<p><span style="color: #201f1e;">In this "Ask Me Anything" (AMA) episode, Peter and Bob answer numerous follow-up questions to recently discussed deep-dive topics such as the use of continuous glucose monitors and getting the most from zone 2 exercise. They also discuss the incredible feats of cyclists in the Tour de France through the lens of the amazing performance physiology required from these athletes. Additionally, Peter ties the conversation together by sharing his foundational framework when considering different interventions, even in the absence of data from a randomized controlled trial.</span><span style="color: #333333;"><br /> <br /></span><span style="color: #201f1e;">If you're not a subscriber and listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/">private RSS feed</a> or on our website at the <a href="https://peterattiamd.com/ama26/">AMA #26 show notes page</a>. If you are not a subscriber, you can learn more about the subscriber benefits <a href="https://peterattiamd.com/subscribe/">here</a>.</span><span style="color: #333333;"><br /> <br /></span><span style="color: #201f1e;">We discuss:</span><span style="color: #333333;"><br /></span></p> <ul> <li><span style="color: #201f1e;">Peter's foundational framework when considering different interventions [1:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Applying Peter's framework to the idea of using a CGM [8:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Why certain fruits have a bigger impact on glucose, and the limitations of a CGM can tell you [16:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Importance of paying attention to insulin, and the prospects of a continuous monitor for insulin levels [20:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">How exercise impacts glucose and peak glucose numbers to stay under [24:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Impact of anxiety on stress on glucose, and why it's important to calibrate your CGM [26:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The five main tools for managing blood glucose numbers [33:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Benefits of moving or exercising after a meal, and where ingested carbohydrates get can be stored [37:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">How to make decisions about an action or intervention in the absence of data from a rigorous, randomized controlled trial [40:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The incredible athletic feats of Tour de France cyclists [48:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Different modalities for doing zone 2 exercise: running, rowing, cycling, and more [1:00:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Proxies for knowing your in zone 2 short of using a lactate monitor [1:07:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Monitoring lactate for zone 2 exercise [1:10:00]; and</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">More.</span><span style="color: #333333;"><br /></span></li> </ul> <p>Learn more: https://peterattiamd.com/</p> <p>Show notes page for this episode: <a href="https://peterattiamd.com/ama26/">https://peterattiamd.com/ama26/</a> </p> <p>Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/</p> <p>Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/</p> <p>Connect with Peter on Facebook | Twitter | Instagram.</p> <p> </p>
Actionable Insights
1. Apply 3-Question Intervention Framework
Evaluate any new intervention by asking three critical questions: What is the risk of harm, what is the probability of benefit, and what is the opportunity cost (financial, time, or sacrificing other beneficial activities)? This framework helps in making informed decisions, especially when clear scientific evidence like RCTs is lacking.
2. Utilize Monitoring for Behavior Change
Employ monitoring tools, such as a food diary or a Continuous Glucose Monitor (CGM), to track your intake or behavior. The act of monitoring itself creates accountability and can lead to immediate, positive changes in behavior and choices, leveraging the Hawthorne effect to your advantage.
3. Consider a 3-Month CGM Trial
If you do not have contraindications like a history of eating disorders, consider undertaking a three-month trial of Continuous Glucose Monitoring (CGM). This initial period is highly insightful for understanding your body’s unique responses to food and activity.
4. Gain Carb Tolerance from CGM
Use a Continuous Glucose Monitor (CGM) to gain insight into your personal carbohydrate tolerance. The device is specifically designed to teach you how your body responds to different carbohydrate sources and quantities.
5. Understand CGM Value Shift
Expect the value derived from CGM use to shift over time; initially, it will be about 90% insight and 10% behavior change, but within approximately three months, this will flip, with the CGM primarily serving as a behavioral tool for accountability and gamification.
6. Use CGM Periodically
Rather than continuous use, consider using a Continuous Glucose Monitor (CGM) periodically to gain insights. You don’t need to be tethered to it every minute of every day to extract significant value, especially given its economic cost for non-diabetics.
7. Avoid CGM with Eating Disorders
Do not advocate the use of Continuous Glucose Monitors (CGM) for individuals with a history of eating disorders. For these patients, CGM can become another tool that fuels a negative cycle of obsession.