Here’s a short video of Hector rowing 500 meters on the Concept2 AFTER lifting weights. Evidently he was feeling pretty good as he set a new personal best time. Congratulations, Hector!

I am pre-diabetic but do not take any kind of medications. After an intense motocross or mountain bike ride I am ravenous. Normally during the ride I will drink Gatorade or Powerade at 50% dilution and will eat some kind of energy bar or a piece of fruit part way through my ride. I know that I need to keep my blood sugar up during and after the event. However, after the ride I find that I have no energy and feel lightheaded. An intense, 12-mile mountain bike ride, for example, can leave me feeling like crap for the next 12 hours!

I’m 38 years old and a former US Marine with a fairly high-stress office job. I’m also a pretty big guy at 6’0, 243 pounds. I was 268 pounds back in January and realize that I still need to drop another 30 to 40 pounds to get back into the shape that I was in when I was 28.

My fasting blood sugar ranges from 113 to 121 mg/dL and my LDL and HDL are both good. My cholesterol is 131 mg/dL and has always been low. My blood pressure is on the high side (135/95 mm Hg) but has dropped from 150/100 mm Hg. Triglycerides were high but are now in the median normal range. Testosterone is low 250 range but up from 150. My supplements include a multivitamin, ALA, CLA, Black Cherry extract and Zinc.

What am I doing wrong? Why do I feel so lousy after the workouts?

Any thoughts would be appreciated.

Tim

First of all, Tim, congratulations on your initial weight loss and improving health. Getting started again after a long lay-off can be a daunting task. As to your question, the simple answer is that, while you are certainly headed in the right direction, you are still dealing with what remains of 10 years of steadily declining health and fitness. As your fitness continues to improve so, too, will your recovery from intense exercise. That being said, as a pre-, Type II diabetic, there are a number of things you must concern yourself with; namely, getting your insulin and blood glucose (i.e. sugar) levels under control. The faster you do this the faster you will return to normal health and function. While exercise certainly plays a major role in whole-body glucose regulation, it alone is probably not enough to get your situation under control. Attention to your diet is of equal if not of more importance.

Carbohydrate-rich diets (especially refined carbohydrate) are expected to have two adverse effects in pre-diabetic and diabetic individuals. First, high carbohydrate intakes require higher insulin levels for postprandial (i.e. after eating) metabolism. In the insulin-resistant state, the high carbohydrate load will raise postprandial glucose levels and in some individuals raise fasting glucose levels if the carbohydrate load exceeds insulin secretion capacity resulting in chronically elevated blood sugar levels. This situation is exacerbated with larger meals.

Second, if diabetic individuals can compensate with greater insulin secretion, the increased magnitude of hyperinsulinemia would be expected to worsen the triglyceride/HDL abnormalities already present resulting in chronically elevated insulin and triglyceride levels and depressed HDL levels. Sound familiar?

It should be noted that a high-fat diet (particularly saturated and trans fats) can also lead to insulin resistance in skeletal muscle so cutting back on refined carbohydrate, saturated fats, and partially hydrogenated vegetable oils is a good first step. However, reducing carbohydrate intake to extremely low levels or cutting out carbohydrate altogether is neither necessary nor wise. This is especially true if you plan on keeping high-intensity exercise as part of your daily routine (which you should, of course).

My suggestion is to increase your consumption of fruits and vegetables (without concern for grams of carbohydrate) while eliminating all processed, nutrient-poor bread, pasta, etc. Processing removes the beneficial components in whole grains including many vitamins, minerals, antioxidants, phytochemicals, lignan, and dietary fibers, which act synergistically in their protective effects.

Both magnesium and fiber, for example, are removed when processing whole grains to produce refined grains and are not required to be added back in. This is unfortunate for you, in particular, as magnesium plays an important role in the regulation of insulin action and carbohydrate metabolism while a high intake of fiber attenuates the glycemic effect of a mixed meal.

A slice of whole-grain bread, for example, has about 14g of magnesium whereas a slice of enriched white bread contains only about 6g. You can see, therefore, that you should definitely substitute whole grain bread for white. Just for reference, the recommended dietary fiber intake is 20-35g per day.

Perhaps more important than macronutrient content (i.e. carbs, proteins, and fats) is the amount of calories consumed. Despite the current popular dietary trends, weight loss is still primarily determined by caloric restriction rather than macronutrient composition. It is, therefore, imperative to create a daily caloric deficit so that you continue to reduce your stores of adipose tissue (i.e. body fat). While you can certainly improve your state through diet alone, the effects of fat loss and exercise training on insulin sensitivity are synergistic.

In addition, be vigilant in your lookout for high fructose corn syrup in your diet. Check your Gatorade. The last time I checked the pre-mixed Gatorade listed high fructose corn syrup as one of it’s main ingredients.

Also, be sure to increase the intake of omega-3 fatty acids, particularly fish oil, in your diet. In healthy humans, three weeks of supplementation with fish oil (1.1g EPA, 0.7g DHA per day) decreased the insulin response to an oral glucose load by >40%! Omega-3 polyunsaturated fatty acid dietary enrichment resulted in lower glucose oxidation, higher fat oxidation, and increased glycogen storage. The glycemic response was unchanged, however, which indicates an improved sensitivity to insulin which, as a pre-diabetic, is exactly what you are looking for.

Finally, a post-workout shake that contains both carbohydrate and protein should do your recovery a world of good. It will provide your muscles with the necessary nutrients for repair as well as resynthesis of glycogen stores to prepare you for the next day’s workout. Take careful note, however, of your physiological response to the shake in the minutes and hours after consuming it. If you find that your energy level increases and your recovery is accelerated, keep it. If it causes you to crash further then, by all means, take it out. Follow this shake with a medium-sized protein and carbohydrate meal an hour or two later to stave off the hunger.

Of course, I shouldn’t have to tell you to always consult with your doctor before making any changes to your diet and exercise routine regardless of how beneficial it might seem.

I think that’s it for now. If you have any more questions, please feel free to ask and good luck with your training and return to a healthy lifestyle.

Steve