Endurance athletes and Hb A1c

[omicron1792]

Quick google search will provide lots of data on the topic. Here's one of many: https://pubmed.ncbi.nlm.nih.gov/17614026/

Right. But I’m not sure it means what you think it does.

Endurance exercise changes the way our bodies process sugars. Up to a point this appears to be a good thing.

Above a certain exercise threshold, the gains seen in studies plateau. At extended levels, the gains start to trend downwards.

Why is this? We don’t know fully, but there is something that flattens the curve. Glucose processing might be one of them. Keeping the body in an extended state of exercise may not allow the body time to do routine maintenance needed for healthy regulation.

Health coaches talking about increase rbc age causing increased a1c might be the answer. But it may not be, and my guess is it’s not. That YouTube video didn’t solve the riddle.

 

[ZachTullock]

Right. But I’m not sure it means what you think it does.

Endurance exercise changes the way our bodies process sugars. Up to a point this appears to be a good thing.

Above a certain exercise threshold, the gains seen in studies plateau. At extended levels, the gains start to trend downwards.

Why is this? We don’t know fully, but there is something that flattens the curve. Glucose processing might be one of them. Keeping the body in an extended state of exercise may not allow the body time to do routine maintenance needed for healthy regulation.

Health coaches talking about increase rbc age causing increased a1c might be the answer. But it may not be, and my guess is it’s not. That YouTube video didn’t solve the riddle.

For me - the available data speaks pretty clearly. Hba1c is a flawed biomarker viewed in isolation. It is useful when you use it as part of your comprehensive test results.

The data shows us that the value is skewed by RBC life and athletes who are metabolically healthy when you look at other biomarkers (insulin, fasted blood sugar, triglyceride /HDL ratio, etc etc) or a glucose tolerance test can often have elevated Hba1c.

So back to my original comment - Wouldn't worry about it too much as long as your other metabolic biomarkers are in line! Hope I was able to help out here. Not a medical professional - Just a hunter concerned about longevity so I can have as many seasons as possible in my life!

 

[Bobrobheimer]

For me - the available data speaks pretty clearly. Hba1c is a flawed biomarker viewed in isolation. It is useful when you use it as part of your comprehensive test results.

The data shows us that the value is skewed by RBC life and athletes who are metabolically healthy when you look at other biomarkers (insulin, fasted blood sugar, triglyceride /HDL ratio, etc etc) or a glucose tolerance test can often have elevated Hba1c.

So back to my original comment - Wouldn't worry about it too much as long as your other metabolic biomarkers are in line! Hope I was able to help out here. Not a medical professional - Just a hunter concerned about longevity so I can have as many seasons as possible in my life!

From what I can tell you might be right. And perhaps worrying tremendously in the circumstances you describe is uncalled for. However it also seems this is all just too new and not very well understood yet such that it might turn out either way for longevity. I would like to believe you are right for my own sake. I meet the triglycerides to HDL ratios generally well over the last few years but my LDL and appo b are too high.

 

[ZachTullock]

From what I can tell you might be right. And perhaps worrying tremendously in the circumstances you describe is uncalled for. However it also seems this is all just too new and not very well understood yet such that it might turn out either way for longevity. I would like to believe you are right for my own sake. I meet the triglycerides to HDL ratios generally well over the last few years but my LDL and appo b are too high.

Fair enough. Just trying to add some light on the discussion.

Regarding LDL and ApoB - Peter Attia has a lot of good information on this topic. Personally, I recommend finding a primary care doctor who is onboard with the "Medicine 3.0' concept outlined in Outlive.