FUDiabetes

What should I consume after exercise?

What should I consume after exercise?
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For post-workout recovery, you need 3 things - fluids, carbs, and protein:
Fluids to replace what you lost.
Carbs to resupply the fuel tank your muscles used during your workout (muscle glycogen).
Protein to help your muscles recover, rebuild, and to fuel the muscle growth.

Carbs
Carbs are used for energy and they also give your muscles their storage of carbohydrates, called muscle glycogen. Muscle glycogen is one of the body’s fuel tanks. It is the storage form of carbohydrates. It is important to replenish this fuel source when you are done exercising.

Protein
Protein is used by your body to repair and rebuild body tissue, including muscle fibers. Protein helps your muscles recover after a workout. Exercise causes your muscles to breakdown a bit, and then they get rebuilt. Over time, this builds stronger muscles. You don’t get stronger during your exercise, you get stronger recovering from exercise! And protein is important for this recovery. This is especially important for workouts that leave you sore!
Note:
Milk is a great drink for after workouts, because it has essential amino acids, and good forms of protein, such as casein.

The crucial time is within 45 minutes after your workout. If you consume carbs and protein within 45 minutes after a workout, you increase your endurance for your next workout and help the muscles recover.

Waiting longer than 45 minutes will greatly increase the amount of time it takes. It can take 24 hours if you do it right away, but if you wait, it can take several days! The most efficient way to restore muscle glycogen is with a simple-sugar type of carb, not a complex carb that takes longer to absorb. Additionally, protein and carbs that do not have a high fat content will help it get absorbed faster.

However, since the process of replacing the glycogen stores will last throughout the day - and can lead to low blood sugar throughout the day and night following exercise - taking complex carbs in a meal that follows the exercise should also be considered.

Not only will replenishing the muscle glycogen today help you with your workout tomorrow, this can also help your blood sugar remain more stable today and tomorrow.

Note:
If you have high or low blood sugar following exercise, and you want to replenish your muscle glycogen, it is important to correct your blood sugar immediately. Your body is not replacing muscle glycogen if you have high blood sugar (not enough insulin to push the carbs) or if you have low blood sugar (not enough carbs to get pushed)!




End of wiki ---------- comments start here

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@Eric, you and I had a couple of discussion on optimal replenishment after exercise. I had mentioned a couple of articles talking about milk. I am listing two below (they are not the main ones):

Milk Protein and the Restoration of Fluid Balance after Exercise This article discusses milk vs carb drinks after aerobic exercise (milk wins big time)

Effects of Drinking Milk Following Exercise This article shows milk also being superior for resistance exercises.

I agree, milk is great for post-exercise. It is good for hydration and for some of the proteins it contains. I drink a mix of milk, protein mix, and chocolate mix (sugar-loaded for carbs) after every hard workout.

Both articles single out skim milk as being better than whole milk for hydration. I also don’t want too much fat to slow down the carb replacement.

The only downside to milk is that it doesn’t contain enough sodium for electrolyte replacement. And it coats your throat so it is not exactly pleasant to use during exercise.

But for after exercise, I agree, milk is my first choice.

How many carbs is optimal for someone in our position to consume after exercise? Bearing in mind that many of us are not as comfortable consuming the amount of carbs that you are? What do you think is an effective minimum to reap some of the benefits for recovery and glycogen.

Sam, I apologize because my answer is much more complicated than anyone probably wants to hear. But I will start by giving you a very simple answer, and then I will follow that with too many details that nobody will want to read!

Simple:
Take calories burned (calculated from Runner’s World calories burned calculator), divide that number by 4, and then multiply that number by 75% (you don’t need to get all of that immediately after exercise, but try to get about half of it if you want to run the next day, and then get the rest through normal meals).

More complicated:
It’s different for everyone. The amount depends on a few things:

  • how much you weigh
  • how much you ran (or exercised) and how much of your muscle glycogen you burnt
  • how hard you ran (or exercised)

On a normal workout effort, you will never totally deplete all of your muscle glycogen. And the speed you run actually affects how much muscle glycogen you used versus how much fat you used (slower speeds will allow you to use a higher percentage of fat). And some of the carbs will come from what you ate recently, and from your liver.

There is an easy (note completely accurate) way to estimate. Runner’s World has a calculator for calories burned:
Runner’s World calories burned calculator
(their calculator is not very accurate because it does not factor fat metabolism based on speed, or gender, or BMI…but it can be used for an estimate).

So the Runner’s World calculator tells you calories. But carbohydrates contain 4 calories per gram. So divide the calories by 4, and that number is an estimate of the carbs you used:

Example:
A 180 pound guy runs 4 miles in a total of 36 minutes. His calories burned is 545.
545 / 4 = 136.25 grams carbs

But some of the carbs he used did not come from his muscle glycogen! It came from the food he ate recently!! So he would not need to eat 136 grams after that 4 mile run.

How much would the runner in our example need? A lot depends on how much he used from his stomach versus his legs. Did he run in an under-fueled state? So now you can see that even the “easy” estimate can again become complicated…

The Academy of Nutrition and Dietetics (AND) has a recommendation that active adults and athletes consume 0.5 to 0.7 gram of carbohydrates per pound of body weight post-exercise.

So for the example, it would be 90-126 grams, or about 66-92% of his total carb expenditure. Higher intensity would be on the higher side.

As a general rule, if you are running at a moderate intensity, and are running every day - about 75% will cover you.

(so, as stated above)
Take calories burned (calculated from Runner’s World calories burned calculator), divide that number by 4, and then multiply that number by 75% (you don’t need to get all of that immediately after exercise, but try to get about half of it if you want to run the next day, and then get the rest through normal meals).
.

A couple of points:

  • Your body restores muscle glycogen most rapidly within the first 45 minutes following exercise.
  • The amount of water in the foods you use to restore affect the time it takes. Carbs with a higher percentage of water are faster.
  • It can take 24-48 hours to restore muscle glycogen. If you want to run everyday, you need to make sure it is closer to 24, not 48! (use simple sugars with a lot of water, and right after exercise).
  • Muscle glycogen is not shared between muscles! Your arms can not lend it to your legs.

Because it has a lot of water, is a simple sugar, and has protein - chocolate milk is the way to go. But take insulin for it! If your BG is high from carbs you use to restore, they do you absolutely no good! Seriously! Run, finish, take insulin, drink chocolate milk, make sure you took enough insulin to cover it.

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I’m not a real math whiz or anything but wouldn’t just dividing by 5 get you right in the ballpark?

Thanks Eric, I have been in the habit of just eating primarily protein after running mostly to prevent my bg from drifting lower later on, but I definitely intend to start trying to add some more carbs if I want to improve my performance and endurance.

I don’t think I am really quite comfortable with THAT many carbs… your 180 lb guy running 4 miles in 36 minutes pretty well describes me and I couldn’t imagine ever eating anywhere near 136g of carbs even in a single meal— but I can definitely try to master the big glass of chocolate milk

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As a comparison, @Sam, my son, who is 120 lbs, after 6 hours of hiking, needs about 25-30 carbs to just stay even.

In an intensive swim session, he needs to take 15 carbs every 20 minutes. After a two-hour swim session, beyond the constant carb feed, he also needs about 15-20 carbs, or more, to stay even.

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I am giving the formula like that, dividing by 4 to show the conversion from calories to carbs, and then using the 75% to show that it’s about middle of the extremes recommended by the AND.

This is good for muscle repair. Keep up with the protein post-run, in addition to the carbs.

Those recommendations are for non-diabetics. It’s easier for them. But you just need to get some of it quickly. The remainder can come later with meals.

The normal recommendations for non-diabetics are always the targets I like to hit. But for diabetics those non-diabetic recommendations sound extreme. For example, for your weight, if you were to be carbo loading for an endurance event, they would recommend 648 grams of carbs for at least a day (based on 8-10 grams per kilo of body weight). That might sound cra-cra. But to me, if that is what the non-D’s are doing, then that’s what I want to do.

The actual amount you need gets complicated. Only part of your weight is muscle tissue. You are storing about 10 grams per kilogram of muscle tissue. You’d have to get in the water tank to see how much muscle tissue you have.

You don’t want to eat it, you want to drink it. You could probably knock half of that out with a big 20 ounce glass of chocolate milk. Take a big dose of your Afrezza to cover it (we need an emoji for that). Then run the next day and see how great you feel.

Plus, you forgot the 75%. In this example, it’s calories burned divided by 4, and then multiplied by 75%. So it is actually only 102 grams, not 136 grams.

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eric, please let me know if you get this email. i don’t know how to PM somebody, so i just got onto this site and am trying to find you.

daisy mae

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eric, looking to re-connect with you and discuss all this exercise stuff. theres so much to learn. i hope i am on the right site. i tried my best to follow your instructions. hope i got it right,
daisy mae

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Daisy Mae! @Eric will get your message here. Really glad you joined! Eric will be with you shortly, he’s been helping me too coaching with exercise and it’s really been paying off. So glad you joined here.

Daisy Mae, welcome! It is great to see you here!

sam, do i know you from the other forum as well? (TUDiabetes)

i recently had to change my basal rates (about 2 months ago) and it has totally screwed up my pre-exercise prep for my long swim (detatched from pump). i was wondering if anyone has some suggestions that would help me out.

thx for connecting with me, sam

daisy mae

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I certainly remember you from there, I used to participate there a lot, my screen name was Sam19.

I’m probably not the best person to answer your specific questions about unhooking your pump for exercise (I’m a tresiba basal guy) but I’m glad you joined here. I always enjoyed reading your posts on tud…

@mike_barry and @Eric and @Gus (are you there, Gus?) are all serious exercisers with way more pump basal know-how than I have and might have some ideas …

i know that this may sound like a stupid question, but what does “LADA” stand for? is it late onset type 1 D ?

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Yeah LADA stands for “latent autoimmune diabetes in adulthood” which is basically a coin termed years ago to help fight the false reasoning that only children onset with type 1 diabetes-- for all practical purposes at this point im a good old fashioned t1… I just didn’t grow up that way

thx. i also have another autoimmune disease called Graves. it interacts with the D which is a pain in the a-s. i had to have radiation treatment for it in 1987. it goes in and out of remission from time to time. but it is, like D, something that is part of the endocrine system. it effects metabolism, heart rate,
and the body kind of beats itself up for fun (not fun for me). it effects the eyes as well, just like D.

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Hey DM! You are in the right place, glad you found us!

The PMs are just like on the TuD site. Go to your avatar in the upper right corner and go to the little envelope…

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@daisymae
Sorry to hear about Graves, it doesn’t sound like fun at all.

On what to eat after exercise, this is what I do:
I train for sprint triathlons at a competitive level. That means that most of my sessions are around 60-90 minutes total, and usually contain intense intervals (for the exercise geeks, Z4, Z5, and/or neuromuscular intervals, or CSS intervals in the water). So I am VERY done after the workout.

My go to food in the magic 45 minutes post are: After a swim, chocolate milk (one of those individual pouches) and two bananas. That will keep my happy for about 60 minutes. Then I get hungry again and I am ready for a full meal. How many carbs? I don’t count. But 2 bananas and a chocolate milk would be around 100gch. And dinner it varies, but I usually end at around 100gch or more if I eat fruit.

After a run or a bike ride, I prepare a shake with 2 bananas, a scoop of protein powder, honey (I use on of those bear honey things, and count 5 to 10 seconds while the honey is pouring out), two spoons of Justin honey almond butter and milk. That’s about 500ml of shake, and around 100-120gch I think, maybe more with the honey. That keeps me in a human state for about an hour also and then I need a full meal. I drink the shake while I am doing an active cool down
In both cases I drink as much water / tea as I can, as I sweat a lot.

I use Afrezza for everything, and its perfect for post exercise. Usually I have 8-12U just before eating my recovery food. I can easily neutralize all the adrenaline from intense exercise, and eat exactly when I want. And then I don’t have to deal with the nightmare of hyper insulin sensitivity with injected. I just sugar surf with Afrezza, and react based on what the CGM tells me. Its so freaking wonderful!

Oh, and after some weeks on Afrezza after ditching the pump, I discovered that injected basal (Tresiba) will let me eat carbs during exercise. Tresiba will cause these veeery slow motion lows that I can track in the CGM. So now I know that form most intensities, I usually can eat 25gch every 30 minutes and my BGs will remain stable. And if I see the BG spiking, I skip one or more of those 25gch doses, and can follow the CGM to know if I need more carbs.
And if I am starting exercise during the 2-3hours Afrezza activity, I usually eat 25-50gch before starting the session and see how it goes.
BTW, 25gch every 30-45 min is what is commonly recommended for training. So I can do the same! Like a non-diabetic! WIN

On the question on how to do exercise with a pump. Now that I am on Afrezza I can see how incredibly hard it was. The key thing with exercise and insulin for me is to minimize IOB. With injected that is very hard to do. And I cant train in the morning in a fasting state. So I would do a very low carb diet all day. Then I would usually reduce basal to 50% 60 minutes before exercise. And turn it off during. And hope for the best. Sometimes it worked, sometimes it didn’t. And of course my whole day was locked into this plan just so I could train in the afternoon.
And after exercise, usually in the late afternoon, I had to wait at least 30 minutes for the insulin to act. Then have 100gch. And from there to a very low carb dinner to avoid dangerous lows at night. Which I sometimes had.
I know we are all different, but I would invite you to, if you are already using Afrezza, to give the pump and rapid injected a break if you can, and try with injected basal and afrezza. It may give you a new incredible level of freedom like it did to me. Especially with exercise.
Cheers!

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@Gus, that was a great write-up!

Do you mean that you are on Tresiba for all your basal?

How do you deal with the variability that comes with changing exercise regimen, with Tresiba? My son is 12 and an athlete – but his regimen changes all the time (he is in 3 sports) and he has to adjust his Lantus a lot depending upon practice schedules etc.