#15 - Exercise and type 2 diabetes with Dr John Hawley

Dr Glenn McConell chats with Professor John Hawley from the Australian Catholic University on Exercise and type 2 diabetes. John is one of the most recognized names in exercise metabolism. He has published over 300 journal articles (Google scholar: 40,000 citations, H index 113). We discussed many things (see time stamps below). 0:00. Introduction 1:34. Putting exercise and diet ahead of medical interventions Medicine tend to focus on medications and surgery ahead of exercise and nutrition. 4:52. John’s background / the All blacks 6:14. Acute exercise in type 2 diabetes 8:28. Exercise snacking Exercise recommendations “don’t work”. Better to do short bouts and accumulate 20-30 min per day. 11:16. Intensity of exercise HIIT exercise increases glucose levels. 12:29. Don’t complicate it, just exercise Need a simple message. 14:34. Take the stairs Break up the periods of inactivity 17:02. Muscle glucose uptake normal during exercise in T2D 18:44. Genes haven’t changed environment has Genes load the gun, environment pulls the trigger. 21:45. Most diets unsuccessful Be concerned with your body composition more than body weight/mass. Exercise-nutrient interaction. 24:43. Time restricted eating Shorten your eating window. 27:20. Continuous glucose monitoring Improved glucose levels overnight with time restricted eating and exercise snacking. CGM can rapidly alter behaviour. 29:17. Circadian biology messed up Messed up circadian biology due to late eating, working all hours, sleep issues etc. 32:53. No national food guidelines consider the timing of meals 33:58. Inactivity and exercise resistance 34:53. Not a fan of intermittent/prolonged fasting It reduces protein synthesis so may lose muscle mass. 37:33. It’s an individual thing 38:00. Timing of exercise 39:07. Assessing glucose control over the day Fasting glucose measurements and oral glucose tolerance tests not particularly useful. Meal tests and CGM better. 2 wks of CGM informative for individuals for people with insulin resistance. Non diabetics do not need CGMs. 45:58. Exercise and insulin sensitivity Walking improves metabolic health. Break up the exercise. Lifestyle change: Rome wasn’t built in a day. 3 months to make it a habit. 50:28. What would be your dream study? Taking controlled proof of concept laboratory studies to real world studies. Need more longitudinal studies. 53:01. Most studies do not involve typical people with T2D Can we apply the findings of such studies to the average person with type 2 diabetes? 55:04. Need to stick to it, not quick fix 56:31. Mechanisms of exercise vs diet Each acute exercise bout adds up so that eventually you end up a trained individual. Need to turn over the energy substrates Exercise uses substrates such as glycogen and intramuscular fat which are getting turned over. This is better for you than diet which doesn’t really turn over these substrates. Intramuscular fat: the athletes paradox. Burn the fuel to replace the fuel. Exercise is fantastic, diet is not as great, combined exercise and diet is ideal. Inside Exercise brings to you the who's who of exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all. The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University. He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.100.... Connect with Inside Exercise and Glenn McConell at: Twitter: @Inside_exercise and @GlennMcConell1 Instagram: insideexercise Facebook: Glenn McConell LinkedIn: Glenn McConell   / glenn-mcconell-83475460   ResearchGate: Glenn McConell Email: [email protected] Subscribe to Inside exercise: Spotify: https://open.spotify.com/show/3pSYnNS... Apple Podcast: https://podcastsconnect.apple.com/my-... Google Podcasts: https://podcasts.google.com/feed/aHR0... Anchor: https://anchor.fm/insideexercise Podcast Addict: https://podcastaddict.com/podcast/402... YouTube:    / @insideexercise