The 4-Hour Body Part 15

2. Even at shorter durations, cold exposure with s.h.i.+vering could increase adiponectin levels and glucose uptake by muscle tissue. This effect could persist long after the cold exposure ends.

3. In the absence of s.h.i.+vering, it is still possible to capitalize on "fat-burning fat" through the stimulation of BAT thermogenesis. Curiously, even without s.h.i.+vering, there are small but unaccounted increases in lean muscle tissue when comparing underwater (superior) vs. land-based exercise.

4. Cold water improves immunity. Acute cold exposure has immunostimulating effects, and preheating with physical exercise or a warm shower can enhance this response. Increases in levels of circulating norepinephrine may account for this.

5. Not germane to fat-loss, but another reason to use cold exposure: cold showers are an effective treatment for depression. One study used showers at 68F for two to three minutes, preceded by a five-minute gradual adaptation to make the procedure less shocking.

6. The visible results, of course: [image]

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TOOLS AND TRICKS.

ColPaC Gel Wrap (www.fourhourbody.com/colpac) These pliable wraps, used in physical therapy clinics, can be cooled quickly and applied to any body part, including the back of the neck, for BAT activation. These pliable wraps, used in physical therapy clinics, can be cooled quickly and applied to any body part, including the back of the neck, for BAT activation.

"How to Make a Real Ice Pack for $0.30" (www.fourhourbody.com/diy-ice) If you prefer the frugal approach, this article will show you how to quickly and easily make your own reusable ice packs at a fraction of the cost of store-bought packs. If you prefer the frugal approach, this article will show you how to quickly and easily make your own reusable ice packs at a fraction of the cost of store-bought packs.

"TED Talks Lewis Pugh Swims the North Pole" (www.fourhourbody.com/pugh) Lewis Pugh is known as the human polar bear. Why? He swam across the icy waters of the North Pole in a Speedo and regularly swims in freezing cold water. Watch this TED speech for astonis.h.i.+ng footage and blunt commentary on super-cold swims. Lewis Pugh is known as the human polar bear. Why? He swam across the icy waters of the North Pole in a Speedo and regularly swims in freezing cold water. Watch this TED speech for astonis.h.i.+ng footage and blunt commentary on super-cold swims.

Ray Cronise Cold Experiments (www.raycronise.com) Explore Ray's experiments in cold exposure to find additional options for accelerating fat-loss. If he can keep NASA shuttles from incinerating, he can help you lose heat. Explore Ray's experiments in cold exposure to find additional options for accelerating fat-loss. If he can keep NASA shuttles from incinerating, he can help you lose heat.

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End of Chapter Notes 15. Men acutely exposed to cold for two hours (in a liquid-conditioned suit perfused with 10C [50F] water) have been observed to increase heat production by 2.6-fold and increase the oxidation rate of plasma glucose by 138%, of muscle glycogen by 109%, and of lipids by 376%. Raising the body's heat in response to cold exposure is done mostly by burning lipids (50%), then glycogen from muscles (30%), then blood glucose and proteins (10% each). Men acutely exposed to cold for two hours (in a liquid-conditioned suit perfused with 10C [50F] water) have been observed to increase heat production by 2.6-fold and increase the oxidation rate of plasma glucose by 138%, of muscle glycogen by 109%, and of lipids by 376%. Raising the body's heat in response to cold exposure is done mostly by burning lipids (50%), then glycogen from muscles (30%), then blood glucose and proteins (10% each).

16. (176.5 46.9)/1,000 g/min * 120 min * 9 cal/g. (176.5 46.9)/1,000 g/min * 120 min * 9 cal/g.

17. s.h.i.+vering also contributes to increased muscular GLUT-4 activity, just like air squats. s.h.i.+vering also contributes to increased muscular GLUT-4 activity, just like air squats.

18. This energy "wasting" is possible due to an uncoupling protein called UCP1, also known aptly as This energy "wasting" is possible due to an uncoupling protein called UCP1, also known aptly as thermogenin. thermogenin.

19. Ephedrine and clenbuterol, neither of which I recommend, are two examples of b-agonists. According to reliable sources interviewed for this book, several infomercial fitness celebrities achieved their amazing transformations with abuse of clenbuterol, not the exercise they claim responsible. "Clen" works, but don't count on your endocrine system working properly after megadoses. Ephedrine and clenbuterol, neither of which I recommend, are two examples of b-agonists. According to reliable sources interviewed for this book, several infomercial fitness celebrities achieved their amazing transformations with abuse of clenbuterol, not the exercise they claim responsible. "Clen" works, but don't count on your endocrine system working properly after megadoses.

20. This evening decline is largely true only for non-obese people; obese individuals tend to have uniformly depressed insulin sensitivity at all times. This evening decline is largely true only for non-obese people; obese individuals tend to have uniformly depressed insulin sensitivity at all times.

21. Nickname courtesy of one test subject in 2009. Nickname courtesy of one test subject in 2009.

THE GLUCOSE SWITCH.

Beautiful Number 100 DISCLAIMER: This chapter discusses the use of medical devices. Speak with your medical professional before jabbing such gadgets in your flesh.Everything is a miracle. It is a miracle that one does not dissolve in one's bath like a lump of sugar.-Pablo Pica.s.so 7:00 A.M. PST, SECURITY LINE, DELTA AIRLINES.

My hands were sweating.

Rehearsing one-line explanations in my head was getting tiring, and the queue ahead of me wasn't getting shorter. I started s.h.i.+fting impatiently from foot to foot, like a boxer waiting for the bell, or a three-year old preparing to wee himself.

Understandably, this behavior made the older midwestern couple to my right nervous. I considered telling them, "Just be glad I didn't go with plan A," but I had a feeling this would make things worse.

Plan A, to be clear, was awesomely stupid.

Plan A was to wear a 50-pound weighted vest through security and onto the plane headed for Central America.

Two days earlier, I'd explained the rationale to a friend: "I don't know if the gyms will have what we need, so I would at least have the vest."

"Hmmmm...okay."

"But it's too heavy to check as luggage, so I'll just wear it. The only downside is it might be impossible to get in the overhead bin, so I'd have to wear the d.a.m.n thing for the whole flight. The two-pound bricks are clearly made of dense black plastic, though, so security shouldn't be an issue."

"Bricks? Ha ha ha...yes, a great idea. Well, give me a call once you have a security boot on your head and an a.s.sault rifle in your eye. Dude, that's a TERRIBLE idea."

"You think?"

"Suicide bomber jacket? Yes, I think."

So the vest remained at home.

But that was just one carry-on item. Fortunately, the metal detectors didn't pick up plan B, which wasn't on on me but me but in in me. This required some tact. I moved to a restaurant near to my gate to check on things. Something was wrong. me. This required some tact. I moved to a restaurant near to my gate to check on things. Something was wrong.

Sitting in the darkest corner I could find, I pulled up the side of my s.h.i.+rt and surveyed the damage. The sensor wasn't working.

"Motherf*cker," I muttered as I winced and slowly pulled it out of my abdomen. I held up the two metal p.r.o.ngs I'd inserted under my skin the night before and looked at them from all angles like a diamond. No visible problem. Perhaps the metal detectors screwed it up.

The Nicaraguans at the closest table had stopped eating and were all staring at me with mouths agape.

"No pasa nada. Soy diabetico." Nothing's wrong. I'm a diabetic. Nothing's wrong. I'm a diabetic. That was the easiest explanation I could offer, even though I wasn't a diabetic. They nodded and went back to eating. That was the easiest explanation I could offer, even though I wasn't a diabetic. They nodded and went back to eating.

I ordered coffee and pulled out a notebook. Despite this minor glitch, I already had some fantastic data.

I would put in a new implant as soon as I landed in Managua.

Two Months Earlier-Firefly Restaurant, San Francisco "Is this really interesting to you?"

It was a group dinner, and the man across from me thought I was just being polite. I'd asked what he did nine-to-five, and his answer was: medical device designer. In the span of "Oh, really?!" I was on him like a two-year-old Labrador on someone's leg. The 20 questions were just getting started, and the wine hadn't even arrived yet.

His cousin, a close friend of mine, chimed in, as I was already plotting experiments in my mind: "Trust me. He's interested. This is all he thinks about. It's weird."

And that is how I first heard the name "DexCom." I jotted it down and did my best to act normal. It was hard to contain my excitement.

Soon thereafter, I knew all about DexCom. I called their headquarters, I called the head of marketing, I called the head of education, I spoke with the chief scientific officer, and I read about Charlie Kimball, over and over again.

Charlie Kimball is a type 1 diabetic. Unlike type 2 diabetics, he needs to inject insulin multiple times per day. He also happens to be a professional race car driver.

In 2006, Charlie became the first American to ever win an F3 Euroseries race. Then, in 2007, at age 22, he went to the doctor for a small skin irritation and left the office with a diagnosis of type 1 diabetes. Tragically, this meant he was forced to abandon racing altogether. p.r.i.c.king your fingers to take blood sugar readings just isn't possible when flying around curves at 150 miles per hour.

In 2008, Charlie returned to the wheel and claimed a podium finish in his first race. How?

He was the first race car driver in the world to have a strange device strapped to his steering wheel: the DexCom SEVEN continuous glucose monitor (CGM).

I check it like it's one of my race car gauges as I'm driving around the track. It's my body's data. And it's not information overload. It's perfect.

In more tangible form, it's a receiver that looks like this: [image]

Charlie has an implant in his side (as I did) that samples his blood glucose levels22 every five seconds. These data are then transmitted to the receiver, a palm-sized device with a screen, where Charlie can see his blood glucose levels in a graph. It displays updates every five minutes, shows his ups and downs, tells him when he's falling too fast, and alerts him when he's at risk of hypoglycemia (low blood sugar). every five seconds. These data are then transmitted to the receiver, a palm-sized device with a screen, where Charlie can see his blood glucose levels in a graph. It displays updates every five minutes, shows his ups and downs, tells him when he's falling too fast, and alerts him when he's at risk of hypoglycemia (low blood sugar).

So why on earth would I want to use this device as a nondiabetic? Why might you?

What if you could tell which meals were most likely to make you fat?

What if you could predict when food would hit your bloodstream and schedule exercise to optimize fat-loss or muscular gain?

What if, as an endurance athlete, you could eat carbs only when you most needed them instead of guessing with a timer?

The wish list went on and on. Now I just needed to check them off, one by one.

Making a (Wish) List...And Checking It Twice After my dinner at Firefly, I immediately started jotting down dream tests, as this little gizmo seemed capable of clearing up some long- standing theoretical bullsh*t.

I'd long been fascinated by the glycemic index (GI) and glycemic load (GL) index, both of which reflect how much certain foods raise blood sugar levels as compared to a control (usually white bread or glucose with a designated value of 100). The higher the GI or GL value (the latter takes into account portion size),23 the more a food causes blood sugar to jump. The more a food causes blood sugar to jump, in general, the fatter you will get. the more a food causes blood sugar to jump. The more a food causes blood sugar to jump, in general, the fatter you will get.

There are two problems with these indices. The first is that real- world meals seldom resemble laboratory meals. When's the last time you ate 100 grams of potato starch by itself? Second, the indices are one- size- fits-all.

Reality isn't one-size-fits-all. If someone of baguette-eating European descent eats white bread, will his blood response be the same as someone from a pastoral bloodline that historically fed off of livestock and little starch? Not likely, as members of the former group often have higher levels of amylase enzyme, which breaks starch down into sugar.

Blood sugar is a very personal thing.

There are some predictable results-eating doughnuts will spike blood sugar more than an equal volume of melon-but what of the more subtle choices? What of the old folk remedies and bodybuilding anecdotes? Here's a short list of questions the DexCom allows us to put to the test: Does lemon or vinegar really decrease the GL of a meal?Which lowers glucose response more, if either: protein or vegetables and fiber?Does eating fat and protein with with a high-carb meal lower GL more than eating either a high-carb meal lower GL more than eating either before before the meal? the meal?Does drinking water with a meal increase or decrease its GL?

How I Used It and What I Learned September 23 was one of the first test days with the implant.

I tried everything, as I wanted to see highs and lows. The following graphs show my data for that 24-hour period, and the downward arrows in the first graph indicate where I inputted glucometer readings.

Taking the blood glucometer readings is the only pain-in-the-a.s.s part.

The SEVEN is designed to show trends and alert you when the upward or downward changes are too dramatic. To ensure that the displayed number is close to accurate, you need to calibrate with a glucometer at least twice a day.

Don't want to become diabetic? Want to curb things like eating sweets, which can lead to adult-onset diabetes? Try using a glucometer for 24 hours. For each glucometer calibration, you stick a lancet (needle) into your finger and put a drop of blood on a test strip, which is read by a hand-held device (the glucometer) to display your number. Many type 1 diabetics p.r.i.c.k their fingers more than four times per day.

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I started off using a OneTouch UltraMini glucometer, one of the most popular glucometers in the United States, but abandoned it after three weeks. It was so erratic as to be unbelievable. For each calibration, I wanted to get two readings within five points (milligrams per deciliter [mg/dL]) of each other, and then input the average in the DexCom device. This would minimize the likelihood of using an error for calibration. I expected this process to take two or three jabs, but it often took more than eight needle sticks. DexCom recommends calibrating twice daily, but I tended to do it at least three times daily (meaning up to 24 needle sticks). Not fun if you have to use your hands for anything. glucometer, one of the most popular glucometers in the United States, but abandoned it after three weeks. It was so erratic as to be unbelievable. For each calibration, I wanted to get two readings within five points (milligrams per deciliter [mg/dL]) of each other, and then input the average in the DexCom device. This would minimize the likelihood of using an error for calibration. I expected this process to take two or three jabs, but it often took more than eight needle sticks. DexCom recommends calibrating twice daily, but I tended to do it at least three times daily (meaning up to 24 needle sticks). Not fun if you have to use your hands for anything.

Everything from humidity and sweat to temperature and air exposure can screw up readings. I ended up depending on the WaveSense Jazz glucometer, the best device I could find that corrected for these variables. It brought the number of sticks per calibration from 8+ down to two to three sticks. I recommend this device. Jazz glucometer, the best device I could find that corrected for these variables. It brought the number of sticks per calibration from 8+ down to two to three sticks. I recommend this device.

But tracking glucose levels 24/7 was just one half of the puzzle.

I recorded everything I ate, and just about everything I did, in a Moleskine journal, which I then had transcribed.

Here is September 23, verbatim with comments in brackets, which corresponds to the graphs on the previous page. I used the OneTouch here, and finger names followed by numbers indicate repeated glucometer jabs: Wednesday 9/2312:22 amGlucometer: [I would often swab multiple fingers with alcohol, wait 30 seconds, then go down the line with multiple lancets]Middle 102Ring 88Pinky 94Index 951:42 am rib-eye .5 lbs.1:54 am 74 glucose (CGM)1:402:30 am 3 gla.s.ses wine (Stag's Leap red)2:132:30 am 200g steakSleep10:57 am Er 5 [this was a glucometer error]Pinky 90 (air exposed 5 sec.)Index 96Index 114 (same needle)Mid 93 (new needle)11:11 am 20 almonds11:16 am 67 glucose11:19 am 2 tbl athletic greens + 2g vit. CBreak: 11:37 am:2 scrambled eggs4 tblsp olive oilhot sauce11:56 am:1 cup spinach133g lentils (first legumes since 9/5, 18 days)2412:10 pm: 22.5 tbs almond b.u.t.ter with celery1:10 pm: 400 ml cold water1:54 pm: 40 air squatOut of range 10 mins [I left the receiver on a table and wandered off]2:35 pm: 128 dexcom -->9496 glucose2:37 pm: Lipo-6 1 pill [a thermogenic] + 2g vit. C3:50 pm: KombuchaLunch: 4:06 pm: hot & sour beef with eggplant4:46 pm: yerba mate (20g sugar)7:09 pm: unsweetened yerba mate7:25 pm: 15 almonds + 2g vit. C9:00 pm: workout start9:30 pm: workout end9:35 pm: super monster protein (Odwalla)10:00 pm: seaweed salad (huge)10:15 pm:1215 pieces sas.h.i.+mi1.75 bowl rice3 cups green tea11:05 pm: 300 ALA11:33 pm: 50 air squat Compare the jagged graph for September 23 on this page this page with the following graph for September 25, which is a near flatline. On the 25th, I deliberately consumed high-fat meals and snacks for pre-s.e.x testosterone (see "s.e.x Machine" for how to do this). with the following graph for September 25, which is a near flatline. On the 25th, I deliberately consumed high-fat meals and snacks for pre-s.e.x testosterone (see "s.e.x Machine" for how to do this).

It's important to note that, at 10:15 P.M P.M. the evening before (September 24), I also consumed two rib-eye steaks (200 grams each) with sides of broccoli and spinach, which explains the flatline even before breakfast.

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Friday 9/2511:50 am: 1 Lipo-612:10 pm: 91,86,95,108 glucose12:30 pm: gra.s.s-fed Prather beef meatb.a.l.l.s with walnut pesto + olive oil2512:42 pm: cobb salad (huge)5:20 pm: 25 almonds + 300mg ALA6:39 pm:4 brazil nuts26Fish/cod oil2 scoops athletic greens8:26 pm: CRAZY LIBIDOAmericano restaurantHierloom tomatoAntipasto mixed (olives, pork, meatb.a.l.l.s)9:29 pm: Pancetta wrapped chicken11 pm12 am: s.e.x [You can see a small b.u.mp in blood glucose, which is partially due to glycogen being released. I also observed this during anaerobic exercise like weight training.]

September 26, a Sat.u.r.day, and my weekly binge day, produced a unusually flat graph considering the jamming of chocolate croissants and other goodies down the gullet: [image]

Sat.u.r.day 9/2610:4011:40 am: s.e.x12:40 pm:4 brazil nuts2 cod caps1 adrenal recovery pills, 3 desiccated liver ["liver"]12:50 pm: 1 cup orange juice1:03 pm:2 chocolate croissants (3)Bearclaw (1)Coffee with cinnamon (3)1:13 pm: done [I sometimes noted when I finished meals for duration]1:44 pm:Carrot juiceAlmond croissant3:45 pm: Kombucha4:084:35 pm:Hot & sour beef + eggplant3/4 cup brown rice5:45 pm:20 almonds4 oz liver6:45 pm: Odwalla protein monster vanilla7:30 pm:2 brazil nuts.5 lb chicken curry salad.4 lb quinoaAGG+ 40 mini-band chest pulls10:04 pm: 1 gla.s.s red wine [started drinking here and sipped]10:45 pm:spinach salad + oyster appetizer11pm: Hanger steak How is such a flat graph on September 26 possible when I was consuming such obvious garbage? Several of the tricks were covered in "Damage Control," but there were other patterns that emerged over the weeks of testing with my implant. Patterns that you can use to your advantage.

The Results The data set, small as it was, allowed me to form some preliminary personal conclusions that others were able to replicate. Here are a few worth considering: IT'S NOT WHEN YOU PUT IT IN YOUR MOUTH THAT COUNTS. IT'S WHEN IT GETS TO THE CELLS.

Food doesn't move to the bloodstream nearly as quickly as I thought.

When I first implanted the SEVEN sensor, I was as giddy as a 10-year-old birthday girl and compulsively checked the values every five minutes during meals. I ended up misattributing all over the place. My blood glucose hit 200 during s.e.x, and I thought it was the horizontal gymnastics that caused it, not taking into account the enormous sus.h.i.+ plate I ate two and a half hours earlier. It was probably 80%+ due to the latter.

It turned out that food and liquids took much, much longer to get to my bloodstream than one would expect. In most cases, I peaked one and a half to two and a half hours after food consumption, even with yogurt. Orange juice peaked 40 minutes after drinking.

This has profound implications and made the entire experiment worth the ha.s.sle.

Think you'll have a quick bite for energy 20 minutes before going to the gym? It might not be available to your muscles until an hour after the gym. The solution: eat it an hour earlier.

Think that protein shake is getting to your muscles in the valuable 30-minute post-workout window? In my case, if I drank the "post-workout" shake post-workout, it didn't. I needed to have it before my workout and then sit down to a large meal almost immediately after the workout. Doing it one and a half hours after the workout, as commonly suggested, just wouldn't get the goods to my muscles in time.