Liz Wolfert seemed to be a picture of health.
The Denver-based financial adviser cycled to work, boarding "14ers" – mountains that towered over 14,000 feet above sea level – took kung fu lessons and swam. 19659002] But in 2015, at the age of 32, she learned that she had high blood sugar levels, a possible sign of prediabetes.
Wolfert's first instinct was to train harder and faster. But soon she learned that she had to do the opposite: train more slowly and with much easier movement.
Wolfert was told of her "metabolic inflexibility" – and the recommendation of low intensity exercises – by Iigo San Milln, Director, of the Sports Performance Program at the Sports Medical Center of the University of Colorado at Boulder. San Milln, a sports physiologist working with elite athletes, defines metabolic flexibility as the body's ability to quickly switch between fat and carbohydrates to exercise.
People with type 2 diabetes are metabolically inflexible. That means they have a poor ability to switch back and forth. Endurance athletes, on the other hand, have an amazing ability to do so. Fats and carbohydrates are metabolized in the mitochondria, so that mitochondrial function is the key element behind metabolic flexibility.
Elite athletes, said San Milln, are incredibly efficient in this task because they have a high level of mitochondrial health.
Mitochondria are used to metabolize carbohydrates and fats to produce energy, "he said," so this is a population that has virtually no Type 2 diabetes. "
However, the average person may have one
"If you are not metabolically flexible, you have a tough time accessing and burning fat," explained San Milln.
Wolfert learned about this after a trip with her mother in San Millns Laboratory.
"We read about his testing methods and that he was looking for average people and trying," Wolfert explained. "We thought it would be a good idea to see where we are and whether it is in my presumed prediabetes
Both Wolfert and her mother expected her to show better metabolic efficiency.
"I'm your typical desktop American, not athletic, and exercise not as much as Liz does, "said Diane Wolfert, who is 66." So we were shocked to see that I had a good metabolic efficiency and Liz did not. "1
"I'm going for a walk," said Diane Wolfert. "Based on my results, nothing had to be changed."
San Milln has spent years testing the metabolic flexibility of high-performance athletes with high-tech and expensive methods, and the standard test involves muscle biopsy that is impractical for widespread use.
Determined to expand the accessibility of the test, San Milln developed a streamlined version that he used on the Wolferts
San Milln did patient exercises gradually increase intensity on a bike or treadmill with a mask that measures how efficiently they use fat and carbohydrates.
" The test emphasizes the mitochondria to give us very clear signals of how well they work, "he said." I take blood samples on a regular basis Fingers and judges how fast the cells break down lactate, a metabolic by-product that can lead to disease when it's accumulating. "
San Milln tested his methods to demonstrate their efficacy over the standard," All Doctors I'm talking to love the concept of my test, and many refer their patients to metabolic rehabilitation to us. "
Rosalie Naglieri, a Maryland-based clinical endocrinologist, finds the approach intriguing, but suggests that several factors matter could play.
"I think this test is likely to be valid to see why some people actually get more benefit from sports other people hardly have any," she said. "I have a lot of patients who are training all the time and can not lose a pound." I also have very heavy patients doing IronGirl-style (Sprint Triathlon) races. "The question in these patients is that the exercise is wrong for them or is it Diet They Eat Wrong? "
According to San Milln, the only treatment for metabolic inefficiency is fitness, and for the sedentary, it should be very low
In contrast, however, some studies have shown that high-intensity interval training, or HIIT, can be useful for both prediabetics and moderate-intensity programs.
"So the interesting question would be," Naglieri said, "what is their mitochondrial status before and after in these HIIT studies, or did these studies somehow have a distorted population?"
Since their test with San Milln in early 2016 Liz Wolfert started to walk 30 to 60 minutes several times a week.
"After a few months I climbed a 14er and realized that it was a lot easier for me," she said. "My body started to work more efficiently."
When retested, Wolfert said she was thrilled to learn that she was in the normal range for metabolic efficiency. And her family doctor ordered a blood test, which indicated that her signs of pre-diabetes had disappeared.
"Of course I had to integrate this less intensive work into my routine," she said.
"I agree that exercise is not a unit size," said Naglieri, "and there are definitely differences in the metabolic response to physical activity."
San Milln said that too many people like Wolfert are: They train, but too high for their fitness level. "If you look at the training load of top athletes, they do 70 to 80 percent of their training with low intensity," he said. "But out in the street we often see the opposite: an unconventional population that jumps in with high intensity."
The result may be burnout, injury or insufficiently low heart rate to form mitochondria. "What we really need is an individualized approach for all," he said. "But for beginners, hiking is a wonderful starting point, it can be an incredible medicine."