Inside Exercise

Dr Glenn McConell chats with Associate Professor Lykke Sylow from The University of Copenhagen. She is a rising star in exercise metabolism and in particular the effect of exercise on cancer. This is the second podcast episode on exercise and cancer (See Professor Kathryn Schmitz episode #9).
Remarkably she said that if you are a non-smoker your biggest risk of getting cancer is inactivity. Not clear if this is independent of obesity etc. Can associated with a reduction of insulin sensitivity and also cachexia (with the loss of muscle mass is very important). The cancer itself may cause insulin resistance. Exercise can reduce the likelihood of getting cancer, improve the prognosis during cancer treatment and reduce the likely of getting cancer again. There is even evidence that exercise can improve the effectiveness of chemotherapy and reduce the extent of metastasis. Really remarkable stuff. A lot more research is needed to clarify these things. X: @lykkesylow
0:00. Introduction
2:40. Lykke is a rising star
3:59. Cancer and exercise overview
6:09. Wasting of muscle mass with cancer
7:00. Evidence that exercise reduces the risk of getting cancer
11:40. Inactivity / obesity and cancer
13:03. Glucose metabolism and cancer
15:20. Cancer cachexia
19:05. The cancer itself may cause insulin resistance
22:55. Cancer cachexia/ loss of muscle mass
29:30. When loss weight tend to lose muscle
30:30. Mechanisms of cancer cachexia
33:20. Pre cancer muscle mass/strength and survival
35:50. With cancer insulin resistance may come before cachexia
40:07. What do different cancers have different effects?
41:48. Exercise can improve tolerance to cancer treatment/fatigue
46:20. Does exercise reverse the insulin sensitivity with cancer
46:30. Exercise increases muscle glucose use during and after exercise
52:10. Exercise during chemotherapy treatment
54:55. What kind/type of exercise are we talking about?
1:01:20. Mechanisms/AMPK
1:03:25. Exercise reduces fatigue in cancer
1:04:13. Exercise may improve the effectiveness of chemotherapy
1:06:25. Exercise may reduce metastasis of cancer
1:08:30. Sex differences, cancer and exercise
1:12:20. Age, cancer and exercise
1:15:15. Availability of exercise in oncology departments
1:18:50. Diet vs exercise in cancer treatment
1:19:50. Strength vs endurance training with cancer
1:21:22. Takeaway messages
1:26:23. Outro
Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
Connect with Inside Exercise and Glenn McConell at:
Twitter: @Inside_exercise and @GlennMcConell1
Instagram: insideexercise
Facebook: Glenn McConell
LinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460
ResearchGate: Glenn McConell
Email: [email protected]
Subscribe to Inside exercise:
Spotify: shorturl.at/tyGHL
Apple Podcasts: shorturl.at/oFQRU
YouTube: https://www.youtube.com/@insideexercise
Anchor: https://anchor.fm/insideexercise
Google Podcasts: shorturl.at/bfhHI
Anchor: https://anchor.fm/insideexercise
Podcast Addict: https://podcastaddict.com/podcast/4025218
Not medical advice

Dr Glenn McConell chats with Professor Paul D. Thompson who is Chief of Cardiology, Emeritus at Hartford Hospital, Hartford, CT and Professor of Medicine, Emeritus at the University of Connecticut. He has published over 500 peer reviewed journal articles, was a past President of the American College of sports medicine (ACSM) and was a impressively fast marathon runner. This is the third of a series of podcast episodes on sport cardiology (See Professor Benjamin Levine and Associate Professor Andre La Gerche’s episodes). We covered a lot of ground. There is a greater prevalence of atrial fibrillation in athletes (is it due to larger hearts?). We discussed possible reasons why coronary artery calcium/calcification is higher in athletes. He recommends 8000 steps done vigorously per day. Exercise is very important for your health. What exercise to do depends on your goals and health status. See time stamps further much more. We discuss his free substack called 500 rules of cardiology.
0:00. Introduction
2:40. Previous IE podcast episodes on sports cardiology
5:30. Worked with ex physiol legend David Costill
8:00. Ex physiol legend Bengt Saltin
9:00. More than 500 publications, importance of collaboration
10:45. Can exercise have negative effects on the heart?
13:00. More atrial fibrillation in athletes (due to larger hearts?)
20:30. Genetics and exercise
25:15. Was excellent marathoner
27:30. Exercise and right ventricle “fatigue”
32:00. Genetics, exercise and longevity
34:10. Cut off points/prevalence of increased risk of atrial fibrillation
36:26. Atrial fibrillation, blood thinners and strokes
39:30. Daily aspirin and heart risk
42:42. Why coronary artery calcium/calcification (CAC) higher in athletes?
48:40. Sex differences
51:03. Less heart beats per day in endurance athletes
53:40. Athletes, higher CAC and cardiovascular events
56:15. Exercise reduces cardiovascular events
58:30. Almost never restricts exercise in patients
1:00:20. Rationale to train hard
1:02:30. Most bang for your buck if less fit to start with
1:05:30. Cadence and turbulence in artery
1:09:30. Better athletes have more heart issues
1:11:40. Exercise intensity and coronary calcification
1:13:55. Walking and the heart
1:18:00. Fit handle operations/illnesses better
1:20:17. Statins and muscle pain /cholesterol
1:24:15. Medications vs lifestyle in diabetes
1:26:32. Metformin and exercise adaptations
1:27:15. Sudden death during exercise
1:29:25. Coronary narrowing and heart attacks
1:31:45. Best athletes have larger aortas
1:35:20. Intermittent fasting /ketosis
1:38:45. Exercise intensity and heart adaptations
1:39:40. Pay attention to symptoms
1:41:55. Broke his hip in a bike accident, cycles now
1:43:25. Exercise training early in life /epigenetics
1:47:05. Drugs and exercise performance
1:49:20. Environmental factors: eg walking to school
1:51:52. Cardiac sex differences re exercise
1:54:05. Wise advice
1:58:45. Be mindful of the media’s take on exercise
2:00:25. Takeaway messages
2:02:12. His free substack 500 rules of cardiology
2:02:59. Outro

Dr Glenn McConell chats with Professor Bryan Heiderscheit from the University of Wisconsin in USA. He is an expert on running injuries. This is the third of a series of podcast episodes on running injuries (See Professor Irene Davis’s and Associate Professor Rasmus Østergaard Nielsen’s episodes). Bryan focuses on overstriding and how increasing the stride rate can reduce overstriding and therefore running injuries. The importance of making gradual changes in all aspects. Different kinds of running injuries when land on the forefoot vs the heel. He thinks the type of shoes (minimalist vs cushioned etc) doesn’t make much difference to running injury rates etc. If bouncing up and down when running then may be overstriding which can result in injury. Some people bounce more but don’t overstride, some people overstride but don’t bounce and some do both. Bryan likes to try altering the stride rate/cadence to reduce over striding in an attempt to reduce bouncing and therefore, hopefully, running injuries. Bryan and the previous running. We also discussed causes of hamstring injuries during sprinting. A very interesting chat that brought together not only his research but also the previous two episodes on running injuries.
0:00. Introduction
3:16. Similarities/differences re the 3 interviews on running injuries
8:36. How Bryan got into running injury research
10:53. Running injuries when land on the forefoot vs heel
17:02. Specificity: function vs capacity
20:08. Do cushioned shoes increases injuries?
26:04. Injury rates /injury risks
28:45. Accumulation of strides, resilience, loads
31:30. The centre of mass movement during running (bounce)
34:20. Changing gait to alter centre of mass movement
36:50. Overstriding re centre of mass
40:20. Overstriding and eccentric load on the knee
41:15. Cadence/step rate to alter overstriding/bounce
45:38. Speed of runner and how land when running
47:13. Loading rate and injuries
49:08. Some overstride but don’t bounce and vice versa
50:42. Experience of runner and overstriding
52:40. Elite runners and extent of overstriding
55:26. Gait retraining and injury rates
57:14. Step rate increase when land on forefoot
1:00:01. Other causes of running injuries
1:00:50. Need shoes to control pronation?
1:03:26. Causes of hamstring injuries during sprinting
1:06:43. Bone density reduction after bone injury
1:08:25. When ready to return after ACL reconstruction?
1:10:00. Takeaway messages
1:11:49. Outro

Rasmus went from an overweight gamer to an injured runner to a exercise researcher! His research focuses on injury prevention, especially the importance of training load. Need to make slow changes. Seems don’t need motion control shoes for those with “excess pronation”. His main point is that one needs to give the body enough time to adapt or the likelihood of injury is increased. So don’t suddenly change things. This includes speed, distance, shoes, terrain etc. How gradual is gradual though? There tend to be different injuries from running long vs running fast (and when returning to running one should consider the cause of the original injury). What do in leisure time affects the total load. Shoes and running injuries. Very interesting stuff.
0:00. Introduction
3:05. Rasmus focuses on injury prevention
4:50. The importance of training load with injuries
8:10. Went from overweight gamer to runner to exercise researcher
15:12. “Excessive pronation” doesn’t increase injuries
20:20. If it ain’t broke, don’t fix it.
21:38. Injury rates
23:50. Don’t suddenly change things
25:00. Should increase 5-10% a week?
26:35. Injury from one session vs more chronic effects
30:20. Running speed, distance and load
32:40. Stride length and stride rate
36:00. Gradual changes are very important
40:08. Different injuries when run long vs fast
43:02. Don’t do too much too soon (change shoes, different terrain etc)
48:45. Generally the body can adapt if give it time
50:40. Might be good to have different shoes if used to them
53:50. How gradual is gradual though?
59:20. What do in leisure time affects the total load
1:02:27. Rearfoot vs forefoot strike and injuries
1:07:08. Evolution and running shoes, fan of minimalist shoes?
1:10:35. Training load needs to be considered in injury research
1:16:43. Quantifying load per stride etc
1:21:00. Recovery from injury (plantar fasciitis)
1:24:02. Shoes and running injuries
1:27:05. “Super shoes” and injury risk
1:28:48. Recovery from achilles tendon recovery
1:31:32. Running and knee osteoarthritis
1:33:53. Strength training and running injuries
1:39:00. Aging, stretching and running injuries
1:42:37. Sex differences and running injuries
1:44:23. Takeaway messages
1:46:26. Outro
Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
Connect with Inside Exercise and Glenn McConell at:
Twitter: @Inside_exercise and @GlennMcConell1
Instagram: insideexercise
Facebook: Glenn McConell
LinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460
ResearchGate: Glenn McConell
Email: [email protected]
Subscribe to Inside exercise:
Spotify: shorturl.at/tyGHL
Apple Podcasts: shorturl.at/oFQRU
YouTube: https://www.youtube.com/@insideexercise
Anchor: https://anchor.fm/insideexercise
Google Podcasts: shorturl.at/bfhHI
Anchor: https://anchor.fm/insideexercise
Podcast Addict: https://podcastaddict.com/podcast/4025218
Not medical advice

Dr Glenn McConell chats with Professor Irene Davis from the University of South Florida who is a top running injuries researcher and the current president of the American College of Sports Medicine. She makes the argument that we were born to run and have evolved to land on the ball of the foot during running and this reduces impact load compared with landing on the heel. Modern running shoes tend to increase the likelihood of landing on one’s heel. She is a fan of minimalist shoes, which tend to result in landing on the forefoot not the heel. She also believes that neutral shoes are best rather than the commonly advised shoes that attempt to minimize pronation. In addition, she also believes that if one has stubborn injuries and have tried other rehabilitation retraining your running gait may be helpful. Not a huge fan of orthotics. I was actually blown away by the chat and very motivated by it. Really fun stuff. Twitter: @IreneSDavis

Dr Glenn McConell chats with Dr David Martin. David has a remarkable and varied background starting off as a research scientist at the Australian Institute Sport and then National Sports Science Coordinator at Cycling Australia. He then became Director, Performance Research and Development at the Philadelphia 76ers. He is currently Chief Scientist, Director of Performance at Apeiron Life, San Francisco where he works to improve the healthspan of high net worth individuals. He is also an Adjunct Professor at the Australian Catholic University. We talked about all of this with a focus on the importance of belief systems in sports performance, how placebo effects are real, the use of placebos/belief effects in sports etc. A really interesting chat. I learned a lot. Twitter: davidtmartin
0:00. Introduction to podcast and David Martin
3:20. Testing Lance Armstrong and Cadel Evans
8:00. Thermoregulation, Heat susceptibility
9:10. Derek Clayton
10:35. Amy Gillett Foundation
11:40. Physiological attributes vs belief for exercise performance
18:05. Cycling selection camps based on combat selection
23:00. Belief effect
25:20. Placebo effect of altitude training
33:25. Does EPO (Erythropoietin) have its own effects on perf etc?
38:00. Placebo effects on pain and depression etc
42:00. The “I went to Harvard” /credentials etc effect
45:05. Lying to win and Belief vs evidence
47:05. How handle if mismatch between belief and evidence
53:20. Real physiological effects of placebos
1:01:40. How much of perf effect of CHO ingestion is belief effect
1:03:10. Believable vs well informed people in sports team
1:05:40. Importance of belief in the coach
1:09:40. Physiological needs of the specific sport
1:13:40. David and the Philadelphia 76ers
1:19:00. NBA and trust/protection/managing
1:23:53. His ideas and finishing up at the Philadelphia 76ers
1:26:20. Regretted not going fully into academia?
1:28:22. Rather fight 1000 x 1lb chickens or 1 x 1000 lb chicken?
1:30:24. Balancing S&C needs and the coaches needs
1:32:55. Reducing injuries in team sports
1:34:55. Importance of pre-season conditioning
1:35:40. Balance of winning vs how much money can make
1:38:40. Lower body strength in NBA vs track cyclists
1:41:18. Improving healthspans of high net worth individuals
1:53:10. A focus on healthspan rather than lifespan
1:58:55. Evidence base re supplements
2:03:45. Miss the adrenaline of working with athletes?
2:05:12. Outro

Dr Glenn McConell chats with Professor Mark Haykowsky from the University of Alberta, Canada and remarkable heart transplant recipients Dwight Kroening, Edmonton, Alberta, Canada and Elmar Sprink, Cologne, Germany. Dwight was very fit before a heart defect resulted in his heart transplantation (HT) way back in 1986. Elmar was an endurance athlete who suffered a series of cardiac arrests before his HT 12 years ago. They have undertaken Ironman triathlons and more. Both had VO2 maxes in the high 50s! (ml/kg/min). They embody the importance of exercise. Really motivating stuff, incredible. I loved this chat with these three remarkable people. Twitter: @mhaykows

Dr Glenn McConell chats with Associate Professor Chris Fry from the University of Kentucky, USA. Joint injury causes muscle weakness and atrophy (reductions in muscle size) due to the the inactivity but also separately due to the injury itself. Substances are released from muscle to help repair the joint/bone. Prehab is important before surgery. There can be residual effects long after joint injury. We also discussed hypertrophy and aging and the importance of having a lot of muscle capillaries as age to obtain the optimum response to resistance training. Lots more. We had a really great chat. Chris has a very pleasant manner. I enjoyed it a lot. Twitter: @ChrisFryPhD
0:00. Introduction and welcome
3:09. How Chris got into exercise research
6:10. ACL injuries and muscle wasting /weakness
9:05. Joint injuries and the risk of arthritis
10:05. The effects of the inactivity vs the injury itself
13:55. Protein synthesis vs breakdown after an ACL injury
19:30. Why in evolutionary sense does joint injury result in muscle atrophy
22:50. What are the signals to cause muscle atrophy
24:00. Myostatin release after joint injury
26:55. Acute vs chronic injury
28:15. Other joint injuries to joints (other than ACL)
29:25. Atrophy in different muscle fibre types
31:15. Best way to prepare for surgery after an injury
34:05. How quickly start rehab after surgery
35:45. Are there residual effects long after joint injury?
39:55. Bone vs joint injury
43:30. Muscle reactive oxygen species/ mitochondria after injury
46:05. Aerobic capacity of muscle still reduced after rehab
47:05. Should take anti inflammatories after injury?
49:20. Vitamin D and muscle injury
52:15. Does joint injury affect muscle in the non injuried limb?
54:45. What can do to slow atrophy after injury?
55:55. Does muscle size and strength go hand in hand after injury
57:15. Time since injury/trauma and surgery
58:55. Sex difference and joint injury
1:00:20. Age and joint injuries
1:01:10. Hypertrophy and aging
1:02:05. Aging: inactivity vs training response
1:03:00. More capillaries in muscle increases response to resistance training
1:05:00. Aerobic pre conditioning can help with hypertrophy
1:08:30. Anabolic resistance and aging
1:12:25. Connective tissue and training responses with aging
1:15:20. Satellite cells and muscle growth
1:17:45. Takeaway messages
1:19:01. Outro

Dr Glenn McConell chats with Assistant Professor Kevin Murach who is a rising star from the University of Arkansas, USA. Kevin is an expert on muscle, muscle growth, adaptation to exercise training, “muscle memory”, the regulation of muscle growth and muscle memory and the effect of aging etc. Muscle memory definitely seems real (especially in slow muscle fibers). Looks like epigenetics involved more than changes to muscle fibers nuclei. But more work needs to be done, especially in humans. We had a really great chat. I enjoyed it a lot. A very smart chap. Twitter: @KevinMurachPhD
0:00. Introduction and welcome
2:16. How Kevin got into exercise research
6:53. What is “muscle memory”.
9:15. Human evidence of muscle memory
13:58. Mice models to investigate resistance training
19:30. Training, detraining and retraining
20:35. Comparing rodents and human re their different lifespans
22:30. Evidence for muscle memory in mice after ex training
31:05. Mouse model that has both endurance and strength effects
33:25. Voluntary wheel running: matching the training
35:45. 10% greater hypertrophy with retraining
39:25. Mice slow postural muscles didn’t detrain!
44:45. Mechanisms: epigenetics
49:50. Muscle nuclei and exercise training/muscle memory
1:02:00. Muscle memory and epigenetics in the nuclei
1:05:40. MicroRNA and muscle memory
1:07:30. Epigenetics
1:08:35. Exercise training and each bout of exercise
1:11:20. MicroRNA and muscle memory
1:16:20. Balance of protein synthesis and breakdown
1:20:20. Muscle memory: Endurance vs resistance training
1:21:35. Time course of muscle memory
1:23:55. How much training need to get muscle memory
1:25:18. Specificity of ex training muscle memory
1:26:40. Nature and nuture
1:27:25. Dutch famine and epigenetics
1:28:18. Age and muscle memory
1:29:38. Biological sex and muscle memory
1:30:40. Common misconceptions: use it or lose it
1:31:38. Identical twins
1:32:25. Don’t need to go hard or go home.
1:33:05. Research experts vs influencers etc
1:37:15. Takeaway messages
1:39:44. Do health benefits have a memory too?
1:41:45. Outro

Dr Glenn McConell chats with Dr Nicola Guess from Oxford University, England and Professor Jonathan Little from the University of British Columbia, Canada. Nicola is a dietitian researcher with many years of expertise including the importance or otherwise of glucose “spikes” or excursions and the pros and cons of continuous glucose monitor use. Jonathan is an expert on exercise metabolism who is coming onto the podcast for the second time after speaking previously about keto diets and exercise. A major point is the difference between having chronically elevated blood glucose levels such as in diabetes (pathology) versus having normal increases in glucose ("spikes") in response to a meal. Also increases in glucose before and during very intense exercise is normal physiology and not a concern. There was also a clear message that the use of continuous glucose monitors (CGMs) have both pros and cons and that need to be considered. A very interesting chat. Twitter: @DrJonLittle
0:00. Introduction and welcome
3:20. What are glucose “spikes”/excursions
4:45. Hyperglycemia in diabetes is very different to “spikes”
6:20. Glucose spikes in type 2 diabetes
7:19. Why is chronically elevated glucose a problem?
12:20. Confusion about glucose levels 2hrs after a meal
15:29. Underlying insulin resistance the problem not spikes
19:08. Fasting glucose and insulin measures
21:10. Meal tests and oral glucose tolerance tests
24:55. Be careful not to make the underlying pathology worse
26:15. Keto diets: T2D, weight loss, exercise
32:10. Glucose even in diabetes is not as important as we think
35:00. Are CGMs useful?
38:30. Too much focus on glucose than more important things
41:00. CGMs very important for people with T1D
42:05. CGMs and anxiety
43:25. CGMs and higher cholesterol
44:00. Misunderstanding of pre-diabetes re CGMs
46:00. Metabolic flexibility
47:40. “Nervous normals”
49:42. Is how loses weight important?
53:41. What about CGMs in type 1 diabetes?
54:15. CGMs, diabetes, diet, behaviour change and exercise
57:40. Glucose metabolism during exercise
59:55. Exercise and insulin sensitivity
1:02:15. Effect of exercise on glucose spikes from a meal
1:04:10. Intense exercise can increase blood glucose levels
1:07:10. Normal to have elevated glucose after intense exercise
1:09:50. Influencers misinterpreting data re glucose spikes etc
1:12:10. Misunderstanding glucose cut offs
1:13:10. Takeaway messages etc
1:14:00. Weight loss diet strategies
1:17:50. Amino acids and insulin secretion
1:24:40. Should everyone use CGMs?
1:26:30. Keep it simple re diet and exercise
1:27:40. Outro
Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all.
The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University.
He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9).
Connect with Inside Exercise and Glenn McConell at:
Twitter: @Inside_exercise and @GlennMcConell1
Instagram: insideexercise
Facebook: Glenn McConell
LinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460
ResearchGate: Glenn McConell
Email: [email protected]
Subscribe to Inside exercise:
Spotify: shorturl.at/tyGHL
Apple Podcasts: shorturl.at/oFQRU
YouTube: https://www.youtube.com/@insideexercise
Anchor: https://anchor.fm/insideexercise
Google Podcasts: shorturl.at/bfhHI
Anchor: https://anchor.fm/insideexercise
Podcast Addict: https://podcastaddict.com/podcast/4025218
Not medical advice