Dr. Hanjabam Barun, Sports & Exercise Medicine Specialist

29/08/2026

When ALA sucks ...literally, all the glucose away - Yes, lipoic acid lowers blood glucose - in certain genotypes potentially enough to make you pass out ( )

Alpha-Lipoic Acid (ALA) is a popular staple for metabolic health and nerve support, but for genetically susceptible individuals, it may trigger a rare "metabolic storm" known as Insulin Autoimmune Syndrome (IAS) or Hirata disease. This immune-mediated disorder causes your body to produce autoantibodies that bind to your own insulin.

The result is a roller coaster of blood sugar: early postprandial hyperglycemia followed by severe, delayed blood sugar crashes (hypoglycemia) as the insulin is unpredictably released back into the bloodstream

But why? Well, when the antibodies bind the , they don't work efficiently, so your insulin levels skyrocket to make up for the lack of efficacy; and then 🛌🏽

When the auto-antibodies which are only loosely bound to insulin fall off (right when your blood glucose is already normalizing) the your body created becomes active all at once and your (hopefully still) insulin-sensitive body sucks up all the glucose that's left =>

⚠️ Warning: It is unlikely that you have a genetic preponderance for , but if you experience unexplained sweating, tremors, or dizziness 2–6 hours after eating while supplementing with ALA, consult a professional.

☝🏽 Fortunately, the "fix" is usually simple: discontinue the supplement. While the symptoms may resolve within a week or two, your body will react immediately, even with much smaller doses of ALA in the future, because the (auto-)immune reaction, once primed, has to be "outlearned" over months, not weeks.

| Vallianou, N. G., Kounatidis, D. C., Dalamaga, M., Panagopoulos, F., Psaroudaki, M., Tantsi, I., & Stratigou, T. (2026). Alpha-Lipoic Acid as a trigger of insulin autoimmune syndrome: Current evidence, a case-based approach, diagnostic pitfalls, and practical management. Metabolism Open.

28/08/2026

27/08/2026

Youth athletes cannot be categorised by chronological age only.

As a parent or coach, there are multiple types of age a child can have that are beneficial to be aware of.

These give us an insight into growth and emotional maturity. This means children can be handled better, from communication to training group selection.

Read the article for free below.

https://www.scienceforsport.com/chronological-biological-technical/

26/08/2026

(POTS) is a chronic autonomic disorder defined by orthostatic symptoms with a sustained heart rate increase within 10 minutes of standing or head-up tilt, without orthostatic hypotension.

This indicates that can substantially impair daily functioning and quality of life, with common symptoms including lightheadedness, palpitations, fatigue, cognitive dysfunction, exercise intolerance, and gastrointestinal symptoms.

🔗 https://ja.ma/46g9BKC

26/08/2026

Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health

Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers ...

26/08/2026

Measures of substrate oxidation have traditionally been calculated from indirect calorimetry measurements using stoichiometric equations. Although this has proven to be a solid technique and it has become one of the standard techniques to measure whole body substrate metabolism, there are also several limitations that have to be considered. When indirect calorimetry is used during exercise most of the assumptions on which the method is based hold true although changes in the size of the bicarbonate pool at higher exercise intensities may invalidate the calculations of carbohydrate and fat oxidation. Most of the existing equations are based on stoichiometric equations of glucose oxidation and the oxidation of a triacylglycerol that is representative of human adipose tissue. However, in many exercise conditions, glycogen and not glucose is the predominant carbohydrate substrate. Therefore we propose slightly modified equations for the calculation of carbohydrate and fat oxidation for use during low to high intensity exercise. Studies that investigated fat oxidation over a wide range of intensities and that determined the exercise intensity at which fat oxidation is maximal have provided useful insights in the variation in fat oxidation between individuals and in the factors that affect fat oxidation. Fat oxidation during exercise can be influenced by exercise intensity and duration, diet, exercise training, exercise mode and gender. Although a number of important factors regulating fat oxidation have been identified, it is apparent that a considerable degree of inter-subject variability in substrate utilization persists and cannot be explained by the aforementioned factors. Future research should investigate the causes of the large inter-individual differences in fat metabolism between individuals and their links with various disease states

26/08/2026

Both carbohydrate (CHO) and caffeine have been used as ergogenic aids during exercise. It has been suggested that caffeine increases intestinal glucose absorption, but there are also suggestions that it may decrease muscle glucose uptake. The purpose of the study was to investigate the effect of caffeine on exogenous CHO oxidation. In a randomized crossover design, eight male cyclists (age 27 ± 2 yr, body mass 71.2 ± 2.3 kg, maximal oxygen uptake 65.7 ± 2.2 ml·kg−1·min−1) exercised at 64 ± 3% of maximal oxygen uptake for 120 min on three occasions. During exercise subjects ingested either a 5.8% glucose solution (Glu; 48 g/h), glucose with caffeine (Glu+Caf, 48 g/h + 5 mg·kg−1·h−1), or plain water (Wat). The glucose solution contained trace amounts of [U-13C]glucose so that exogenous CHO oxidation could be calculated. CHO and fat oxidation were measured by indirect calorimetry, and 13C appearance in the expired gases was measured by continuous-flow IRMS. Average exogenous CHO oxidation over the 90- to 120-min period was 26% higher (P < 0.05) in Glu+Caf (0.72 ± 0.04 g/min) compared with Glu (0.57 ± 0.04 g/min). Total CHO oxidation rates were higher (P < 0.05) in the CHO ingestion trials compared with Wat, but they were highest when Glu+Caf was ingested (1.21 ± 0.37, 1.84 ± 0.14, and 2.47 ± 0.23 g/min for Wat, Glu, and Glu+Caf, respectively; P < 0.05). There was also a trend (P = 0.082) toward an increased endogenous CHO oxidation with Glu+Caf (1.81 ± 0.22 g/min vs. 1.27 ± 0.13 g/min for Glu and 1.12 ± 0.37 g/min for Wat). In conclusion, compared with glucose alone, 5 mg·kg−1·h−1 of caffeine coingested with glucose increases exogenous CHO oxidation, possibly as a result of an enhanced intestinal absorption

Both carbohydrate (CHO) and caffeine have been used as ergogenic aids during exercise. It has been suggested that caffeine increases intestinal glucose absorption, but there are also suggestions that it may decrease muscle glucose uptake. The purpose of the study was to investigate the effect of caf...