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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The Diagnosis That Was Missed, Until History Spoke 1/ A 55-year-old man had back pain for 4 months.
He did everything right. He consulted local doctors
Blood tests, Nerve conduction studies and MRI (neck & lower back) were normal
Yet, his pain did not go away.
2/ He was treated with painkillers, muscle relaxants and advised rest. Still, he had no relief.
This is where many cases get labeled as "Chronic back pain” But this one wasn’t.
3/ When he consulted me online (from another city), one detail changed everything:
🔸Pain was in the mid-back (not neck or lower back)
And there was one more crucial clue:
🔸Pain increased on coughing & deep breathing.
The "Cholesterol Myth" just got a reality check
We have been obsessed with "clogged pipes" (LDL-C) for decades.
But a massive new study of 40k+ patients just confirmed: The "Fire" (Inflammation) is more dangerous than the "Gunk." 🧵
New research data shows why your "normal" cholesterol might be lying to you.
39,697 adults with established heart disease (ASCVD) in a real-world setting were followed up.
Researchers compared two groups:
1️⃣ High Inflammation (hsCRP ≥ 2 mg/L)
2️⃣ High Cholesterol (LDL-C ≥ 1.8 mmol/L)
The results were a wake-up call for cardiology.
When it comes to Major Adverse Cardiovascular Events (MACE), inflammation is the stronger predictor:
High hsCRP alone: +18% increased risk
High LDL-C alone: +12% increased risk
Both Elevated: +39% increased risk
If you only track LDL, you are missing the most potent driver of risk.
“A brain-dead woman came back to life after an ambulance hit a pothole.”
This news story from Uttar Pradesh has gone viral.
But from a neurological standpoint, this raises several important questions.
Let’s examine what likely happened. 🧵
1️⃣ Can a brain-dead person suddenly start breathing again?
No.
True brain death is irreversible.
🔸It means complete and permanent loss of all brain and brainstem functions, including the breathing center.
🔸If a patient later starts breathing, they were not brain-dead.
🔸They may have been in deep coma or a toxin-induced neurological suppression.
2️⃣ Brain death cannot be declared casually
🔸Diagnosing brain death requires a strict medical protocol.
🔸Doctors must demonstrate:
• Deep coma
• Absence of all brainstem reflexes
• No spontaneous breathing (apnea test)
🔸In India, this examination must be performed twice by a panel of doctors under the Transplantation of Human Organs Act.
🔸Without this protocol, brain death cannot be certified.
🧵 The "Acidity Pill" Trap: A Silent Health Crisis?
That daily antacid you pop for "gas" or heartburn might be doing more than just stopping the burn. As a neurologist, I see the long-term fallout of over-the-counter (OTC) drug misuse every day.
Let's talk about the hidden risks of PPIs (Omeprazole, Pantoprazole, etc.). 👇
1/5 Proton Pump Inhibitors (PPIs) are among the most over-prescribed and over-consumed drugs globally. They are intended for short-term (4–8 weeks) use for ulcers or severe GERD.
Yet, millions take them for years to manage minor indigestion.
The cost? Your long-term health.
2/5 Kidney Health & "Nutrient Theft"
🔸Chronic PPI use is strongly linked to Chronic Kidney Disease (CKD).
▶️By suppressing stomach acid, you also block the absorption of:
🔸Magnesium & Calcium: Leading to brittle bones/fractures.
🔸Vitamin B12: Critical for nerve health and brain function.
🔸Iron: Causing unexplained fatigue and anemia.
Abdominal obesity is not cosmetic.
It indicates poor metabolic health. It is linked to inflammation, and it increases risk of stroke & heart attack.
If you have a “belly,” this thread may reduce your risk of diabetes, stroke & heart attack. 🧵👇
1️⃣ First truth:
You cannot spot-reduce belly fat.
No exercise melts abdominal fat selectively.
Fat loss is systemic.
But yes; visceral fat can be reduced.
2️⃣ Why is abdominal fat dangerous?
Visceral fat:
• Releases inflammatory cytokines
• Worsens insulin resistance
• Raises triglycerides
• Increases BP
• Promotes fatty liver
It is strongly linked to stroke & vascular dementia.
Tailbone pain from prolonged sitting?
Read this before buying a “donut cushion.”
A 50-year-old woman.
Desk job 8–9 hrs.
Commute 1–2 hrs.
Now severe tailbone (coccyx) pain.
Most people immediately buy this 👇 (donut cushion).
1/n
But here is what evidence & biomechanics tell us:
1️⃣ Donut cushions are NOT ideal for coccyx pain
They:
🔸Shift pressure to the rim
🔸Increase pressure on ischial tuberosities
🔸Can paradoxically increase coccygeal strain
🔸Are better for perianal pain and hemorrhoids; not true coccydynia
▶️Several rehabilitation guidelines advise caution with donut cushions for coccyx pain.
2/n
2️⃣ What works better?
✅ Coccyx cut-out cushion (U-shaped wedge)
🔸Offloads direct pressure from the tailbone
🔸Maintains pelvic alignment
🔸Reduces posterior tilt stress
This is the preferred design for true coccydynia.