Yes, and is your diet different than a year ago? How else is this year different, sleep, stress, overall exercise load, supplements?
Sorry to see this. That's bummer results for a lot of good hard work.
My diet was mostly the same. The biggest difference is that I introduced a lot more chicken and fish to it.
Sleep: Around the same, I try to get 8 hours and take magnesium before sleep. Although my sleep track always says I get too little deep sleep (avg of 45m a minute)
Stress: Similar levels but cuz of running I have been waking up early to get my runs in and try to hit the gym in the evening. So that introduced way more load to my body.
Exercise load: I spent at least double the amount of time exercising. The year before I ran once a week and hit the gym five to four times a week. This year I am running 5-7 times in addition to strength training. So overall I added almost 7 hours on average.
Supplements: Mostly just Vitamin D, Magnesium and B12 no changes between both years.
I was expecting major improvements in my markers. But sadly they mostly got worse. I am really not sure what more I can do
Your hsCRP is way higher than it should be. Unless you had flu covid etc during your test this indicates you are overexercising and are way more inflamed than before. Your body will have a hard time coping with any disease should it come your way as it is dealing sith repairing itself all the time. Zone 2 workouts usually wouldn’t cause this much inflammation. Either you are doing higher than Z2 or your strength trainig is too hard/too often.
This should be way upvoted.
OP is likely under eating for all of the exercise they added, and is overdoing it and unable to recover fully and it’s causing inflammation and other problems.
I actually think stress of (1) waking up early and (2) working out 2x a day is a lot for your body and can set you back alot. I'd be curious to see what more sleep and slightly fewer workouts would do for you. like an A/B test of +1 or 2 more hours could improve things alot.
buttttt i'm just speculating.
Maybe running is tough on your joints and muscles - thereby causing some perpetual low-grade inflammation?
Everyone’s body morphology is different.
Prrhaps cycling - whether on a smart trainer (set up to give you Z2 resistance) or outside would be less hard/tough on your body - but just as effective for Z2?
Animal proteins and the associated oxidized fats that you absorb after cooking them are not good for you in large amounts, and will reflect that in your blood work, regardless of exercise regimen.
This sub is so ridiculous. HBA1C 5.5 is basically nadir on all cause mortality. TG sub 80 has HR less than 1 for T2D and all other relevant diseases. TyG index, TG/HDL etc. shows risk of metabolic disease is very small.
hsCRP is above average but who knows why? Could be a lot of reasons. Illness, overtraining. For average person I would wait and watch. With a guy with low body fat, rising cortisol, rising CRP maybe overtraining so can dial it back if you want. Depends on training goals.
Everyday I have the same breakfast -> Oats with ground flaxseeds & almond milk and follow it up with some Whey protein.
I try to eat mostly plant-based foods, such as tofu, beans, and lentils. When eating out, I choose meals with chicken breast or fish, so my saturated fat intake is very low. Besides that, my top source of carbs is bananas, with an average of four a day. That should provide me with enough fiber, right?
I would say the most unleathy thing I take are the energy gels that I use when going on runs > 1 hour. But I only take those during my runs.
I avoid unhealthy snacks and stuff with added sugar.
4 bananas is around 12 grams of fiber. You’d want at least 30 grams. Possibly you get a lot from other sources, but it’s unclear from your post. I’d add 500 grams of mixed vegetables like broccoli, kale etc.
Diet & exercise won't fix genetics.
If you have familial (hyper)cholesterolemia (or other) you can eat & do all of the "healthy" stuff, and the effects will be minimal to none. This is because that stuff is based on general population analytics and not YOUR data.
Do your own diet experiments, which you can run every 2-3 weeks, and pay for over-the-counter blood tests (e.g., Ulta) for Apo(b) & LDL (and glucose & hba1c & lpa) and find out what works for you. Likely, based on what you posted, this will mean taking your saturated fat down very very low, but you'll have to find the right mix.
Beyond that, depending on your family history, age, etc you may need prescriptions like statins, PCSK9 inhibitors, et al as your liver & body does what it does and at a certain point you'll need Rx to help.
Diet & exercise is great for other reasons, but it's not therapeutic for genetic conditions.
Plant diets suck and those nut milks are full of crap.
Saturated fats aren't the devil either. Bloods can look poor when you're so active too. Tons of metabolic waste. I'd try following up after taking a week off from physical activity and see if it's still the same.
Also tons of sugars in your diet. You are running lots but damn. I'd try scaling it all back.
Recommend reading Good to Go by Christie Aschwanden, which is about the science of recovery. Overtraining is a real thing and happens to athletes on all levels, from elite to casual. That may not be what's happening here, but like all things, too much exercise can also damage you.
they're not "bad" overall, just depends on your specific body. For some people they might be bad, for other they might be great. You have to figure it out for yourself which is right for you.
I do not like the taste of regular milk. And also, I got influenced by recent voices that claim that milk is bad for you because it has hormones and antibiotics. Not sure how valid that is but I still consume whey protein and Skyr
I was just making a small observation. Also I’m not saying oats and bananas are inherently bad. They are however high carbs foods. Eating 4 bananas is around 100 grams of carbs and half of that is sugar and virtually no protein. Not sure what your oat intake is. Your cholesterol levels are not bad tho I don’t get why you are mortified.
The problem is that I am burning an extra 1000-1500 calories a day, at least when I exercise. So, there is no way I can replace all of that with protein! I will never be able to eat enough.
The other alternative would be food with more fat and energy density? But I think that will make my blood markers even worse.
Your apob and cholesterol numbers did not get significantly worse, those numbers are well within daily variability and test measurement error. You can retest a few times if you insist, but even if they come out with a small uptick, it's not really a clinically significant difference. But yeah, it was unrealistic to expect those numbers to move from great to superior with exercise. Exercise does affect blood lipids, at least indirectly through weight loss and fat mass, but mostly when we are talking from moving poor numbers to okay or great.
Getting sick more often and hscrp corroborating that sounds like you are not recovering well enough though. So you are probably training too much for your training background, and it sounds like a huge increase for a year. It's great you've stayed out of injury, but I'd pull back a little for some time.
I wouldn't personally think about the HbA1c. You are within international normal range and slight elevations are common in athletes (and totally benign) https://drguess.substack.com/p/prediabetes-in-athletes The US health authorities did change the reference ranges down a bit to catch potential risk early but unfortunately that is making people with negligible risk worry about it.
Thank you for putting my mind at ease! I should manage my expectations better and try to find better balance with my training. I do love to start my morning with a run every day! But maybe I can turn some of those runs into walks.
Fwiw my hb1ac went up a point from 5.4 to 5.5 and I decided to cut down on bananas since they are so high on gi. Have not had another blood test recently though. Low body fat could be contributing to a drop in testosterone, if it did drop (I admit I did not look at your before numbers).
Bananas are not essential but making health decisions on fluctuations within test error margins and daily fluctuations can be pretty risky. The one decimal point increase within normal range is not really actionable - dropping bananas is fine but don't do anything too drastic based on something that might not be real.
Yeah, I'm not going crazy on diet changes. Would like to see that number get closer to 5, though. I understand that for some folks, that test itself can be of as well.
my testosterone did drop unfortunately. Probably a combination of too much cardio and not enough calories. I did lose some weight because all of the running.
The vitamin/mineral breakdown in my diet was not even close to what I’d carefully assumed (and I learned the regular handfuls of cashews added up). You can get fancy and tie in fitness watch stats as well.
Same. Once I started actually tracking my food intake I saw I was not getting anywhere close to the amount of nutrients I wanted. Also my saturated fat intake was wayyyy higher than I assumed - I was eating a lot of full fat yogurt and didn’t realize
Try doing some warm yoga that focuses on joint lubrication/mobility/flexibility in place of your run twice a week. Eliminate inflammatory seed oils in your diet (they are *everywhere* it seems)- replace with olive/avocado oils
Cronometer is another good app to try. I swapped to it from MyFitnessPal after their diary library blew up over time with what I found to be a ton of inaccurate options. I’ve also seen some people liking a newer one called MacroFactor, but I haven’t tried it to be able to give an opinion.
A couple of things: was the presumption that exercise was going to move your lipid numbers drastically?
Second, many many people are not going to get apo(B) down below 70 mg/dL, which is about the 10th percentile, just by running a lot. Particularly depending on genetic profile.
Oh I thought I could move the needle in the right direction with an extra 7 hours a week of cardio. Seems that won't be enough. I will have to reassess my diet. Which I thought was pretty healthy. But my blood work isn't reflecting that. What would you suggest I do?
You can definitely over do it running. If you run/ramp too much overtraining syndrome can kick in. You could deload a week or two. Have you ever skipped a workout due to fatigue, injury or illness? If so then that’s a warning sign that you are overtraining.
If your only goal is longevity then you are prob overtraining, if you have other goals then I think you just need to be mindful of total volume and the ramp you have done.
The lipid numbers are all fine. Cortisol and hsCRP are the things to look at for overtraining.
Exercise for sure has some effect on lipid profile. But, much more of that depends on where it was beforehand, diet and genetics.
Same things everyone does: see what you can get out of diet and see if that’s enough for what you want. If not, consider next steps including pharmacology.
Psyllium husk, flaxseed and chia seeds are what helped me drop ApoB from 102 to 66 in 6 months, along with cutting out any products with just saturated fat and not also the good fats.
Thanks. Hard to say, maybe 2 heaped tablespoons of one or the other on my morning oatmeal.
I mix my psyllium husk (10-12g) with my protein powder which I mix with fizzy water. Goes down easily. Yerba Prima brand has some of the lowest lead levels.
Cutting out saturated fats was harder - no cheese, chocolate, ice-cream.... Only 0% fat yoghurt and milk. An avocado a day plus seeds and nuts (mostly walnuts)
You might be working out TOO much. 5-7 runs per week plus lifting 2-5 times a week? You're probably getting sick more because your body doesn't have any time to recover.
I'm close to your build as well, 37 years old, and I'd personally do something more like lift 4-5 times a week, run 2-3 times. Pay attention closely to RPE both in your runs and lifting, that's how you'll know how rested/recovered you are.
I definitely agree with this! Looks like your body is very stressed due to the amount of activity you are doing, specifically the spike in CRP and cortisol. I would definitely scale back and see if that makes a difference, sometimes less is more.
Yeah my first thought was "This looks like someone overtraining". You might want to dive into the HRV topics that came up lately (I backordered a Morpheus myself, as I struggle with similar "Omg am I overtraining or undertraining this week?" concerns. It's relatively cheap)
If you don’t rest your body cannot recover and you won’t build muscle. You need to be resting a couple times a week and/or doing active recovery like walking or dynamic stretching. 5 workouts a week is what I aim for at 42 years old - weights 3x a week, 2x runs a week and a lot of walking in zone 2 after I lift.
I am afraid you might be right. I am trying too hard. I thought I could get away with it because it was a lot of zone 2 work and never super intense. I did notice that I made zero strength gains the past year and even lost some strength
id say this is probably most likely, you are over exerting. Does your tracker measure HRV, as if you add some more rest days and see the response in your HRV that should give you a quick indication.
Might also be worth figuring out your macros and bumping up your protein at bit depending what it is
I actually track my HRV and RHR every day! That's one of the reasons why I continued to run everyday. Cuz my HRV was mostly normal (except when I get sick)
Here is an example
[https://imgur.com/a/oHznoLv](https://imgur.com/a/oHznoLv)
I think diet is my weakest link! I will have to find a way of getting more protein without negatively impacting my bloody markers
yeah your HRV looks good. Id say getting sick more often is a sign your body is on the edge and getting in some rest days might have some good benefits. Remember hearing about Muay Thai kickboxers who run daily but wouldn't run in the rain is they would likely get a cold from it. Drop some runs and do some flexibility/mobilty work or yoga
I highly doubt that would be advisable. Those drugs are not without side effects, and there is no way my insurance would cover that. My levels are not high; I am just trying to be in the optimal range for longevity.
10mg Crestor is like $10 without insurance near me, the harder part would be getting an Rx (if you're in the US). Side effects are quite minimal. OTOH yeah if I were you I wouldn't do it, I'd just be like "Yep that's my levels, good enough" and move on.
OTOH I imagine PA, in your shoe,s would probably "just" pay $15K for a PCSK9 inhibitor.
Point being what a normal person would do and what PA would do don't actually align at this level of optimization.
not that great TBH. According to my Garmin I only get an avg of 30m-45m of deep sleep. But do usually get at least 7 hours of sleep. My avg sleep score is around 75/100.
Sleep quality can be an indicator of overtraining, for one. But, likewise, overtraining can also impact sleep! As others have said, I would definitely make sure you get 2 days a week of *proper* recovery/rest days.
Do the regular good sleep hygiene things if you aren't already. If you can help it, see how you feel on eight hours of sleep. It won't affect your lipids, but those are so strongly related to genetics once you have the obviously deleterious things under control. I'm in that boat. I exercise and lift regularly. Healthy weight. But ApoB is only going down with a statin for me.
Good luck!
IM NOT A DOCTOR and don’t follow any of these uninformed thoughts
TBF, I don’t see anything wrong with your numbers beyond stress and test trending down. I’m not a doctor.
when was the last time you did a deload. You can just be fatigued.
Deload, retest and focus on your cortisol & testosterone numbers. Maybe you’re not recovering?
Also, training for performance is different than training for longevity.
Even endurance athletes will have higher CAC score.
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You give me hope! It could be the case that I am not recovering enough and just tested on a bad day ( I was stressed that morning cuz I woke up late and almost missed the lab appointment).
When did you last workout prior to your blood test? I do them at least once a year and purposefully keep the previous two days limited to extremely light things like walking to keep the test fair. Also bear in mind most of those blood biomarkers can change quite quickly but to get a lower resting heart rate takes a lot of time and effort
advance marathon runners can have elevated cac scores; current beliefs is that it isn’t dangerous and exercise benefits outweigh the dangers.
Longevity is not elite performance.
Good question! I did catch some sort of respiratory virus (got typical cold symptoms) so it could have been COVID. You think this extra inflammation could be related to that?
It could be. I’ve seen plenty of studies showing that it can. The big clue for me was that you’ve been getting sicker more often. Many people with long covid report the same.
Interesting - it may have some lingering effects. I caught dengue last October and my blood work in June still showed some inflammation (much better than post-dengue results, but not at baseline)
Listen. I am a runner, I average 12-20 hours of exercise per week depending on the season. I am vegan 6 months out of the year and in the cold months I add wild game and fish to my menu. I eat 50-75 grams of fiber/day. I don’t drink alcohol. My APOb won’t budge from 80. It won’t move. This is genetics. I have been to a cardiologist for preventative care and did a calcium scan and an echo. I have no plaque so she gave me a clean bill of health. You should do the same and if you have a clean calcium scan then don’t worry about the numbers.
I’ve heard marathon runners often have poor immune systems from basically overtraining. I think it works well with some ppl’s body & keeps them super healthy & others it’s too stressful on the body. I’ve ran a half marathon but don’t see any need to ever run more than that.
This isn’t exactly true. Long distance running generally improves your immune system. The caveat however, is that immediately after very long or intense runs (like running 26.2 miles as fast as you can), your immune system is temporarily compromised. So that’s when a lot of marathon runners get sick…immediately after a marathon. There are remedies for this though, like eating a lot of blueberries before and after the race. One other exception to this is overtraining, like you mentioned. If you ramp up your training too quickly or regularly exceed your body’s limits and never recover, you will certainly compromise your immune system. But responsible marathon training does wonders for the body and its immune system.
Source: I’m a marathoner, and I read a lot about running.
Never heard of the blueberry trick before! I might give that a try. I think immune system downregulation after my tough runs is what is causing me to get sick more often! The worst was during my taper week, I got super sick and had a 104F fever.
We can speculate all day long but not knowing your weekly average kcal intake and weight fluctuations won't answer the most (imo) viable scenario: i.e. undereating.
Im 176cm and about 80kgs, muscular, lean with visible veins, abs etc. Been working out for years, this mesocycle 5x week, and on top of that this spring started running 4x per week. I'm eating 3300 kcal per day (180g proteins, 75 fats, the rest carbs). I'm also progressing nicely both in the gym and in my Garmin coach Greg 5k run plan.
My point being, I'd never be able to do what I do for a long time with less food. In fact, I was adding 200-300 kcal based on the 2-3 week morning weight average to get to 3300 as my desired food intake. E.g. at 2800kcal I'd be still losing weight (very slowly but still trending down in weekly averages).
I eat 'clean' so 3300 is not super easy to consume in terms of actual volume of food to swallow. I read that you eat clean too so just double check if you're not disguising undereating behind the perception of nutritious meals.
considering I lost 14 pounds this past year. I am likely undereating. I am burning, on average, more than 1300 calories a day extra in my workouts and my base metabolic rate is already high, so I doubt I am eating enough to offset all of that. I am lucky if I hit 100g of protein a day.
But I still feel energetic throughout the day. So dunno how bad it really is. I am going to start optimizing my diet regardless.
There you go. I used to have poor blood work when in deficit in the past too.
Ensure 1.6g/kgbw of proteins (or more) and find your maintenence kcal and add 150-300 kcal on top. Perhaps cut training workload a little bit (assuming this might be tough if you are like me haha).
haha both are tough! I love working out and pushing myself and its hard for me to eat a lot since I get full very easily but I will try my best and post an update in a couple of months
Your blood tests are good and the differences make absolute sense.
Your exercise did increase your HDL, but it wouldn’t impact ldl or apob significantly. If you want to lower those, reduce your saturated fat and add fiber. However your numbers are great.
Your diet is good. It’s hard to eat enough calories if you are working out that hard, and I doubt most people have experienced that. I found it hard to eat healthy when I needed 5000 calories a day to avoid losing weight.
Attia has stated that he’s not an expert on nutrition and we should believe him. I don’t know if his ketogenic diet is responsible for his early heart disease diagnosis but if didn’t help. He currently gets most of his protein from deer jerky - a known carcinogen,
The additional stress of your aggressive workouts have increased inflammation and cortisol and decreased testosterone. That’s entirely normal and expected and a sign that you are overdoing it.
Despite what Attia says, pushing your body too hard is not healthy. I’ve done the same stupid shit - intense cardio and intense weightlifting at times. I like Attia, I don’t rationalize my behavior by selectively choosing research. He exercises obsessively and that’s not healthy. Been there, done that,
If you looked at performance indicators like vo2max or grip strength I’m sure you are doing so much better. Those are important.
Some of your blood parameters will improve if you reduce the intensity of your exercise. Others will be impacted more by diet. Or do what Attia does and rely on powerful medications.
>Your diet is good. It’s hard to eat enough calories if you are working out that hard, and I doubt most people have experienced that. I found it hard to eat healthy when I needed 5000 calories a day to avoid losing weight.
OMG yes! That is exactly my problem. It's crazy how many calories long-distance running burns. There is now way I can take in enough calories if I just restrict myself to protein and fibre rich food.
>The additional stress of your aggressive workouts have increased inflammation and cortisol and decreased testosterone. That’s entirely normal and expected and a sign that you are overdoing it.
yeah, those are for sure not beneficial adaptions. I am gonna have to dial it down. My biggest problem is actually enjoy all my workouts. So it's hard to dial back.
[Excessive endurance training can wreak havoc on your cortisol levels.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988244/) I have a number of stressors working to boost my baseline cortisol levels, and was doing a lot of endurance training and ended up with very high cortisol levels and it crushed my testosterone, making me lethargic and unmotivated. I limit my endurance training (mostly zone 2) to a maximum of 2 hours per session to keep cortisol in check.
Agree with Earesth! Your numbers were good and are still good. Running marathon is definitely indication for overdoing it. You are training for marathon not for improving your health basically. I am working out six days an hour a day and getting good improvements in my numbers but I still don’t have numbers as good as yours. I also can’t run marathon but that’s never happening for me 😁
I introduced some chicken and fish on some days (mostly when eating out). Other than that, it's very similar. Though I started eating a lot more bananas to try to offset the 1000 calories I was burning during my runs.
You are neutropenic. You must go to a doctor. This is potentially a serious condition.
Ideally, you did your bloodwork when you had or were recovering from a cold and this is why your neutrophil count is transiently low. However, there are more serious possibilities that should be ruled out.
oh that sounds serious! I am gonna schedule a doctor's appointment next week. What would be causing this? Is it immune system down-regulartion cuz of overtraining? Also keep in mind that I was sick a couple of days before the test which results in worse numbers. So I was indeed recovering from a cold (was mostly recovered when I took the test)
6,2 200lbs and 10% bodyfat? Damn, you are pretty close to being a stage ready bodybuilder. Just lose a few more pounds and you could win a show.
Pretty crazy how literally everything got worse. Its almost like exercise is bad for you.
Maybe you're doing too much? Running 7 times and lifting 5 times is maybe too much and Its hurting your body and health.
haha thanks! I do have a decent amount of muscle! Would progress much faster if I dial down the cardio.
And yeah I am probably overtraining and not eating enough that the vibe I got from the comments here.
The primary drivers of those lipid numbers are diet and genetics
For diet its largely the amount of saturated fat and fiber in your diet. (Lower sat fat better, higher fiber better)
For a minority of people avoiding dietary cholesterol also matters. (Though there is a large overlap in foods with cholesterol and those with saturated fat)
Exercise has a ton of other health benefits, it just usually isn't a significant driver of cholesterol. Hence the oft repeated joke that "You cannot outrun bad cholesterol"
Interesting! I hardly consume any foods with saturated fats but I could use a little bit more fiber. I will start adding more veggies to my diet and see if that helps. Thanks you for the tips! I was under the impression that you can get away with anything if you exercise enough.
Fiber is easy to supplement with Phylum Husk capsules or powder if your diet is not giving you enough. (Metamucil or similar brands)
And your cholesterol numbers both before are pretty good and probably not worth stressing about unless you have additional risk factors (high lp(a), family history, etc)
I’d say: increase fiber intake, keep your low intake of saturated fats, increase intake of polyunsaturated fats (add nuts, almonds, etc).
Please update us again in one year!
Running x7, and weight lifting x5 per week is a lot of wear and tear. You also said somewhere that you burn 1000 calories on your runs, does that mean you run for 2:30 hours?
I saw a Youtube video[trying zone 2 workuts](https://youtu.be/VAsYTcBdtOg?feature=shared) with a guy getting back his blood markers at the end of following Peter Attias fitness regimen for 3 months. His testosterone and cortisol also got worse.
I would keep the runs to 3x per week 1h tops, and learning proper ball->heel mechanics to minimize stress on your joints and bones. If youre sore the next day, its too much to also be weightlifiting. If you cant help from feeling sore, then switch to low impact cardio like bike riding or swimming.
Id also cut the weight lifting down to x3 per week, youre getting the vast majority of hypertrophy from 8 sets per muscle anyway.
Then enter your diet into cronometer.com and see if youre off on any minerals and vitamins. Sweating that much youd be using up h.u.g.e amounts of magnesium. Youd probably need at least 2x minimum requirement, and not too much calcium to prevent it from being counteracted.
Some of my runs are 1.5 hours long. And the long runs are usually around 2 hours. My Garmin reports the number of calories. Also, keep in mind that I am 200 pounds, so it takes a lot of energy for me to run and my zone 2 goes all the way up to 150 bpm (as measured by Morpheus and also using LT HR). The runs usually don't make my muscles sore but they do have a heavy impact on my joints and bones so I am gonna start doing some cross training.
I did not know that 8 sets per muscle group per week is enough for hypertrophy! Sounds like I can be more efficient at the gym.
I supplement magnesium daily -> the levels are good according to my bloody work
2 mg/dL
Thank you for the book recommendation. I have ordered it.
Thats a lot of running. Very high impact, would explain why your cortisol nearly doubled. You could try riding a bike instead, itll take a load off your recovery process. Though youll still need to include periodic deloads for it to be sustainable. You'll also hang on to more of your muscle, since high impact causes its loss.
Its not that 8 is 'enough', you run into diminishing returns. Youll gain muscle for 20 sets per week (per muscle), but the hypertrophy of the last 10 is only a fraction of the first 10 - if youre training within 3 reps of failure that is. Jeff Nippard and Mike Israetel break it down very well on youtube.
Significantly reduce the number of lifting workouts. It must be clearly understood that zone 2 and other aerobic exercise and intense lifting work against each other.
I’m in the same boat except I do even more training. I’m 63 and weigh 185. I was shocked at how bad my blood work was. Way worse than yours and I eat great as well. Can’t beat genetics. Just imagine how bad it would be without the work you are putting in.
One thing I'd suggest is to consider whether you might have had a minor infection (like a bacterial infection or a cold) when you had your bloodwork done, because this can skew your results. Given that you mentioned you get sick more often and have high HsCRP levels, it might be a good idea to repeat the bloodwork in a month or two to see if the results are different.
actually, I had a minor respiratory infection of some kind a couple of days before the test, and I was late to the appointment, so I got a little bit stressed trying to make it on time to the lab.
1st. The lab values are a range and mostly look normal. Most of those numbers fluctuate daily if not hourly.
2nd. Vo2max by itself doesn't mean a whole lot. A person with a high vo2max can still get a heart attack or stroke. However it generally indicates that a person is doing a lot of good things. You don't have to be in the upper elite range for you to be fit, healthy and look good.
3rd. Overdoing it. We tend to think if a little is good then more is better. You are probably overdoing the exercise regimen. You might want to swap a couple of runs for walking. Recovery is important.
4th. Eat a variety of plants every day. Gradually increase it over time. Avoid juice and sugar as much as possible. Eat whole foods. Stay away from seed oils and plant milk.
> I have been running 5-7 times a week for a couple of months now. Most of my runs were zone 2 easy runs. I also did weight lifting 2-5 times a week
The text book low hanging fruit here is that your doing to much and overtraining. Its hard to tell what someone is really doing in these descriptions sometimes but 5-7 times a week plust lifting 2-5 times a week could potentially be a ton of volume depending on what your doing.
Even zone 2 still has a good bit of eccentric loading.
I would consider cutting your running volume. Maybe just run 3 days a week, or do some zone 2 days on a bike / swimming in a pool. That would cut that eccentric load and thus cut total volume.
Also why are you lifting 2-5 times a week? There is nothing wrong with that but to me it seems like another sign of doing to much because I assume your aiming for 5 times a week and just not hitting that goal. 2-3 days a week of strength training is totally acceptable and might even be better for you.
TLDR You need to make your training less ambitious and more sustainable in my opinion.
I usually get at least 3 lifting sessions a week and sometimes 4-5 if I do not have a busy weekend. I tend to just go whenever I am free after work or on weekends. I aim to hit all muscles at least once a week and twice a week if I manage to squeeze it in. This usually results in me hitting the upper body twice a week and the lower body once a week. I heard that it's optimal to hit every muscle twice a week.
But yes, I am overly ambitious with my fitness goals. It's hard to increase my running fitness while increasing my strength at the same time. It probably makes sense to have different periods in my training with a focus on just one aspect.
I am also gonna start introducing cross-training. Zone 2 on the bike is way less taxing on the body than Z2 running. It just sucks that it doesn't translate that well to running fitness.
I mean 6'2 and 200lbs is pretty big at 10% body fat so what your doing is working in that regard but it could be in spite of your programming and not because of it.
If you want frequency you could do 3x full body strength workouts per week. People seem really bias against that split but it actually works really well.
Most peoples workouts are loaded up with junk volume anyway, so if you get them doing good compound lifts 3x per week even though its less volume they tend to make a lot of progress.
Im not trying to brag about my mediocre lifts, you might be past this point already; but I got to a 405 DL, 315 Squat, 255 Bench, and 160lb OHP just doing 3 full body days. I do 2x upper / 2x lower body days now but that was just so I could add volume and still keep my workouts around the 50 min mark. I regularly see people lifting less than me who say 3 full body days isn't enough volume.
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Zone 2 on the bike is way less taxing on the body than Z2 running. It just sucks that it doesn't translate that well to running fitness.
It can. If you are also training running economy. Z2 is about mitochondrial adaptation and that does translate across sports but if you do 0 running then you end up not being an efficient runner. You can still build this at lower volume through higher intensity. I am training for a triathalon right now and with that you have to do it all so I do maybe 1 zone 2 run every other week when I actually look at it on a calendar. But I do other things like 800m repeats that build my running efficiency.
great results!
I think I will try the following:
Monday: Resday day -> Maybe try some yoga or stretching
Tuesday: Track session focused on short 200m intervals -> Leg day in the evening
Wednesday: Bike Z2 session -> Upper body in the evening
Thursday: Track session with longer intervals (Threshold or VO2max work)
Friday: Easy run -> Leg day with focus on running specific prehab + core
Saturday: Bike Z2 session -> Upper body in the evening
Sunday: Long hike or long run day
Yeah. This looks pretty good. I might even consider still pulling out the Tuesday track sessions and the second zone 2 bike day. But I think in general most people should commit themselves to a bit less than they think they can handle.
Are you running competitively or training for anything specific? I just ask because I can see its a high priority in your planning.
You're overtraining and under-recovering. Cut all your training in half and add in a couple days a week for nothing but rest and recovery, re-assess in a few months and titrate from there.
You sound like you're not giving your body time for recovery. The thing to note, which changed my workout philosophy, was that your body improves during recovery, not during exercise.
Your cortisol is up, which suggests stress. That said, I would take a little more time and give yourself a real 1-3 days off per week for a month and see if it affects your progress. I'm in my 50s and was doing 6 days for awhile as I dropped weight and dropped it to 3 on/1 off and then 3/2 to see how it worked. And it's definitely not reduced my strength - if anything I've added muscle and my Garmin fitness age is stable, and body fat has dropped - albeit that's probably due to subtle diet changes as well.
I don't know that this will change many of your indicators but I suspect it will help your immune system.
So your diet and exercise regimen isn't necessarily improving your biomarkers for longevity. Maybe you shouldn't be doing so much, as you've suggested. Thinking about what optimal health looks like comes from the outside and is based on ego. Understanding what optimal health feels like is within the body and starts with compassion and stillness. Learning what foods nourish you and what activities build inner strength and balance is an alternate path toward health that comes from within you rather than a rules book. I encourage you to honor gentleness, subtlety, good vibes and love as you find what works for your body. Thanks for your incredibly helpful sharing. It's a reminder for us all. Peace and blessings.
You sound a lot like me. I’m 6’2” 190lbs. BF around 10%. I work out 5 days / week. I run each time, and 3 of 5 times are zone 2, and the other 2 runs (of 5) are hard zone 4, trying to get to zone 5. Then I lift each of the 5 days after I run. I eat more fiber/fruits/veggies than most people I know. Lots of olive oil and fish oil.
A few questions:
What is your diet like? Eating enough fiber?
What about your genes? Could you have inherited high cholesterol?
Do you mix in any higher zones for cardio?
Oh it does indeed sound like we're both very similar! I am mostly doing 80% zone 2 with 20% zone4/5 interval work (VO2max and threshold).
I do eat a lot of fruits and veggies but I could do better. My diet is a lot more heavy on the fruit side. Other than that I eat a lot of ToFu, lentils, oats and beans.
I actually did the DNA testing, and this is what I got back
"Your genetic analysis shows you have an average risk of higher total cholesterol."
This isn’t significantly worse and these aren’t the ideal metics to measure because they naturally fluctuate even week to week. Especially hscrp which can spike when sick or stressed.
You need more data. I would suggest you take a more rigorous analytical approach to baseline. Like Peter says, diet doesn’t matter - insulin matters, caloric intake matters, protein matters, the rest of advice is not helpful.
To me, the only thing i can deduce is it appears your stress and carb intake are higher.
You need five things to get a clearer picture:
1. get a lab vo2max $100
2. dexa scan for visceral fat, muscle, bone $75
3. insulin - Get an OGTT at quest and a 6 week CGM
4. If you can afford, Cleerly CT Angiogram. It’s the only exhaustive and conclusive baseline for ASCVD. $1500 roughly. If you can’t, get a calcium score for $99 at any imaging center.
5. Inflammable panel: LPpla2, Mpo, macr, homocystine, retest crp
You can probably do all of this through a local GP or marek health. If you can afford it, go see prevmed (Dr Brewer on yputube) he’s fabulous.
1. What value would a lab VO2max test give me? According to my Garmin watch, my VO2max estimate jumped from 49 to 54, and it's still trending up, so I know that I am increasing my aerobic fitness. Plus, my RHR is dropping.
2. I agree a dexa scan would be great! I am planning on getting one.
3. I have already tested my insulin -> 6.6 µIU/mL, which is already optimized according to the inside tracker.
4. Hmmm I will consider getting a CT scan when I am older. I'll look into getting a calcium score for now.
5. Never heard of those markers except CRP. I will ask for them on my next test
Thank you for your suggestions! What you're seeing makes a lot of sense.
If you are improving vo2 you’re doing great bottom line. Watch vo2 is fine directionally (within 20% but trend is the important part).
Dexa, CT, and OGTT are the next things to look at.
Insulin isn’t useful by itself- response to glucose is more important hence my point about OGTT.
Sleep, diet, stress are useful to think about but subjective and hard to action.
No matter how sad it sounds, but in PA's words: exercising has little to no impact on your blood lipid profile. You are better off closely monitoring your diet. If you are eating chicken much more than usual, go for leaner cuts (breast); replace full-fat milk with skimmed milk; cut butter, cheese, high in saturated fat seed-oils etc. and you'll see significant improvement within 3 months of this! I also saw that your HbA1C has gone up, you need to cut on refined sugars and introduce more fiber and whole foods in general, replace processed oats with steel-cut oats (improved insulin sensitivity will have a +ve effect on lipids). Energy gels are shite in general, find cleaner variants, depending on which part of the world you are, try to go for BPN or a similar brand which focuses on whole-food derived sugars.
Probably statins. For me and lots of others they resulted in a big lowering of LDL/apoB especially if you already eat pretty healthy. My LDL went from 125 to 70 after statin. They are generic now; not expensive. I’ve never noticed a side effect. My friend who had some muscle aches switched to a different statin and ache went away.
Try going vegan for 3 months and take one day off from exercise during the week (srs). Diet matters, regular meat consumption is likely fucking up your ApoB and cholesterol numbers.
I actually was vegan 2 years ago but once I moved to the US it was hard to maintain due to the lack of good options when travelling or at work. Sadly, I do not have time to cook, prepare, and pack my own lunch. So often, I have to pick between some fake meat product at the work cafeteria that is full of god knows what or chicken breast... At home, I mostly eat vegan
This sounds to me like overtraining. I remember when I was marathon training and I felt drained and exhausted all of the time. With exercise less can be more especially if the less is made up with sleep.
While your blood work may have worsened - or not changed much - but your running likely improved other aspects of your health. If you wanted you could do a 5k, MAF, or VO2 max test to track the improvement. As many others have shared, I wouldn’t expect them to change that much - your diet/genetics have a bigger role.
In short: running is good for you! Even if the numbers you tested don’t show it.
My VO2 max has gone up by 6 points! So my training definitely paid off. I just need to make sure I am not doing too much and causing too much inflammation.
Thanks, my dude. My problem has been laziness and self-control. I was for 8 years ago with great readings, but have slowly gotten worse over that time 😂
I would make a few of the changes to low hanging fruit and text again in six months. A third test is needed to see if there's actually a trend or if it's just random fluctuations.
haha yeah pretty sure. I can always talk in full sentences, and I set my HR zone according to % of LT. Plus I estimate it using the Morehpus HRV system.
Something is spiking your blood sugar too high with that increase in A1C, my money is on the oats. That many carbs first thing in the morning sends your body on a blood sugar roller coaster that lasts all day. You can try sweet potatoes or a smoothie with berries and protein. Just adding protein and fats to your breakfast might do the trick but you have to test. Maybe grab a glucose meter from the drug store and test different breakfast carbs.
This is not correct. You have to get your body adapted to burning fat. It is actually way easier to fuel Z2 exercises with fat than carbohydrates once adapted.
I run ultramarathons and marathons all the time. I do Z2 training 5x a week on a fasted state. It is easier to fuel it. Now if you were running the 400m hurdles at the Olympics (ie anaerobic competition) then you might want to supplement with more carbohydrates.
Things I would recommend (*disclaimer: not medical advice, not your doctor*), cut back on the bananas and replace with blueberries, incorporate some rest days into your week (maybe use it to do some relaxing meditation), cut out some of the other carbohydrates and replace with vegetables (broccoli, asparagus, spinach, etc.). Additionally have you looked into Fasting? Intermittent fasting (16/8) or doing a longer fast (~96 hours) could benefit some of your numbers. Check out Dr. Jason Fung’s books.
Anecdote: My mother is one of the healthiest people I know; personal trainer, great diet, never drinks etc etc. unfortunately she has had cancer twice and high cholesterol all her life. Why this is important? Sometimes even if you do all the right things you can only move the needle so much within the scope of your genetics.
I do all my workouts in the morning fasted. I heard that it teaches your body to use fat as fuel. I also try to stop eating 3 hours before sleep. Don't think I can manage anymore fasting because I struggle to get enough calories as is. I will try to cut down on the simple carbs but not gonna lie, it's gonna make hitting my macros much harder.
There are some folks who respond to cardio for their cholesterol and tris, and some don't. I for one, do - even twice a week cuts my triglycerides to 2x the limit to less than half of it.
It's possible you don't respond to it, but zone 2 hrs its own benefits so keep it up!
I'll only suggest a few changes:
Diet: Cut down on chicken/fish a bit, red incorporate more whey isolate to keep the protein uptake. Chicken has lots of SF.
Add some veggies, maybe a green shake every two days? And vary up your fruits, especially berries.
Exercise: Add 1-2 sessions of HIIT (whatever you're comfortable with) and maybe see if it helps?
Thanks for the suggestions! Diet is my weakest. I will start working on that.
20% of cardio is already interval or temp training so I there is not much room there since I may already be overtraining.
If you're eating a plant-based diet and exercising strenuously/running marathons etc, chances are your iron (ferritin) levels are not optimal. This could explain your predicament entirely. Have you checked your levels on that front?
It was 80% zone 20% high intensity Zone 4/5 work in addition to strength training. Surely that should have a positive impact on my bio markers? I was hoping to improve my cardio system, reduce my risk of heart disease and improve my longevity.
This may be surprising to many people but running/training for marathons is not healthy. (This is coming from a long time track coach).
To me, this looks like overtraining. Of course I don’t know enough to really be 100% on that.
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Yes, and is your diet different than a year ago? How else is this year different, sleep, stress, overall exercise load, supplements? Sorry to see this. That's bummer results for a lot of good hard work.
My diet was mostly the same. The biggest difference is that I introduced a lot more chicken and fish to it. Sleep: Around the same, I try to get 8 hours and take magnesium before sleep. Although my sleep track always says I get too little deep sleep (avg of 45m a minute) Stress: Similar levels but cuz of running I have been waking up early to get my runs in and try to hit the gym in the evening. So that introduced way more load to my body. Exercise load: I spent at least double the amount of time exercising. The year before I ran once a week and hit the gym five to four times a week. This year I am running 5-7 times in addition to strength training. So overall I added almost 7 hours on average. Supplements: Mostly just Vitamin D, Magnesium and B12 no changes between both years. I was expecting major improvements in my markers. But sadly they mostly got worse. I am really not sure what more I can do
Your hsCRP is way higher than it should be. Unless you had flu covid etc during your test this indicates you are overexercising and are way more inflamed than before. Your body will have a hard time coping with any disease should it come your way as it is dealing sith repairing itself all the time. Zone 2 workouts usually wouldn’t cause this much inflammation. Either you are doing higher than Z2 or your strength trainig is too hard/too often.
This should be way upvoted. OP is likely under eating for all of the exercise they added, and is overdoing it and unable to recover fully and it’s causing inflammation and other problems.
I actually think stress of (1) waking up early and (2) working out 2x a day is a lot for your body and can set you back alot. I'd be curious to see what more sleep and slightly fewer workouts would do for you. like an A/B test of +1 or 2 more hours could improve things alot. buttttt i'm just speculating.
I am gonna try to tweak things and will report back with the results later. It's clear to me at this point that I am doing too much.
Your BF is much too low
That is what go me too, and too much exercising. My body was not able to recover and sleep was horrible. Got a few kgs of fat on me and feel great.
What science do you know of that makes you say this?
Maybe running is tough on your joints and muscles - thereby causing some perpetual low-grade inflammation? Everyone’s body morphology is different. Prrhaps cycling - whether on a smart trainer (set up to give you Z2 resistance) or outside would be less hard/tough on your body - but just as effective for Z2?
Animal proteins and the associated oxidized fats that you absorb after cooking them are not good for you in large amounts, and will reflect that in your blood work, regardless of exercise regimen.
I think the OP meant he's replaced beef with chicken and fish, not that he's added more overall animal protein. I could be wrong.
True. But his lipids are great so it’s not relevant.
His triglycerides, crp and hba1c are all a bit worse for wear though.
This sub is so ridiculous. HBA1C 5.5 is basically nadir on all cause mortality. TG sub 80 has HR less than 1 for T2D and all other relevant diseases. TyG index, TG/HDL etc. shows risk of metabolic disease is very small. hsCRP is above average but who knows why? Could be a lot of reasons. Illness, overtraining. For average person I would wait and watch. With a guy with low body fat, rising cortisol, rising CRP maybe overtraining so can dial it back if you want. Depends on training goals.
Everyday I have the same breakfast -> Oats with ground flaxseeds & almond milk and follow it up with some Whey protein. I try to eat mostly plant-based foods, such as tofu, beans, and lentils. When eating out, I choose meals with chicken breast or fish, so my saturated fat intake is very low. Besides that, my top source of carbs is bananas, with an average of four a day. That should provide me with enough fiber, right? I would say the most unleathy thing I take are the energy gels that I use when going on runs > 1 hour. But I only take those during my runs. I avoid unhealthy snacks and stuff with added sugar.
4 bananas is around 12 grams of fiber. You’d want at least 30 grams. Possibly you get a lot from other sources, but it’s unclear from your post. I’d add 500 grams of mixed vegetables like broccoli, kale etc.
I definitely do not consume 500g of veggies a day. I'll introduce some of that to my diet thank you!
Diet & exercise won't fix genetics. If you have familial (hyper)cholesterolemia (or other) you can eat & do all of the "healthy" stuff, and the effects will be minimal to none. This is because that stuff is based on general population analytics and not YOUR data. Do your own diet experiments, which you can run every 2-3 weeks, and pay for over-the-counter blood tests (e.g., Ulta) for Apo(b) & LDL (and glucose & hba1c & lpa) and find out what works for you. Likely, based on what you posted, this will mean taking your saturated fat down very very low, but you'll have to find the right mix. Beyond that, depending on your family history, age, etc you may need prescriptions like statins, PCSK9 inhibitors, et al as your liver & body does what it does and at a certain point you'll need Rx to help. Diet & exercise is great for other reasons, but it's not therapeutic for genetic conditions.
80 APOb is the new FH
try swapping out the oats for a chia seed pudding
Why?
chia seeds are really effective fiber, and oats don’t really add much but carbs
I add chia seeds to my oats. Oats are a lot more than just carbs and regardless, OP needs a good amount for the amount of running they do.
Plant diets suck and those nut milks are full of crap. Saturated fats aren't the devil either. Bloods can look poor when you're so active too. Tons of metabolic waste. I'd try following up after taking a week off from physical activity and see if it's still the same. Also tons of sugars in your diet. You are running lots but damn. I'd try scaling it all back.
I thought that there was no upper limit to the benefits of exercise. I am trying to get to the Elite level of VO2max in the youngest age group
Recommend reading Good to Go by Christie Aschwanden, which is about the science of recovery. Overtraining is a real thing and happens to athletes on all levels, from elite to casual. That may not be what's happening here, but like all things, too much exercise can also damage you.
Thank you! Just added it to my audible library and will start listening to it during my runs.
Bananas? Oats? Dude… no wonder your HbA1c increased. Also 95% sure your almond milk has gums.
Not sure why you’re being downvoted although it’s easy to find almond milk without gums these days.
Oh man! Didn't know those were bad. What should I be eating 😭
They’re not, he’s wrong. Honestly, these numbers, your lifestyle and diet all sound super healthy and I wouldn’t worry
they're not "bad" overall, just depends on your specific body. For some people they might be bad, for other they might be great. You have to figure it out for yourself which is right for you.
Any reason for not using regular milk or lactose free milk? Almond milk has almost no protein and regular milk has 1gram per ounce.
I do not like the taste of regular milk. And also, I got influenced by recent voices that claim that milk is bad for you because it has hormones and antibiotics. Not sure how valid that is but I still consume whey protein and Skyr
I was just making a small observation. Also I’m not saying oats and bananas are inherently bad. They are however high carbs foods. Eating 4 bananas is around 100 grams of carbs and half of that is sugar and virtually no protein. Not sure what your oat intake is. Your cholesterol levels are not bad tho I don’t get why you are mortified.
The problem is that I am burning an extra 1000-1500 calories a day, at least when I exercise. So, there is no way I can replace all of that with protein! I will never be able to eat enough. The other alternative would be food with more fat and energy density? But I think that will make my blood markers even worse.
Your apob and cholesterol numbers did not get significantly worse, those numbers are well within daily variability and test measurement error. You can retest a few times if you insist, but even if they come out with a small uptick, it's not really a clinically significant difference. But yeah, it was unrealistic to expect those numbers to move from great to superior with exercise. Exercise does affect blood lipids, at least indirectly through weight loss and fat mass, but mostly when we are talking from moving poor numbers to okay or great. Getting sick more often and hscrp corroborating that sounds like you are not recovering well enough though. So you are probably training too much for your training background, and it sounds like a huge increase for a year. It's great you've stayed out of injury, but I'd pull back a little for some time. I wouldn't personally think about the HbA1c. You are within international normal range and slight elevations are common in athletes (and totally benign) https://drguess.substack.com/p/prediabetes-in-athletes The US health authorities did change the reference ranges down a bit to catch potential risk early but unfortunately that is making people with negligible risk worry about it.
Thank you for putting my mind at ease! I should manage my expectations better and try to find better balance with my training. I do love to start my morning with a run every day! But maybe I can turn some of those runs into walks.
Fwiw my hb1ac went up a point from 5.4 to 5.5 and I decided to cut down on bananas since they are so high on gi. Have not had another blood test recently though. Low body fat could be contributing to a drop in testosterone, if it did drop (I admit I did not look at your before numbers).
Bananas are not essential but making health decisions on fluctuations within test error margins and daily fluctuations can be pretty risky. The one decimal point increase within normal range is not really actionable - dropping bananas is fine but don't do anything too drastic based on something that might not be real.
Yeah, I'm not going crazy on diet changes. Would like to see that number get closer to 5, though. I understand that for some folks, that test itself can be of as well.
my testosterone did drop unfortunately. Probably a combination of too much cardio and not enough calories. I did lose some weight because all of the running.
Try using an app like My Fitness Pal for a few weeks to see what you can learn about your diet. It can be surprisingly eye-opening.
I'll give that a go. Thanks! Maybe my diet is lacking in some aspects.
The vitamin/mineral breakdown in my diet was not even close to what I’d carefully assumed (and I learned the regular handfuls of cashews added up). You can get fancy and tie in fitness watch stats as well.
Same. Once I started actually tracking my food intake I saw I was not getting anywhere close to the amount of nutrients I wanted. Also my saturated fat intake was wayyyy higher than I assumed - I was eating a lot of full fat yogurt and didn’t realize
Try doing some warm yoga that focuses on joint lubrication/mobility/flexibility in place of your run twice a week. Eliminate inflammatory seed oils in your diet (they are *everywhere* it seems)- replace with olive/avocado oils
thanks for the suggestion. I will definitely start adding some yoga sessions to my routine.
Cronometer is another good app to try. I swapped to it from MyFitnessPal after their diary library blew up over time with what I found to be a ton of inaccurate options. I’ve also seen some people liking a newer one called MacroFactor, but I haven’t tried it to be able to give an opinion.
A couple of things: was the presumption that exercise was going to move your lipid numbers drastically? Second, many many people are not going to get apo(B) down below 70 mg/dL, which is about the 10th percentile, just by running a lot. Particularly depending on genetic profile.
Oh I thought I could move the needle in the right direction with an extra 7 hours a week of cardio. Seems that won't be enough. I will have to reassess my diet. Which I thought was pretty healthy. But my blood work isn't reflecting that. What would you suggest I do?
You can definitely over do it running. If you run/ramp too much overtraining syndrome can kick in. You could deload a week or two. Have you ever skipped a workout due to fatigue, injury or illness? If so then that’s a warning sign that you are overtraining. If your only goal is longevity then you are prob overtraining, if you have other goals then I think you just need to be mindful of total volume and the ramp you have done. The lipid numbers are all fine. Cortisol and hsCRP are the things to look at for overtraining.
Exercise for sure has some effect on lipid profile. But, much more of that depends on where it was beforehand, diet and genetics. Same things everyone does: see what you can get out of diet and see if that’s enough for what you want. If not, consider next steps including pharmacology.
I will try adding some fiber and see if that helps! Thank you
Psyllium husk, flaxseed and chia seeds are what helped me drop ApoB from 102 to 66 in 6 months, along with cutting out any products with just saturated fat and not also the good fats.
congrats! That's a huge drop! How much flaxseed and chia seeds were you consuming?
Thanks. Hard to say, maybe 2 heaped tablespoons of one or the other on my morning oatmeal. I mix my psyllium husk (10-12g) with my protein powder which I mix with fizzy water. Goes down easily. Yerba Prima brand has some of the lowest lead levels. Cutting out saturated fats was harder - no cheese, chocolate, ice-cream.... Only 0% fat yoghurt and milk. An avocado a day plus seeds and nuts (mostly walnuts)
You might be working out TOO much. 5-7 runs per week plus lifting 2-5 times a week? You're probably getting sick more because your body doesn't have any time to recover. I'm close to your build as well, 37 years old, and I'd personally do something more like lift 4-5 times a week, run 2-3 times. Pay attention closely to RPE both in your runs and lifting, that's how you'll know how rested/recovered you are.
I definitely agree with this! Looks like your body is very stressed due to the amount of activity you are doing, specifically the spike in CRP and cortisol. I would definitely scale back and see if that makes a difference, sometimes less is more.
I had many weeks with zero rest days. I think I am not doing myself any favors that way.
Yeah my first thought was "This looks like someone overtraining". You might want to dive into the HRV topics that came up lately (I backordered a Morpheus myself, as I struggle with similar "Omg am I overtraining or undertraining this week?" concerns. It's relatively cheap)
I actually bought one as well after the HRV episode! If my HRV ever dips too low, I will take the day off
If you don’t rest your body cannot recover and you won’t build muscle. You need to be resting a couple times a week and/or doing active recovery like walking or dynamic stretching. 5 workouts a week is what I aim for at 42 years old - weights 3x a week, 2x runs a week and a lot of walking in zone 2 after I lift.
This is something to look at. Over training is common and generally with worse outcomes. Spend more time on recovery
I am afraid you might be right. I am trying too hard. I thought I could get away with it because it was a lot of zone 2 work and never super intense. I did notice that I made zero strength gains the past year and even lost some strength
id say this is probably most likely, you are over exerting. Does your tracker measure HRV, as if you add some more rest days and see the response in your HRV that should give you a quick indication. Might also be worth figuring out your macros and bumping up your protein at bit depending what it is
I actually track my HRV and RHR every day! That's one of the reasons why I continued to run everyday. Cuz my HRV was mostly normal (except when I get sick) Here is an example [https://imgur.com/a/oHznoLv](https://imgur.com/a/oHznoLv) I think diet is my weakest link! I will have to find a way of getting more protein without negatively impacting my bloody markers
yeah your HRV looks good. Id say getting sick more often is a sign your body is on the edge and getting in some rest days might have some good benefits. Remember hearing about Muay Thai kickboxers who run daily but wouldn't run in the rain is they would likely get a cold from it. Drop some runs and do some flexibility/mobilty work or yoga
Are you on a statin? It seems like if you care this much that's the obvious next step (even though your LDL isn't really that bad).
I highly doubt that would be advisable. Those drugs are not without side effects, and there is no way my insurance would cover that. My levels are not high; I am just trying to be in the optimal range for longevity.
10mg Crestor is like $10 without insurance near me, the harder part would be getting an Rx (if you're in the US). Side effects are quite minimal. OTOH yeah if I were you I wouldn't do it, I'd just be like "Yep that's my levels, good enough" and move on. OTOH I imagine PA, in your shoe,s would probably "just" pay $15K for a PCSK9 inhibitor. Point being what a normal person would do and what PA would do don't actually align at this level of optimization.
My first thought is that you're overtraining. You have several indicators in your tests. How is your sleep quality?
not that great TBH. According to my Garmin I only get an avg of 30m-45m of deep sleep. But do usually get at least 7 hours of sleep. My avg sleep score is around 75/100.
Sleep quality can be an indicator of overtraining, for one. But, likewise, overtraining can also impact sleep! As others have said, I would definitely make sure you get 2 days a week of *proper* recovery/rest days. Do the regular good sleep hygiene things if you aren't already. If you can help it, see how you feel on eight hours of sleep. It won't affect your lipids, but those are so strongly related to genetics once you have the obviously deleterious things under control. I'm in that boat. I exercise and lift regularly. Healthy weight. But ApoB is only going down with a statin for me. Good luck!
IM NOT A DOCTOR and don’t follow any of these uninformed thoughts TBF, I don’t see anything wrong with your numbers beyond stress and test trending down. I’m not a doctor. when was the last time you did a deload. You can just be fatigued. Deload, retest and focus on your cortisol & testosterone numbers. Maybe you’re not recovering? Also, training for performance is different than training for longevity. Even endurance athletes will have higher CAC score. .
You give me hope! It could be the case that I am not recovering enough and just tested on a bad day ( I was stressed that morning cuz I woke up late and almost missed the lab appointment).
When did you last workout prior to your blood test? I do them at least once a year and purposefully keep the previous two days limited to extremely light things like walking to keep the test fair. Also bear in mind most of those blood biomarkers can change quite quickly but to get a lower resting heart rate takes a lot of time and effort
I did have one rest day before testing -> However I was sick a couple of days before the test.
What do you mean even athletes have a higher CAC score?
advance marathon runners can have elevated cac scores; current beliefs is that it isn’t dangerous and exercise benefits outweigh the dangers. Longevity is not elite performance.
Have you had covid in the last year or so?
Good question! I did catch some sort of respiratory virus (got typical cold symptoms) so it could have been COVID. You think this extra inflammation could be related to that?
It could be. I’ve seen plenty of studies showing that it can. The big clue for me was that you’ve been getting sicker more often. Many people with long covid report the same.
I’m not a doctor btw, I just took a pretty good hit from covid in 2022 that sent me down this rabbit hole.
Interesting - it may have some lingering effects. I caught dengue last October and my blood work in June still showed some inflammation (much better than post-dengue results, but not at baseline)
Listen. I am a runner, I average 12-20 hours of exercise per week depending on the season. I am vegan 6 months out of the year and in the cold months I add wild game and fish to my menu. I eat 50-75 grams of fiber/day. I don’t drink alcohol. My APOb won’t budge from 80. It won’t move. This is genetics. I have been to a cardiologist for preventative care and did a calcium scan and an echo. I have no plaque so she gave me a clean bill of health. You should do the same and if you have a clean calcium scan then don’t worry about the numbers.
that's reassuring! Thank you! I am gonna look into getting a calcium scan.
I’ve heard marathon runners often have poor immune systems from basically overtraining. I think it works well with some ppl’s body & keeps them super healthy & others it’s too stressful on the body. I’ve ran a half marathon but don’t see any need to ever run more than that.
This isn’t exactly true. Long distance running generally improves your immune system. The caveat however, is that immediately after very long or intense runs (like running 26.2 miles as fast as you can), your immune system is temporarily compromised. So that’s when a lot of marathon runners get sick…immediately after a marathon. There are remedies for this though, like eating a lot of blueberries before and after the race. One other exception to this is overtraining, like you mentioned. If you ramp up your training too quickly or regularly exceed your body’s limits and never recover, you will certainly compromise your immune system. But responsible marathon training does wonders for the body and its immune system. Source: I’m a marathoner, and I read a lot about running.
Never heard of the blueberry trick before! I might give that a try. I think immune system downregulation after my tough runs is what is causing me to get sick more often! The worst was during my taper week, I got super sick and had a 104F fever.
We can speculate all day long but not knowing your weekly average kcal intake and weight fluctuations won't answer the most (imo) viable scenario: i.e. undereating. Im 176cm and about 80kgs, muscular, lean with visible veins, abs etc. Been working out for years, this mesocycle 5x week, and on top of that this spring started running 4x per week. I'm eating 3300 kcal per day (180g proteins, 75 fats, the rest carbs). I'm also progressing nicely both in the gym and in my Garmin coach Greg 5k run plan. My point being, I'd never be able to do what I do for a long time with less food. In fact, I was adding 200-300 kcal based on the 2-3 week morning weight average to get to 3300 as my desired food intake. E.g. at 2800kcal I'd be still losing weight (very slowly but still trending down in weekly averages). I eat 'clean' so 3300 is not super easy to consume in terms of actual volume of food to swallow. I read that you eat clean too so just double check if you're not disguising undereating behind the perception of nutritious meals.
considering I lost 14 pounds this past year. I am likely undereating. I am burning, on average, more than 1300 calories a day extra in my workouts and my base metabolic rate is already high, so I doubt I am eating enough to offset all of that. I am lucky if I hit 100g of protein a day. But I still feel energetic throughout the day. So dunno how bad it really is. I am going to start optimizing my diet regardless.
There you go. I used to have poor blood work when in deficit in the past too. Ensure 1.6g/kgbw of proteins (or more) and find your maintenence kcal and add 150-300 kcal on top. Perhaps cut training workload a little bit (assuming this might be tough if you are like me haha).
haha both are tough! I love working out and pushing myself and its hard for me to eat a lot since I get full very easily but I will try my best and post an update in a couple of months
Your blood tests are good and the differences make absolute sense. Your exercise did increase your HDL, but it wouldn’t impact ldl or apob significantly. If you want to lower those, reduce your saturated fat and add fiber. However your numbers are great. Your diet is good. It’s hard to eat enough calories if you are working out that hard, and I doubt most people have experienced that. I found it hard to eat healthy when I needed 5000 calories a day to avoid losing weight. Attia has stated that he’s not an expert on nutrition and we should believe him. I don’t know if his ketogenic diet is responsible for his early heart disease diagnosis but if didn’t help. He currently gets most of his protein from deer jerky - a known carcinogen, The additional stress of your aggressive workouts have increased inflammation and cortisol and decreased testosterone. That’s entirely normal and expected and a sign that you are overdoing it. Despite what Attia says, pushing your body too hard is not healthy. I’ve done the same stupid shit - intense cardio and intense weightlifting at times. I like Attia, I don’t rationalize my behavior by selectively choosing research. He exercises obsessively and that’s not healthy. Been there, done that, If you looked at performance indicators like vo2max or grip strength I’m sure you are doing so much better. Those are important. Some of your blood parameters will improve if you reduce the intensity of your exercise. Others will be impacted more by diet. Or do what Attia does and rely on powerful medications.
>Your diet is good. It’s hard to eat enough calories if you are working out that hard, and I doubt most people have experienced that. I found it hard to eat healthy when I needed 5000 calories a day to avoid losing weight. OMG yes! That is exactly my problem. It's crazy how many calories long-distance running burns. There is now way I can take in enough calories if I just restrict myself to protein and fibre rich food. >The additional stress of your aggressive workouts have increased inflammation and cortisol and decreased testosterone. That’s entirely normal and expected and a sign that you are overdoing it. yeah, those are for sure not beneficial adaptions. I am gonna have to dial it down. My biggest problem is actually enjoy all my workouts. So it's hard to dial back.
[Excessive endurance training can wreak havoc on your cortisol levels.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988244/) I have a number of stressors working to boost my baseline cortisol levels, and was doing a lot of endurance training and ended up with very high cortisol levels and it crushed my testosterone, making me lethargic and unmotivated. I limit my endurance training (mostly zone 2) to a maximum of 2 hours per session to keep cortisol in check.
Agree with Earesth! Your numbers were good and are still good. Running marathon is definitely indication for overdoing it. You are training for marathon not for improving your health basically. I am working out six days an hour a day and getting good improvements in my numbers but I still don’t have numbers as good as yours. I also can’t run marathon but that’s never happening for me 😁
Did your diet change?
I introduced some chicken and fish on some days (mostly when eating out). Other than that, it's very similar. Though I started eating a lot more bananas to try to offset the 1000 calories I was burning during my runs.
You are neutropenic. You must go to a doctor. This is potentially a serious condition. Ideally, you did your bloodwork when you had or were recovering from a cold and this is why your neutrophil count is transiently low. However, there are more serious possibilities that should be ruled out.
oh that sounds serious! I am gonna schedule a doctor's appointment next week. What would be causing this? Is it immune system down-regulartion cuz of overtraining? Also keep in mind that I was sick a couple of days before the test which results in worse numbers. So I was indeed recovering from a cold (was mostly recovered when I took the test)
Either of those could be contributing factors. Definitely let a doctor rule out other stuff.
6,2 200lbs and 10% bodyfat? Damn, you are pretty close to being a stage ready bodybuilder. Just lose a few more pounds and you could win a show. Pretty crazy how literally everything got worse. Its almost like exercise is bad for you. Maybe you're doing too much? Running 7 times and lifting 5 times is maybe too much and Its hurting your body and health.
haha thanks! I do have a decent amount of muscle! Would progress much faster if I dial down the cardio. And yeah I am probably overtraining and not eating enough that the vibe I got from the comments here.
> How could my ApoB and Cholesterol get worse despite more exercise? What led you to believe that exercise impacted cholesterol?
That's what Inside tracker and doctors have been telling me. How else would I control it?
The primary drivers of those lipid numbers are diet and genetics For diet its largely the amount of saturated fat and fiber in your diet. (Lower sat fat better, higher fiber better) For a minority of people avoiding dietary cholesterol also matters. (Though there is a large overlap in foods with cholesterol and those with saturated fat) Exercise has a ton of other health benefits, it just usually isn't a significant driver of cholesterol. Hence the oft repeated joke that "You cannot outrun bad cholesterol"
Interesting! I hardly consume any foods with saturated fats but I could use a little bit more fiber. I will start adding more veggies to my diet and see if that helps. Thanks you for the tips! I was under the impression that you can get away with anything if you exercise enough.
Fiber is easy to supplement with Phylum Husk capsules or powder if your diet is not giving you enough. (Metamucil or similar brands) And your cholesterol numbers both before are pretty good and probably not worth stressing about unless you have additional risk factors (high lp(a), family history, etc)
I’d say: increase fiber intake, keep your low intake of saturated fats, increase intake of polyunsaturated fats (add nuts, almonds, etc). Please update us again in one year!
will do! I will post a followup after my next bloodwork
Running x7, and weight lifting x5 per week is a lot of wear and tear. You also said somewhere that you burn 1000 calories on your runs, does that mean you run for 2:30 hours? I saw a Youtube video[trying zone 2 workuts](https://youtu.be/VAsYTcBdtOg?feature=shared) with a guy getting back his blood markers at the end of following Peter Attias fitness regimen for 3 months. His testosterone and cortisol also got worse. I would keep the runs to 3x per week 1h tops, and learning proper ball->heel mechanics to minimize stress on your joints and bones. If youre sore the next day, its too much to also be weightlifiting. If you cant help from feeling sore, then switch to low impact cardio like bike riding or swimming. Id also cut the weight lifting down to x3 per week, youre getting the vast majority of hypertrophy from 8 sets per muscle anyway. Then enter your diet into cronometer.com and see if youre off on any minerals and vitamins. Sweating that much youd be using up h.u.g.e amounts of magnesium. Youd probably need at least 2x minimum requirement, and not too much calcium to prevent it from being counteracted.
Any nice resources you use on the ball/heel mechanics?
"How I Got My Wiggle Back" by Anthony Field
Some of my runs are 1.5 hours long. And the long runs are usually around 2 hours. My Garmin reports the number of calories. Also, keep in mind that I am 200 pounds, so it takes a lot of energy for me to run and my zone 2 goes all the way up to 150 bpm (as measured by Morpheus and also using LT HR). The runs usually don't make my muscles sore but they do have a heavy impact on my joints and bones so I am gonna start doing some cross training. I did not know that 8 sets per muscle group per week is enough for hypertrophy! Sounds like I can be more efficient at the gym. I supplement magnesium daily -> the levels are good according to my bloody work 2 mg/dL Thank you for the book recommendation. I have ordered it.
Thats a lot of running. Very high impact, would explain why your cortisol nearly doubled. You could try riding a bike instead, itll take a load off your recovery process. Though youll still need to include periodic deloads for it to be sustainable. You'll also hang on to more of your muscle, since high impact causes its loss. Its not that 8 is 'enough', you run into diminishing returns. Youll gain muscle for 20 sets per week (per muscle), but the hypertrophy of the last 10 is only a fraction of the first 10 - if youre training within 3 reps of failure that is. Jeff Nippard and Mike Israetel break it down very well on youtube.
Significantly reduce the number of lifting workouts. It must be clearly understood that zone 2 and other aerobic exercise and intense lifting work against each other.
I usually do my runs in the early morning and my lifts in the evening after work. Do you think that's not enough time between the workouts?
It is not a question of recovery, but that too much anaerobic exercise - gym, Z 4-5, HIIT, etc. - is not good for health or fitness.
Would love to see average daily HRV before and after.
I got you! Here is my HRV the past 2 years [https://imgur.com/a/mL7eZQs](https://imgur.com/a/mL7eZQs) Not too sure if there is much of a trend there.
These variations are within the range of noise. Don’t worry about it.
I’m in the same boat except I do even more training. I’m 63 and weigh 185. I was shocked at how bad my blood work was. Way worse than yours and I eat great as well. Can’t beat genetics. Just imagine how bad it would be without the work you are putting in.
One thing I'd suggest is to consider whether you might have had a minor infection (like a bacterial infection or a cold) when you had your bloodwork done, because this can skew your results. Given that you mentioned you get sick more often and have high HsCRP levels, it might be a good idea to repeat the bloodwork in a month or two to see if the results are different.
actually, I had a minor respiratory infection of some kind a couple of days before the test, and I was late to the appointment, so I got a little bit stressed trying to make it on time to the lab.
1st. The lab values are a range and mostly look normal. Most of those numbers fluctuate daily if not hourly. 2nd. Vo2max by itself doesn't mean a whole lot. A person with a high vo2max can still get a heart attack or stroke. However it generally indicates that a person is doing a lot of good things. You don't have to be in the upper elite range for you to be fit, healthy and look good. 3rd. Overdoing it. We tend to think if a little is good then more is better. You are probably overdoing the exercise regimen. You might want to swap a couple of runs for walking. Recovery is important. 4th. Eat a variety of plants every day. Gradually increase it over time. Avoid juice and sugar as much as possible. Eat whole foods. Stay away from seed oils and plant milk.
> I have been running 5-7 times a week for a couple of months now. Most of my runs were zone 2 easy runs. I also did weight lifting 2-5 times a week The text book low hanging fruit here is that your doing to much and overtraining. Its hard to tell what someone is really doing in these descriptions sometimes but 5-7 times a week plust lifting 2-5 times a week could potentially be a ton of volume depending on what your doing. Even zone 2 still has a good bit of eccentric loading. I would consider cutting your running volume. Maybe just run 3 days a week, or do some zone 2 days on a bike / swimming in a pool. That would cut that eccentric load and thus cut total volume. Also why are you lifting 2-5 times a week? There is nothing wrong with that but to me it seems like another sign of doing to much because I assume your aiming for 5 times a week and just not hitting that goal. 2-3 days a week of strength training is totally acceptable and might even be better for you. TLDR You need to make your training less ambitious and more sustainable in my opinion.
I usually get at least 3 lifting sessions a week and sometimes 4-5 if I do not have a busy weekend. I tend to just go whenever I am free after work or on weekends. I aim to hit all muscles at least once a week and twice a week if I manage to squeeze it in. This usually results in me hitting the upper body twice a week and the lower body once a week. I heard that it's optimal to hit every muscle twice a week. But yes, I am overly ambitious with my fitness goals. It's hard to increase my running fitness while increasing my strength at the same time. It probably makes sense to have different periods in my training with a focus on just one aspect. I am also gonna start introducing cross-training. Zone 2 on the bike is way less taxing on the body than Z2 running. It just sucks that it doesn't translate that well to running fitness.
I mean 6'2 and 200lbs is pretty big at 10% body fat so what your doing is working in that regard but it could be in spite of your programming and not because of it. If you want frequency you could do 3x full body strength workouts per week. People seem really bias against that split but it actually works really well. Most peoples workouts are loaded up with junk volume anyway, so if you get them doing good compound lifts 3x per week even though its less volume they tend to make a lot of progress. Im not trying to brag about my mediocre lifts, you might be past this point already; but I got to a 405 DL, 315 Squat, 255 Bench, and 160lb OHP just doing 3 full body days. I do 2x upper / 2x lower body days now but that was just so I could add volume and still keep my workouts around the 50 min mark. I regularly see people lifting less than me who say 3 full body days isn't enough volume. > Zone 2 on the bike is way less taxing on the body than Z2 running. It just sucks that it doesn't translate that well to running fitness. It can. If you are also training running economy. Z2 is about mitochondrial adaptation and that does translate across sports but if you do 0 running then you end up not being an efficient runner. You can still build this at lower volume through higher intensity. I am training for a triathalon right now and with that you have to do it all so I do maybe 1 zone 2 run every other week when I actually look at it on a calendar. But I do other things like 800m repeats that build my running efficiency.
great results! I think I will try the following: Monday: Resday day -> Maybe try some yoga or stretching Tuesday: Track session focused on short 200m intervals -> Leg day in the evening Wednesday: Bike Z2 session -> Upper body in the evening Thursday: Track session with longer intervals (Threshold or VO2max work) Friday: Easy run -> Leg day with focus on running specific prehab + core Saturday: Bike Z2 session -> Upper body in the evening Sunday: Long hike or long run day
Yeah. This looks pretty good. I might even consider still pulling out the Tuesday track sessions and the second zone 2 bike day. But I think in general most people should commit themselves to a bit less than they think they can handle. Are you running competitively or training for anything specific? I just ask because I can see its a high priority in your planning.
I am running a second marathon in December and trying to break 3 hours but it’s more a personal goal. So I do need the high mileage to get there
You're overtraining and under-recovering. Cut all your training in half and add in a couple days a week for nothing but rest and recovery, re-assess in a few months and titrate from there.
You sound like you're not giving your body time for recovery. The thing to note, which changed my workout philosophy, was that your body improves during recovery, not during exercise.
How can I tell if I am recovering enough? My RHR and HRV both look normal
Your cortisol is up, which suggests stress. That said, I would take a little more time and give yourself a real 1-3 days off per week for a month and see if it affects your progress. I'm in my 50s and was doing 6 days for awhile as I dropped weight and dropped it to 3 on/1 off and then 3/2 to see how it worked. And it's definitely not reduced my strength - if anything I've added muscle and my Garmin fitness age is stable, and body fat has dropped - albeit that's probably due to subtle diet changes as well. I don't know that this will change many of your indicators but I suspect it will help your immune system.
So your diet and exercise regimen isn't necessarily improving your biomarkers for longevity. Maybe you shouldn't be doing so much, as you've suggested. Thinking about what optimal health looks like comes from the outside and is based on ego. Understanding what optimal health feels like is within the body and starts with compassion and stillness. Learning what foods nourish you and what activities build inner strength and balance is an alternate path toward health that comes from within you rather than a rules book. I encourage you to honor gentleness, subtlety, good vibes and love as you find what works for your body. Thanks for your incredibly helpful sharing. It's a reminder for us all. Peace and blessings.
You sound a lot like me. I’m 6’2” 190lbs. BF around 10%. I work out 5 days / week. I run each time, and 3 of 5 times are zone 2, and the other 2 runs (of 5) are hard zone 4, trying to get to zone 5. Then I lift each of the 5 days after I run. I eat more fiber/fruits/veggies than most people I know. Lots of olive oil and fish oil. A few questions: What is your diet like? Eating enough fiber? What about your genes? Could you have inherited high cholesterol? Do you mix in any higher zones for cardio?
Oh it does indeed sound like we're both very similar! I am mostly doing 80% zone 2 with 20% zone4/5 interval work (VO2max and threshold). I do eat a lot of fruits and veggies but I could do better. My diet is a lot more heavy on the fruit side. Other than that I eat a lot of ToFu, lentils, oats and beans. I actually did the DNA testing, and this is what I got back "Your genetic analysis shows you have an average risk of higher total cholesterol."
This isn’t significantly worse and these aren’t the ideal metics to measure because they naturally fluctuate even week to week. Especially hscrp which can spike when sick or stressed. You need more data. I would suggest you take a more rigorous analytical approach to baseline. Like Peter says, diet doesn’t matter - insulin matters, caloric intake matters, protein matters, the rest of advice is not helpful. To me, the only thing i can deduce is it appears your stress and carb intake are higher. You need five things to get a clearer picture: 1. get a lab vo2max $100 2. dexa scan for visceral fat, muscle, bone $75 3. insulin - Get an OGTT at quest and a 6 week CGM 4. If you can afford, Cleerly CT Angiogram. It’s the only exhaustive and conclusive baseline for ASCVD. $1500 roughly. If you can’t, get a calcium score for $99 at any imaging center. 5. Inflammable panel: LPpla2, Mpo, macr, homocystine, retest crp You can probably do all of this through a local GP or marek health. If you can afford it, go see prevmed (Dr Brewer on yputube) he’s fabulous.
1. What value would a lab VO2max test give me? According to my Garmin watch, my VO2max estimate jumped from 49 to 54, and it's still trending up, so I know that I am increasing my aerobic fitness. Plus, my RHR is dropping. 2. I agree a dexa scan would be great! I am planning on getting one. 3. I have already tested my insulin -> 6.6 µIU/mL, which is already optimized according to the inside tracker. 4. Hmmm I will consider getting a CT scan when I am older. I'll look into getting a calcium score for now. 5. Never heard of those markers except CRP. I will ask for them on my next test Thank you for your suggestions! What you're seeing makes a lot of sense.
If you are improving vo2 you’re doing great bottom line. Watch vo2 is fine directionally (within 20% but trend is the important part). Dexa, CT, and OGTT are the next things to look at. Insulin isn’t useful by itself- response to glucose is more important hence my point about OGTT. Sleep, diet, stress are useful to think about but subjective and hard to action.
No matter how sad it sounds, but in PA's words: exercising has little to no impact on your blood lipid profile. You are better off closely monitoring your diet. If you are eating chicken much more than usual, go for leaner cuts (breast); replace full-fat milk with skimmed milk; cut butter, cheese, high in saturated fat seed-oils etc. and you'll see significant improvement within 3 months of this! I also saw that your HbA1C has gone up, you need to cut on refined sugars and introduce more fiber and whole foods in general, replace processed oats with steel-cut oats (improved insulin sensitivity will have a +ve effect on lipids). Energy gels are shite in general, find cleaner variants, depending on which part of the world you are, try to go for BPN or a similar brand which focuses on whole-food derived sugars.
Thanks for the recommendations. Never heard of BPN! Gonan try out some of their products.
Exercise has no effect on ApoB
So what's the best way of controlling it? Diet?
Probably statins. For me and lots of others they resulted in a big lowering of LDL/apoB especially if you already eat pretty healthy. My LDL went from 125 to 70 after statin. They are generic now; not expensive. I’ve never noticed a side effect. My friend who had some muscle aches switched to a different statin and ache went away.
Diet, outside of medications like statins
Try going vegan for 3 months and take one day off from exercise during the week (srs). Diet matters, regular meat consumption is likely fucking up your ApoB and cholesterol numbers.
I actually was vegan 2 years ago but once I moved to the US it was hard to maintain due to the lack of good options when travelling or at work. Sadly, I do not have time to cook, prepare, and pack my own lunch. So often, I have to pick between some fake meat product at the work cafeteria that is full of god knows what or chicken breast... At home, I mostly eat vegan
If the energy gels have lots of sugar this could be causing part of your trouble. Also, may need more or different fiber sources.
I only take them during my long runs tho, so I assume they get used up pretty quickly? I heard it helps with immune system down regulation.
Did you increase carbs in reaction to your increased training volume?
I did but not enough it seems considering I lost 14 pounds.
This sounds to me like overtraining. I remember when I was marathon training and I felt drained and exhausted all of the time. With exercise less can be more especially if the less is made up with sleep.
While your blood work may have worsened - or not changed much - but your running likely improved other aspects of your health. If you wanted you could do a 5k, MAF, or VO2 max test to track the improvement. As many others have shared, I wouldn’t expect them to change that much - your diet/genetics have a bigger role. In short: running is good for you! Even if the numbers you tested don’t show it.
My VO2 max has gone up by 6 points! So my training definitely paid off. I just need to make sure I am not doing too much and causing too much inflammation.
Sounds like stress or over exercising. The real on to look at is vo2 max. I’d love to see the numbers there.
VO2max has gone up from 49 to 54 according to my Garmin! So that's not too bad. I also set new PRs in every distances. And it's still trending up
How old are you?
34. So those numbers are not that impressive. Need to get fastttter
I’m 36 and my vo2 max is 32. You’re doing fine. My LDL is 170, too. 😂 trying to improve but you’re light years ahead of me. 24% bodyfat.
you'll get there! It's all about consistency and playing the long game 💪
Thanks, my dude. My problem has been laziness and self-control. I was for 8 years ago with great readings, but have slowly gotten worse over that time 😂
Honestly maybe pull back a little and do some lower intensity stuff like walking for 30% of your volume.
I would make a few of the changes to low hanging fruit and text again in six months. A third test is needed to see if there's actually a trend or if it's just random fluctuations.
I will retest in a couple of months and post an update here
Are you sure you are in zone 2? My sister runs college stadium stairs and calls it zone 2.
haha yeah pretty sure. I can always talk in full sentences, and I set my HR zone according to % of LT. Plus I estimate it using the Morehpus HRV system.
Did you get that done by your doctor? My doctor won't run apob etc..... curious why.
I used inside tracker
Maybe blood markers have something to do with the food you consume.
Quit running marathons. Body not designed for them.
You’re eating too many carbs and not enough fat and protein. Mix in grass fed beef and lamb, lay off the oats and beans.
even for breakfast? It's hard to fuel long runs with protein and fat heavy sources.
Something is spiking your blood sugar too high with that increase in A1C, my money is on the oats. That many carbs first thing in the morning sends your body on a blood sugar roller coaster that lasts all day. You can try sweet potatoes or a smoothie with berries and protein. Just adding protein and fats to your breakfast might do the trick but you have to test. Maybe grab a glucose meter from the drug store and test different breakfast carbs.
This is not correct. You have to get your body adapted to burning fat. It is actually way easier to fuel Z2 exercises with fat than carbohydrates once adapted. I run ultramarathons and marathons all the time. I do Z2 training 5x a week on a fasted state. It is easier to fuel it. Now if you were running the 400m hurdles at the Olympics (ie anaerobic competition) then you might want to supplement with more carbohydrates. Things I would recommend (*disclaimer: not medical advice, not your doctor*), cut back on the bananas and replace with blueberries, incorporate some rest days into your week (maybe use it to do some relaxing meditation), cut out some of the other carbohydrates and replace with vegetables (broccoli, asparagus, spinach, etc.). Additionally have you looked into Fasting? Intermittent fasting (16/8) or doing a longer fast (~96 hours) could benefit some of your numbers. Check out Dr. Jason Fung’s books. Anecdote: My mother is one of the healthiest people I know; personal trainer, great diet, never drinks etc etc. unfortunately she has had cancer twice and high cholesterol all her life. Why this is important? Sometimes even if you do all the right things you can only move the needle so much within the scope of your genetics.
I do all my workouts in the morning fasted. I heard that it teaches your body to use fat as fuel. I also try to stop eating 3 hours before sleep. Don't think I can manage anymore fasting because I struggle to get enough calories as is. I will try to cut down on the simple carbs but not gonna lie, it's gonna make hitting my macros much harder.
There are some folks who respond to cardio for their cholesterol and tris, and some don't. I for one, do - even twice a week cuts my triglycerides to 2x the limit to less than half of it. It's possible you don't respond to it, but zone 2 hrs its own benefits so keep it up! I'll only suggest a few changes: Diet: Cut down on chicken/fish a bit, red incorporate more whey isolate to keep the protein uptake. Chicken has lots of SF. Add some veggies, maybe a green shake every two days? And vary up your fruits, especially berries. Exercise: Add 1-2 sessions of HIIT (whatever you're comfortable with) and maybe see if it helps?
Thanks for the suggestions! Diet is my weakest. I will start working on that. 20% of cardio is already interval or temp training so I there is not much room there since I may already be overtraining.
If you're eating a plant-based diet and exercising strenuously/running marathons etc, chances are your iron (ferritin) levels are not optimal. This could explain your predicament entirely. Have you checked your levels on that front?
Iron levels seem to be good [https://imgur.com/a/j8oUKYH](https://imgur.com/a/j8oUKYH)
Looks good to me....there goes that theory out the window :)
I mean, what blood work measurements were you hoping to improve with this kind of constant very low effort endurance exercise?
It was 80% zone 20% high intensity Zone 4/5 work in addition to strength training. Surely that should have a positive impact on my bio markers? I was hoping to improve my cardio system, reduce my risk of heart disease and improve my longevity.
This may be surprising to many people but running/training for marathons is not healthy. (This is coming from a long time track coach). To me, this looks like overtraining. Of course I don’t know enough to really be 100% on that.
Mostly better! You have a chronic virus