprise you to learn that getting fit won’t just help you lose much weight. It’ll help you do something far more important because it will help keep you alive and just as important it’ll help you thrive.

It is now becoming clear that the major diseases in the west are diseases of our lifestyles. They never used to occur on such a large scale. The good news is that because they’re caused by our lifestyle, they can be treated and prevented by our lifestyle too.

The problem is that most attempts to treat these illnesses through lifestyle stop us having fun. As trivial as that sounds the way we have our fun is literally what is killing us. But it’s not the fun itself that’s the problem. It’s just how we go about having fun. How we think of it.

I want to show you ways to literally have your cake and eat it. To set targets to have fun every day and know that this is keeping you healthy not making you sick. First I want to show you directly how doing something as simple as getting fit really can prevent and treat serious illness.

You’ll see how being fit forces your body to manage its fuel sources well. Fuels in the body are like fuels we use elsewhere. Both electricity and petrol are dangerous if not handled correctly. So are the fuels our bodies use. Sugar is the fuel we’re going to focus on. Technically it’s known as carbohydrate but for simplicity, because few people understand the term carbohydrate, we’ll stick to sugar.

Sugar is actually toxic to our bodies. It can cause all sorts of damage. Of course we’ve evolved mechanisms to prevent or repair this damage. As long as these mechanisms work correctly we stay healthy. It’s when they don’t work correctly or stop working altogether that we get sick.

We’ll see how two major diseases: Diabetes type 2 (Mellitus) and Heart disease can both be treated or prevented simply by getting fit. Both diseases are related to bad sugar management within the body. Getting fit fixes the sugar management and with time can help fix these diseases.

The problem: Diseases of unregulated sugar

Getting fit makes the body work correctly. In this example it handles sugar correctly. Reducing the insulin required. Lowering blood sugar and insulin concentrations.


Disease is obviously the opposite of fitness. So the underlying question here is how to prevent or cure disease to regain fitness. The message throughout this blog is that regular challenges are necessary to develop a strong enough mind, body and soul to both prevent major damage occurring and also provide fast repair and recovery to a pre damaged state. So either injuries don’t last long because they’re fixed quickly or prevented in the first place. Each disease and its prevention follows this basic principle.

Common Factors

To most people our bodies, and the processes that make them function, seem so complex and impossible to understand that we don’t even bother learning about them. Instead we rely on other peoples knowledge and experience.

This isn’t just a shame it’s a recipe for a heart attack. The irony is that our minds and bodies are more important to us than anything we own. Yet the basic reasons why they go wrong are common and well understood. The same way we all know the basics about taking care of our prized possessions, from our houses, to our cars, computers and everything else. It makes sense to know the basics about taking care of ourselves and our loved ones.

So, with that in mind in this section we’ll consider the common illnesses we face today and the common factors involved in preventing or curing them. First, have a read of my discussion What factors make us kick the bucket? elaborating on this basic point, that we in general know less about ourselves than we do about our possessions. This means we know less about fixing problems with our bodies than problems with our possessions. That just doesn’t seem right.

Active Immunity

In terms of disease resistance some forms of immunity are provided for us, we don’t do anything to make them happen. Like taking a cough medicine. We may take it but it doesn’t teach our body anything about overcoming the illness or set up a system to prevent a future recurrence. This is passive immunity.

Being fit is about active immmunity. That means that we’re teaching our body how to deal with future threats. How to be strong and resilient enough to overcome future challenges. Just like our immune system prepares for current and future infections. By developing our fitness we prepare our bodies for current and future challenges.

The threats I describe are the diseases or challenges. Nutritional interventions are more about passive immunity. Learning to become fit is more about active immunity. You’re training your body to resist infections and overcome challenges. At the same time you are becoming active in your life, not passive. You are making your destiny not watching your life go by.

Coronary Heart Disease (CHD)

What is heart disease?

At the simplest level heart disease is when your body starts to have trouble pumping enough blood around your body. This is because the blood vessels aren’t clean, supple and soft like they should be. Instead they’re rough, covered in fibrous plaques and rigid, unable to expand and contract easily. This is known as atherosclerosis.

When this happens around your heart it is known as coronary heart disease. If you don’t get enough blood to your heart then when you’re under pressure and your heart needs to work over time it just doesn’t get the nutrients it requires. Without the nutrients it can’t work hard for long and starts to get damaged. This would happen to any organ that has a restricted blood supply in this way.

What causes heart disease?

Unfortunately no one knows the exact cause. We believe that’s because there are lots of reasons which each contribute to the problem. Two of these factors are sugar and Insulin levels in the blood.

There is increasing evidence that high levels of sugar and Insulin in the blood system can encourage the kinds of damage we see in heart disease. The explanation is that sugar and Insulin in high concentration can be toxic. Leading to damage to the walls of arteries. To heal the artery walls inflammation occurs. Natures healing process. But if damage is occurring faster than the healing process then chronic inflammation and incorrect repair will result. Leaving the artery walls injured and unable to function properly. This is heart disease.

When this happens over a long time the damage builds up and prevents the blood vessels from transporting blood properly. This heart disease eventually becomes critical.

What reduces risk of heart disease?

Put simply you reduce your risk of heart disease by reducing blood sugar and insulin levels. Unfortunately there are no reliable and safe medications to do this. Eating less sugar should help but it also seems to mean having less fun. There is however another way you can do this. Through being more active. We’ll talk about this later.

What troubles me with most approaches to treating heart disease is that humans are assumed to be essentially weak creatures. That nature has no answer to these problems and that humans must manufacture their own solution. This means medical or nutritional interventions which cost money and often have side effects.

The point of this article is that I don’t accept this. On a daily basis the human body overcomes many difficulties. There’s plenty of evidence that a well maintained body does not suffer from these maladies and does not require interventions. So my question is, what natural, possibly lifestyle, factors should we be considering that may be preventing our bodies from repairing this damage in the first place? or even prevent the damage itself.

Next we will learn about Type II Diabetes. A condition linked to heart disease and that has two of the same contributing factors. High blood insulin and sugar levels.


Diabetes Type II (NIDDM)

What is Diabetes Type II?

In Greek, Diabetes means sweet urine because the main symptom is an inability to control blood sugar levels. This is because the cell mechanisms for regulating blood sugar have been disrupted.

In type 1 diabetes this is because your body can’t produce insulin. Insulin helps regulate the amount of sugar in the blood. So an inability to produce insulin leads to an inability to control sugar levels. The only treatment is injections of insulin.

The most common form of Diabetes, Type 2, is a disease of our modern sedentary lifestyles because our bodies develop resistance to insulin. Meaning that they can produce insulin but the cells of the body no longer respond correctly to it. Disrupting our ability to control blood sugar because much more insulin must be released into the blood than normal to control blood sugar levels. Many people have this condition without even knowing because it develops slowly over many years.

Diabetes is a serious condition because it is associated with long term illnesses including: cardiovascular disease, chronic kidney failure, and diabetic retinopathy (retinal damage).

A problem of sugar regulation

Diabetes is a problem of blood sugar regulation, but why is this important?

If you don’t regulate blood sugar properly many functions of the body become disrupted. In Diabetes the primary problems are the dangers of high and low blood sugar and high blood insulin levels. Long term there is increasing evidence that not regulating sugar properly can cause harm to the cells of our body. It is even being claimed that diabetes drives Atherosclerosis.

Sugar itself can also cause damage. An example is advanced glycation end products (AGEs) and their influence on diabetes

How we regulate sugar

The way our bodies regulate sugar is through the hormone insulin allowing glucose transfer into cells. Normal cells respond to the presence of insulin by moving glucose transporters to the edge of the cell wall and initiating transfer of glucose.

What disrupts sugar regulation? What is insulin resistance?

This glucose transfer goes wrong in Diabetes Type II because cells start losing their natural response to the presence of Insulin. There are several types of glucose transporter. The one implicated in Diabetes is Glucose Transporter 4 (GLUT4) because it responds directly to the presence of insulin. GLUT4 is the glucose transporter found in (skeletal) muscle and fat (Adipose) cells

In type 2 Diabetes the number of GLUT4 receptors present in the cell membrane declines. The ability to transfer glucose in and out of a cell is directly proportional to the number of GLUT4 receptors. So each time an Insulin molecule attaches to a cell less GLUT4 receptors respond. This can lead to sugar shortages within the cell and an inability to clear sugar from the blood. Both situations can have serious consequences.

This is often compounded by the pancreas secreting more insulin in an effort to trigger greater uptake of glucose within cells. Over time this feedback loop can overload the pancreas and create problems in producing any insulin at all.

My interpretation of why insulin resistance occurs is that the body is constantly adapting to our lifestyle and looking for ways to save precious resources. When you lead a sedentary life you rarely create a big demand within your cells for carbohydrate. So the GLUT4 receptors are lost by the cell. There seems no need. This lack of GLUT4 receptors leads to a low rate of glucose transfer in cells when Insulin is present. This is known as Insulin resistance.

How important is insulin resistance?

The size of the problem can be large because insulin resistance affects two thirds of the human body since it affects both muscle and fat cells which account for around two thirds of an average humans weight.

The solution: Get fit to regulate sugar properly

Now we’ll look at how we can help both heart disease and type II diabetes simply by being more active and getting fit. As simple as it sounds it really is a way to prevent or reduce these serious conditions.

Why get fit?

So we’ve seen that when sugar is not regulated within the body it acts like a poison, it causes damage. We’ve also seen that two major illnesses are connected to poor blood sugar and insulin regulation. Heart disease is worsened by too much sugar and insulin hanging around in the blood. We’ve seen how Type 2 Diabetes leads to high levels of blood sugar and insulin due to an inability to regulate sugar because you are not sensitive enough to insulin.

Now, we’ll find out a natural way to regain your insulin sensitivity and bring your blood sugar and insulin levels back to normal. It’s common for people to look for a medical, generally pill based, cure. So often there is one. But in this case you don’t actually need one. The answer is literally as simple as getting of your butt.

Only a highly functioning efficient human is capable of reaching their best. That’s obvious. Not so obvious is that the very act of getting fit directly reduces the risks of the major diseases of the 20th century. This is because the major diseases these days are caused by our wealth. Never before have we had it so nice.

Unfortunately it turns out that the things we used to do to avoid these illnesses we no longer do. That’s why we get sick. The 20th century was the first ever where the majority of the western population didn’t have to do all that much to meet their basic needs of food, shelter and safety. For the millions of years that preceded we had to work very hard to achieve these basic needs. That hard work is something we’ve evolved to need. With the unprecedented rise of diseases of affluence we’re starting to realise just how much we need to move. It’s literally becoming a matter of life and death.

Movement as medicine

The act of becoming fit changes your body for the better. It has now been confirmed that exercise changes your DNA which is the reason I recommend exercise. Getting fit literally means getting healthy but few people know just how much a positive impact fitness has on health. Unfortunately most people get fit to lose weight though that isn’t the primary benefit of exercise because it excellent at helping you keep weight off but exercise alone doesn’t help you lose weight.

What getting fit does best is make your body work properly by making your body stronger and more able to survive or even thrive in really tough conditions. The kind of conditions that might cause heart disease or diabetes in other, unfit individuals.

Controlling sugar

What is not commonly known is that regular exercise can reverse the reduction in GLUT 4 receptors within cells that we see in sedentary individuals. The same reduction in GLUT 4 receptors we associate with insulin resistance leading to type 2 diabetes.

Research shows that this is because exercise places a high demand on the carbohydrate (sugar) stores of the bod and It tests its ability to mobilise and use carbohydrate to power the muscles to create movement. In fact most of the adaptations that happen when you get fit are designed to conserve carbohydrate by using it efficiently. As a result the body will increasingly prefer fat as a fuel to the point that small amounts of exercise have been shown to have a big impact on the bodies ability to regulate carbohydrate.

I was introduced to GLUT 4 and its role in controlling blood sugar levels while studying for my degree in sports science. It became clear that activity forces the body to regulate sugar well. I kept hearing that the main factor determining running, cycling or swimming performance was the rate of sugar use within the body. The key being the use of blood sugar over muscle sugar (glycogen). This created a sugar sparing effect that could prolong activity.

To get technical a major review of sugar and exercise performance by Hargreaves and friends in 1995 reported“Under most circumstances membrane transport of glucose is the rate limiting factor of glucose uptake in exercise”

In simple terms this means that the speed at which sugar can be transferred from the blood into cells determines the amount of sugar available for running around or cycling or any other activity. So what does all this extra sugar in the cell mean?

It means you can run further.

Bergstrom et al 1967 muscle glycogen concentration and exercise capacity.
muscle glycogen concentration (mM/kg) v time (min)
low 80 : 60 mins
medium 100 : 100 mins
high 200 \; 180 mins

Fat being used instead of sugar when high sugar sports drinks were consumed to Fallowfield et al 1996
Hitting the wall while running a marathon is when your muscle carbohydrate runs out.

Glut 4 levels have been shown to be closely related to oxidative capacity. In english this means higher GLUT 4 levels means you can run faster for longer.

As you learnt in the explanation of diabetes. GLUT 4 is the glucose transporter in fat and muscle cells that listens for insulin. It determines insulin sensitivity. When insulin is present it moves to the cell membrane and starts transporting sugar.

Contractile activity results in an increase in plasma membrane glut4 content. This means that using your muscles moves GLUT 4 to the cell membrane. When you move regularly your cells start to contain even more GLUT 4 transporters than before.

The effects of muscle contraction (exercise) and insulin are additive. They both stimulate glucose uptake. This is what makes moving around even better at clearing sugar from your blood. The act of moving makes the GLUT 4 transport sugar and the addition of insulin from your pancreas makes the effect even greater. So you clear sugar from the blood even faster than you would normally. So your risk of diabetes and heart disease is reduced much faster because you move.

So how big an impact does this change in GLUT 4 have? In 1998 henriksson and friends concluded that 75% of the sugar consumed during exercise was taken up by muscle. Their exact words were

“skeletal muscle is the principle site of glucose uptake under insulin stimulated conditions and accounts for approximately 75% of glucose disposal following glucose infusion.”

This ties up with other findings that insulin resistance affects two thirds of the human body

Overall you can see that the research clearly shows that exercise increases sensitivity of skeletal muscle to insulin, improving your ability to regulate blood sugar and reducing your risk of heart disease and type 2 diabetes.

So, in summary. Exercise has been shown to reverse insulin resistance by creating a scarcity of carbohydrate within muscle cells. This creates a need for more GLUT4 receptors which the cell begins producing. These new receptors increase the rate that carbohydrate can enter and exit the cell and increase the response the cell makes to the presence of insulin molecules. This is how our cells reverse insulin resistance in response to exercise.

The reason is simple. Sugar is crucial to exercise performance. Transport of sugar across the cell membrane is the key factor in using sugar during exercise.


Hargreaves 1995 skeletal muscle carbohydrate metabolism during exercise. Summary of all data.

  1. Sports med 1998 jan wallberg henriksson et al p 28
  2. Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus. Ivy 1997
  3.  How insulin allows entry of glucose into cells explains very clearly how glut 4 is key to insulin related disorders.
  4. molecular basis of insulin resistance pt2
  5. can you reverse insulin resistance?
  6. The many ways to regulate glucose transporter 4.: 2009 paper. Needs subscription to view paper. explains in detail latest knowledge on GLUT 4 regulation

Outstanding questions

This article doesn’t explain all we know. There are many further questions:

What type of exercise, intensity, regularity has an impact on GLUT 4 response?
Low intensity has little impact. HIgh – medium has greatest impact. What is high intensity?

The result: No disease when sugar properly regulated

Diabetes Type II

We learnt earlier that Diabetes is a disease of poor sugar control where the sugar controlling insulin pathway is ineffective or inefficient. We also learnt that certain kinds of activity are capable of correcting the process of insulin encouraging sugar to travel from the blood to the inside of cells.

It’s because of this that Brad thompson of oncolytics goes so far as to say that Type 2 Diabetes is generally considered a self inflicted disease. Brad is an expert in micro biology and cell dynamics who appeared on This week in virology (TWIV). During the episode Brad backs up what we’ve seen in this article. That type 2 diabetes is nothing to do with genetics. Everything to do with lifestyle. Exercise being the main lifestyle factor able to reverse insulin resistance.

So how do you exercise to prevent or treat diabetes?

This is a very important and complex question. The simple answer is just to move more than you do now. The more you move on a daily basis, the more you will be able to now and in the future. Learn to listen to yourself. Your mind, body and soul. Balance is extremely important. You can be too active or not active enough. Both can cause harm. So you need to learn what the right balance is. The aim of this article is to inspire you to become more active in general. Future articles will explore becoming active in detail.

For now. Just look at your current balance of activity and rest. Is it appropriate for you? should you be doing more? What kind of activity do you want to do? Regular activity over many years is far more important and helpful than sporadic bursts. So choosing activities you enjoy is key because you’ll then stick to them because you want to do them.

In the meantime lots of people have already addressed the question. So instead of spending a lot of time explaining how to do it I’ll leave it to a doctor to explain how to go about managing diabetes through exercise

Coronary Heart Disease

We have just seen that with Diabetes, our bodies forget how to handle sugars but we can remind them. So is there a similar story with heart attack and strokes and the arterial disease that causes them?

Thankfully there is. We saw that a key factor in heart disease is persistent high blood sugar and insulin levels. High levels of sugar and insulin travelling in our blood cause damage which can lead to heart disease.

We also saw that with increasing fitness our ability to quickly reduce blood insulin and sugar levels improves. So activity helps heart disease by reducing the damage that occurs to the blood vessels in the first place. In turn this reduces the inflammation that occurs. Providing less opportunity for Atherosclerosis (artery hardening) to form.

As your fitness improves your ability to control sugar and insulin levels improves. Eventually the rate of damage to your blood vessels becomes less than the rate they can be repaired. Over time they will then recover.

So how do you exercise to prevent or treat heart disease?

The advice is the same as for Diabetes. Just move more than you do now. Do it every day. A little every day is much better than a lot in a short period.


So, while Heart disease and Diabetes are both complex conditions with many causes. You’ve seen how the simple act of being more active can play an important role in treating and preventing both.

If nothing else, by being active you are strengthening your body and teaching it to function correctly instead of letting it become lazy and weak, open to the threats of diseases like heart disease and Diabetes.This is the theme of this article. That our bodies are inherently strong and well designed to thrive. Yet without a manual to guide us, our lifestyles often cause as many problems as they solve. This isn’t a bad thing. Just something that we can address once we understand our bodies relationship to our lifestyle.

How do I know I’m getting fitter?

Would you be able to telling you were getting fitter. More importantly would you know whether the fitness you’re gaining is helping fight Diabetes and heart disease?

Now that you know that you need to train your cells to produce more GLUT 4 receptors. This means cells can use blood sugar instead of their internal sugar supplies. This means that not only do they save their internal sugar supplies until when they really need them later in the activity or when you’re really working hard. It’s also much easier for your cells to replenish their internal sugar stores. That means that when you’re fit you’re ready to work hard much sooner after an intense training session than before.

In fact I now believe that Training is about fast recovery: fitter people actually heal faster. That’s the point. Activity forces your body to work around challenges. Makes you strong enough to overcome challenges and quickly get ready for the next challenge. This is made possible in many ways including Glut 4 adaptations, more blood carrying capillaries, and sugar and water saving effects.

So a simple measure you can use to see that your activity is helping you fight disease is to time how long it takes to do something you find physically difficult, but also how long it takes for you to be ready to do it again. As always. Build up to this. Don’t worry about how fast the improvements come. Rushing is generally a quick way of injuring yourself or worse. Just know that over time things you find difficult now will seem much easier and you’ll be able to do them much more regularly and in comfort.

That’s the end of this long article. I hope you’ve found it useful and feel more empowered in using your body to its fullest.

[Learn more about]


Links that should appear in this chapter but haven’t found a place yet:.

  1. Learn more about reversing insulin resistance
  2. Training is about fast recovery: fitter people heal faster. That’s the point. activity forces your body to work around challenges. Makes you strong enough to overcome challenges. Glut 4 adaptations, capillaries, sugar and water saving effects.
  3. Calorie and nutrient intake over time: pins actual calorie values over time to increasing weight. Doesn’t point out the lack of data on activity
  4. how crucial is your diet to your health?
  5. You can’t burn fat without a carbohydrate flame. A general point that must be made clear The body has an abundant supply of fat for energy but a very limited (generally around 500g) store of sugar (carbohydrate) in the form of glycogen. Carbohydrate is crucial to providing energy because you can’t burn fat without a carbohydrate flame. This is because the citric acid cycle
  6. Horizon: The truth about exercise. Brilliant episode: In line with everything I believe. Much of his research is from Loughborough. Shows that 3 mins High intensity Training per week has major health benefits, and that just being active in general is most important. Common theory is being challenged. It’s easier than we thought to get fit. High intentsity exercise and can 3 minutes of exercise a week help make you fit
  7. How white blood cells are transported could explain heart disease

Blood pressure and salt: A question of balance

Here’s a fascinating insight. High Blood pressure could have some relation to your ability to balance the level of salt in your body.

That’s the advice from Marc Pelletier discussing research on blood pressure on episode 103 of Dr Kiki’s science hour podcast .

Marc explains that his research indicates that high blood pressure could be a problem of salt balance and water balance. The brain having more power to regulate water than the kidneys.

Similarities to Diabetes

My interpretation is that it could be similar to the way sugar regulation is so critical to diabetes. Essentially diabetics have trouble regulating the sugar levels in blood and cells. It is fixed by helping the body regulate sugar. Activity, running around, plays a key role by improving levels of an insulin specific sugar receptor. Diabetes has wider ranging implications just because sugar regulation is faulty. So activity can fix sugar regulation and prevent so many of the negative effects of diabetes.

I’m wondering if salt and high blood pressure could have a similar story. Could activity help in a similar way.

Activity regulates sugar?

The reason activity helps diabetes is because activity forces the body to regulate sugar well. You see this in all sports research on making people run fast or far. The improvements always come from preserving sugar within cells. So obviously each improvement that makes you run further requires that your body be better at storing and preserving cell sugar. So a fit person can’t have diabetes, type II at least, because they are opposites. The take home lesson Diabetics can’t control their cell sugar levels well while fit people can.

Could activity regulate salt?

So could the same be true for high blood pressure. Activity forces the body to regulate salt. Because salt is key in being good at sports. It makes your nerves work properly, encourages the right type of chemical reactions and basically makes the body work properly. Low salt might also be one of the causes of cramps. So you need salt to be in the right places in the right amounts through out your body to be fit and perform well when running around.

Exercise is known to lower high blood pressure. It makes sense that this could be one of the ways it works. The idea being that someone who runs around a lot and pushes themselves physically will be able to regulate salt in their blood and cells very well and blood pressure will be normal. At the same time those people who don’t run around often develop high blood pressure because their bodies aren’t being pushed to regulate their salt well. So the blood and cell salt levels aren’t controlled and bad things happen.

That’s the theory I take from this. I hope it makes sense. Now I can look at investigating it.

I have just found another clue to the question why salt raises blood pressure. The explanation is that salt triggers adrenaline which constricts blood vessels and raises blood pressure. Similar results are found in pubmed and thankfully this all backs up the concept that to regulate your salt levels is to regulate your blood pressure.