Why do some people "backload" carbs?

What does this mean and what is the science behind it?

A 🧵 1/12

#exercise #carbs #lowcarb #lchf Image
"Carb backloading" is the practice of avoiding carbs early in the day and eating them later in the day, usually after some exercise.

Why would this make sense to do?
2/12 Image
Some rationalise this based on evidence that after exercise, muscle glycogen levels are ⬇️ and muscle glucose uptake is ⬆️.

Ingested carbs can therefore restore glycogen.

⬆️ muscle glucose uptake should mean our blood glucose remains low right?

doi.org/10.1152/jappl.…
3/12 Image
Not so fast...

Ingested carbs will contribute to glycogen.

But, ⬆️ muscle glucose uptake after exercise wont always keep blood glucose levels low.

Often, prior exercise can increase glucose in response to a meal (white bar in image = postexercise).

Whats going on here?
4/12 Image
Early work used a single-leg model of exercise to measure the effect of exercise on glucose uptake.

This is a very useful model but does have some downsides too.

The problem is that it doesn't capture what happens to the other (inactive) muscles.

doi.org/10.1152/jappl.…
5/12 Image
If we do cycling exercise with our legs, some of our inactive muscles (e.g. forearm) can actually be less insulin sensitive after exercise.

Possibly due to increased exposure to fatty acids without burning them.
doi.org/10.1152/ajpend…
6/12 Image
Another reason that prior exercise could increase blood glucose levels after a meal could be due to changes in the liver and/or the gut.

These will affect the rate of appearance of glucose into the blood and could counteract increased disappearance rates.

7/12 Image
Whereas muscle shows high glycogen storage rates immediately after exercise, the liver displays a different pattern.

Slow immediately after exercise but then speeding up later.

Why isn't the liver storing glycogen as effectively after exercise?
doi.org/10.1152/japplp…
8/12 Image
It might be because after exercise, the hormone glucagon is increased, and this counteracts the effects of insulin on liver glycogen storage (but doesn't affect muscle glycogen).
9/12 Image
What about the gut?

In this study by @DrAJRose prior exercise ⬆️ the rate of blood glucose appearance from both the liver (B) and the gut (C).

Why this happens is still unclear. What are the implications?

Is exercise bad for our glucose control?
doi.org/10.1152/ajpend…
10/12 Image
Luckily, in people with type 2 diabetes, the increase in glucose appearance rate does not offset the increase in muscle glucose uptake after exercise.

In other words, this effect is interesting but unlikely to be relevant to people with diabetes.
doi.org/10.14814/phy2.…
11/12 Image
This effect might explain why foods which normally can be classified as high and low glycaemic index (GI), can show very similar glucose responses in the first hour after exercise.

This one from @LouiseMBurke demonstrates this very clearly.

doi.org/10.1152/jappl.…

12/12 Image

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More from @Gonzalez_JT

Oct 16
There is no evidence that sugar directly causes any negative health effects.

Is this true?

A 🧵
#sugar #health #metabolism
1/10
Latest UK guidelines suggest there is only sufficient evidence that diets high in sugars:

1) cause increased calorie intake
2) are associated with tooth decay

So if calorie intake is not maintained, there are no harmful effects of sugars?

2/10

assets.publishing.service.gov.uk/government/upl…
Absence of evidence is not evidence of absence, but we also should be careful about believing anything with weak or little evidence.

So what does the evidence show?
3/10
Read 10 tweets
Oct 11
Do doses of fat respond the same way as glucose?

A 🧵 1/8

#metabolism #fat #nutrition #diet
This time, the measure of interest is the level of fat in the blood (triacylglycerol; aka TAG)

When fasted, levels of TAG are low (left)

High levels of TAG make the plasma part of blood look cloudy/turgid (right)

2/8
In contrast to glucose, the more fat eaten in a meal, the higher the level of TAG

Does the type of fat matter?

3/8
Read 8 tweets
Oct 7
Which fuels do human foetuses use?

This may surprise you... (1/5)🧵
First, how do we even know what the human foetus uses as a fuel?

The amount of carbon dioxide released relative to the amount of oxygen used (aka RER or RQ) is a good marker of fuel use.

But how can this be measured in a human foetus?
2/5
With some clever techniques, scientists in 1927 sampled blood from arteries delivering blood to the foetus and veins draining blood from the foetus

By measuring the O2 & CO2 concentrations, RQ could be calculated
3/5

doi.org/10.1016/S0002-…
Read 5 tweets
Oct 3
Which of these will produce the biggest blood sugar response?

75 g glucose alone

75 g glucose + 7.5 g fructose?

🧵 1/8
Adding 7.5 g fructose to 75 g glucose reduces the blood glucose response.

Since this is more total carbohydrate ingested with 75 g glucose + 7.5 fructose why is the blood glucose response lower? 2/8

pubmed.ncbi.nlm.nih.gov/11134101/
I'll get to that in a moment, but I assume people may also want to know if this effect holds true in people with type 2 diabetes?

Yes it does.

Lower glucose and insulin responses when fructose is added to an oral glucose tolerance test 3/8

diabetesjournals.org/care/article/2…
Read 8 tweets
Oct 2
Q: Which of these would produce biggest the blood sugar response?
(i.e., biggest change in glucose concentration)

Answers below (1/8) 🧵 #glucose #health #metabolism
Have a guess here before reading on to find out if you are right... (2/8)
A: There is no meaningful difference (at least in healthy people) - data from: pubmed.ncbi.nlm.nih.gov/28684634/

How can 75 g glucose (3 times more) not increase glucose more than 25 g?

(3/8)
Read 8 tweets
Sep 28
Have a guess what these people did at timepoint 0-300 mins in this study.

The read the 🧵 to find out if you are right... (1/7)
A reasonable guess would be that they ate some carbs at 0 min and then stopped eating because glucose dropped to fasting levels by hour 3.

That isn't what they did here...(2/7)

Study 🔗: journals.physiology.org/doi/full/10.11…
Led by @27CJ
These people were consuming A LOT of carbs throughout 5 h 🍭

1.5 g CHO/kg body mass/h
= 560 g of pure carbs over the 5 hours
equivalent to ~1.5 kg of cooked pasta! 🍝

So how come their glucose levels were not sky high? & why is glucose at 3-5 hours back at fasting levels? (3/7)
Read 7 tweets

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