Dr Sudhir Kumar MD DM Profile picture
Sep 8, 2023 1 tweets 2 min read Read on X
Intermittent fasting and running

1. Time-restricted feeding (8-hour eating window), as compared to normal feeding (12-hour eating window) decreases fat mass and maintains fat-free mass, while not affecting running performance, in trained male endurance runners.
2. Time restricted eating (TRE) results in a significant change in body composition with whole body fat mass, leg fat mass, and percent body fat declining more in the TRE intervention, with no change in fat-free mass.
3. TRE does not result in any significant differences in resting energy expenditure, markers of insulin resistance, serum lipids or blood pressure, as compared to normal feeding group.
4. Maximum oxygen uptake (VO2max) increases significantly after TRE. A possible explanation for the improvements in VO2max with TRE includes an increase of cardiac output due to an increase of sympathetic stimulation during exercise or a greater oxidative capacity in fat adapted muscle. Ultimately, the combination of these phenomena may lead to improvements in aerobic performance.
5. In a group of active women, high intensity interval training (HIIT) and HIIT+IF interventions resulted in a reduction in the percentage of body fat of −0.3% and 1.0%, respectively. HIIT+ IF combination also results in a significant reduction in waist circumference (WC).
6. Women in HIIT+IF group also had a better jumping performance as compared to women who did HIIT without IF.
7. Duration of IF & running (or exercise) also matters. Benefits may not be seen within 4-6 weeks; however, benefits are definitely seen if running + IF is practiced for 12 weeks or longer.

Summary of findings & recommendations
1. Exercise in a fasting state decreases body weight, free fat mass and fat mass.
2. Exercise is relatively safe, if fasting duration is less than 24 hours,
3. Running up to a distance of 10 Km is reasonably safe for most people, if fasting duration is less than 24 hours.
4. Trained athletes could run up to 2 hours (a half marathon), if the duration of fasting is <24 hours.
5. Distances more than half marathon should be avoided if the period of fasting is >24 hours.
6. It may not be a good idea to go for your best pace, after a fasting for longer than 24 hours.
7. Adequate hydration should be maintained while exercising in a fasted state.
8. Those practicing intermittent fasting (16/8) could prefer to run in a fasted or a fed state. For example, if the eating window is from 8 AM to 4 PM, one could run at 6 AM (fasted state) or 6 PM (fed state) depending on his/her preference and the running distance planned.

#running #fasting
Dr Sudhir Kumar MD DM X (Twitter): @hyderabaddoctor
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More from @hyderabaddoctor

Jul 31
Running as a form of aerobic exercise increases longevity, but there are other factors to consider too.

The news of Jogi ji's passing away due to cardiac arrest during sleep is shocking. Our heartfelt condolences🙏

1. Joginder Chandna ji was extremely fit and had amazing statistics for a long-distance runner. His PB for 5k, 10k, HM and FM were 23 min, 46 min, 1:39 hours and 3:40 hours.Image
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2. He had an amazing control over heart rate while running long distances. His latest long run (23 Km) was on Sunday, 28th July (2 days before we lost him). An AHR of 127 bpm (and a max HR of 139 bpm) for a pace of 6:50 min/Km is amazing.Image
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3. His running mileage was not excessive. If we look at his last 12 months, his monthly running mileage ranged from 170-240 Km (which translates to 6-8 km per day, or 50-60 Km per week). This is within the safe zone as per research.Image
Read 7 tweets
Jan 30
By the time diabetes mellitus is diagnosed, it is already too late.

Take control when insulin resistance sets in. Or may be even before that.

Low carbohydrate diet and regular exercise are the keys to prevent insulin resistance, prediabetes and type 2 diabetes.

Ref: (1/n)doi.org/10.3390/antiox…Image
Lifestyle tips to manage insulin resistance

1. Lose excess weight (especially abdominal and visceral fat),
2. Engage in regular physical activity,
3. Sleep well,
4. Minimize stress,
5. Reduce carbohydrate intake,
6. Quit smoking.
(2/n)Image
Insulin resistance-related diseases in humans
(3/n)Image
Read 5 tweets
Jan 26
Running and heart diseases
Learning points from the past 30 years of published research

1. Runners have a lower risk of heart attack, as compared to people leading sedentary lifestyles,

2. Runners are 45% less likely to die from heart disease than non-runners,

3. The benefit starts with as little as 10 minutes of running per day, and increases with increasing running duration up to 60 minutes. There is no additional mortality benefit from running beyond 60 minutes per day (or beyond 7 hours per week),

4. In terms of distance, the benefit starts with 1 mile (1.6 km) of running and increases with greater running mileage. There is no established upper limit beyond which running is detrimental to heart health, however, benefits may plateau beyond 80 km of running per week,

5. Runners have a lower resting heart rate. Lower resting HR is associated with greater longevity,

6. Running has a favourable effect on risk factors for heart attack. Running is associated with higher HDL-cholesterol, lower LDL-cholesterol, lower triglyceride, lowering of BP, improved insulin sensitivity, lower HbA1C level and lower body mass index,

7. Sudden cardiac arrest during long distance running is rare. The incidence is 0.8 per 100,000. The fatality due to sudden cardiac arrest during running is 0.4 per 100,000,

8. Majority of cardiac arrests occur while a person is sleeping, sitting or standing; only a miniscule of them occur while a person is running or doing some form of exercise,
9. Sudden cardiac arrests that occur during marathons make it to the headlines, as they are dramatic, unexpected and those affected are younger and fitter,

10. Marathoners have a greater chance of surviving a cardiac arrest, as compared to non-runners,

11. Sudden cardiac arrest during running is more common among men as compared to women,

12. Sudden cardiac arrest during running is most often NOT caused by running. However, running may precipitate sudden cardiac arrest among people with pre-existing cardiac diseases,

13. The commonest cause of sudden cardiac arrest in people aged 35 or less is hypertrophic obstructive cardiomyopathy,

14. The commonest cause of sudden cardiac arrest among people above 35 is coronary artery disease (due to blockage of artery supplying blood to the heart muscles),

15. The ideal average heart rate while running is 180 minus age (ref: MAF method). This ensures better recovery between runs, reduces the risk of injuries, and allows adaptation of the heart for better pace during races,

16. A good night sleep (7-8 hours) before a long run is of paramount importance,

17. Periodic hydration/nutrition breaks during a long run is also important. Dehydration, exhaustion, fatigue, and heat stroke can lead to a runner collapsing during a marathon,

18. If the body gives signals, such as dizziness, breathing difficulty, chest pain, tightness in chest, severe fatigue, or light-headedness, during a run; withdraw from the run and seek immediate medical help,

19. Do not start a run with a pre-meditated pace or finishing time. Alter thepace (increase or decrease) based on the route, elevation, temperature, how you feel and other race-day factors,

20. Long distance running is not a competition to be ahead of others. It is a passion to be enjoyed and cherished. Enjoy the entire run and not just the chip time.

Dr Sudhir Kumar MD DM 26-01-2024Image
There are various causes for cardiac arrest among runners and they differ based on the runner's age. Survival depends on the underlying cause of cardiac arrest; prompt performance of CPR (by the bystander) and use of defibrillator (on site).

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Majority of cardiac arrests among marathon and half marathon runners occur during the last qartile of the run (after 26th mile in marathon, and after 10th mild in half marathon, until completion).Image
Read 6 tweets
Dec 17, 2023
Why are teenagers (adolescents) getting affected by heart attacks?

1. Heart attacks commonly affect older people. However, we have seen a recent increase in number of young people and even teenagers getting affected. What are the underlying reasons?Image
2. It is easy to put the entire blame on Covid 19 illness & covid vaccines, but that won't do proper justice (to our youth). There are several other possible reasons that have increased the risk of heart attacks in younger population, including adolescents. Let us look at them:
3. High prevalence of depression, anxiety & stress (DAS) among school-going children.
In a survey done among school going adolescents, the prevalence of depression, anxiety and stress was found to be 65%, 81% and 47%, respectively.
DAS increase the risk of heart attack. Image
Read 12 tweets
Aug 6, 2023
Tips for NMDC Hyderabad Half Marathon

Hyderabad marathon is scheduled on August 27th (3 weeks from now). It is one of the most popular marathons in the country and many of you may be planning to run here. I have done two half marathons on this route.
Sharing my experience
1/n https://t.co/0XGzatZkIatwitter.com/i/web/status/1…
Image
The HM flag off time is 6 AM. Location is near Necklace road (Hussain Sagar lake, Secunderabad). Since one needs to assemble by 5 AM, it would be wiser to stay closer to this location, or make advance transport arrangements accordingly. Ample parking space is available.
(2/n)
Crowding at start:
Thousands of people participate and you would find difficult to run fast during the first 500 meters. Take it easy, as the rest of the route is un-crowded and you would enjoy running.
(3/n)
Read 7 tweets
Jul 13, 2023
A woman whose head dropped and eyes closed after talking to someone for 30 minutes or more

1. 49-year old Mrs Jhuma consulted me with a strange problem for one month. Whenever she talked with a friend or family member for 30 min or more, her head dropped forwards.
#MedTwitter twitter.com/i/web/status/1…
2. In addition, her eyes closed. She could not voluntarily raise her head or open her eyes. However, after taking rest for a few minutes, she was able to raise her head & open eyes.
She had no other problems.
She consulted local doctors without any success.
#neurotwitter
3. I carefully listened to her symptoms and examined her. Clinical examination was non-contributory except for sluggish ankle jerks (it turned out to be the clue to diagnosis).
I wanted to first rule out neuromuscular diseases due to her typical clinical presentation.
Read 8 tweets

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