Blog Archives

May 9

If you've ever pushed your physical limits - no matter if at work, at home, or in sport - you've likely experienced a strain or sprain. They account for about one of every three injuries in the American workplace and when lumped together into the more broad category of "soft tissue" or "movement-related pain" are by far the most common type of injury, representing more than half (58.3%) of the 6.7 million non-fatal injuries reported in the last year on record (2021-22). It's a BIG number and it not only represents a lot of people who are hurting, but also a largely preventable drag on both the quality and, as one 2017 study, showed knee arthritis to be an even greater predictor of dying over 15 years than smoking or diabetes, quantity of life for those impacted. Movement, as we are fond of saying, is a window into future health.

Six weeks from today, on Friday, the 20th of June, we will once again enter the official Summer season, a particularly high-risk period for aches, pains, and injuries of this type. While many forces and factors impact total risk at play during the Summer, the heat, as a fatigue accelerant, is one of the most important. Cardio-fitness improvements (4-6 weeks), acclimating (10-20 days of exposure), hydrating (ongoing), and "cooling" the working tissues in order to maximize recovery time are all important. However, as the Pro-Activity team began to pull resources for our annual dive into Summer-preparedness for clients who get regular educational content, 3 studies jumped out at me that are worth sharing - 2 with new ideas and 1 with even better proof of an old standby.

First, the standby. Strength training reduces injury risk. This 2025 review of 15 randomized controlled trials of team-sport athletes set out to determine whether strength training could reduce soft tissue injury risk. The answer, which shouldn't surprise anyone, was "yes". Strength training improved movement proficiency, corrected muscular imbalances, and not only reduced injury incidence but also improved performance. If we want to strain-proof our muscles, maximizing their capacity to do work makes sense. Starting now with even as little as 10 minutes of bodyweight-oriented exercise will make a difference when peak Summer is here.

Next, a really "cool" idea that sounds a bit like sci-fi could be the future of risk screening for strains. A research team from China set out to determine whether infrared imaging combined with artificial intelligence models could accurately scan and find body areas showing localized and abnormal inflammatory responses after physical activity and whether these "hot spots" were precursors of injury. It passed the first test - the team concluded that the infrared thermal monitoring system "can effectively identify the abnormal hot area of the athlete's body". Now, while I suspect most of us who try to "listen to our bodies" would be close if asked which body areas were a little "angry" after a hard bit of physical activity, we might be more inclined to actively cool those hot tissues if we saw red on the screen. However, since most fires require 3 elements to start or persist, one of which we can't live without (oxygen) and the other which ramps up dramatically in the summer (heat), the final question is - can we strain proof ourselves by minimizing the last component, inflammatory fuel?

Of course, this is a concept that we've pointed to many times - lowering whole-body inflammation by changing the gut biome through diet can make a risk-lowering impact. This study from March showed that both fiber and protein sources impacted detectable inflammation in the body. Individuals who reported higher fiber intakes and lower animal protein consumption had lower levels of resting inflammation. "If only you could package the inflammation-lowering benefits of a healthier diet into a pill," you say. Well, people are trying. It's still early days (this was a rodent study), but the results are certainly interesting. The research team found that by giving rats a probiotic to stimulate the gut biome for 8 weeks, they were able to protect the skeletal muscles mostly by improving their efficiency in processing fuel. While not the first time the connection between metabolic health and muscular health has been made - this 2020 study for example showed that adults with metabolic disease (less efficient at converting fuel to energy) are more likely to have musculoskeletal pain, inching closer to knowing exactly which levers to pull is certainly intriguing.

It's time to start strain-proofing for Summer. Changing the FUEL mix, cooling the hotspots, and adding capacity with strength is a great way to start.

Have a great weekend,
Mike E.

Apr 25

Historians group periods of time in eras. Terms like Prehistoric, Middle Ages, and Modern are some we recognize. While it's possible that history will show artificial intelligence acted to spark a new era where we humans directed our limited resources toward new discoveries and let machines summarize the past, right now many are still trying to ride the tidal wave of information which is estimated to double every 17 years, by surfing the headlines. The pitfalls of this strategy should be obvious, especially in cases where proprietary algorithms decide which undercurrents we are actually exposed to. And so, in an effort to do our part, this week we bring you an update on FUEL, which compares Pro-Activity's essential message on the topic (gleaned from decades examining the research), artificial intelligence's take, and a few recent and intriguing updates which add to the discussion.

First, Pro-Activity's historical take: 

• Eating primarily real food, loaded with nutrients and fiber, low in sugar and other inflammatory agents, which can provide the energy needed to stay strong both physically and mentally without straining the body to actually utilize can prevent disease, lower injury risk, improve recovery from the day to day and dramatically increase the odds of living a long healthy high-quality life for those who do so consistently. Said another way - eating primarily perishable foods with heavy doses of plants in an effort to avoid extra sugars and processing, with a nutrient profile we can use without straining the system to do so yields the best results.

Or, as summarized by one of two AI tools - 

• Nutrition helps prevent and manage chronic diseases like heart disease, diabetes, and obesity. Diets rich in fruits, vegetables, whole grains, lean proteins, and healthy fats have been linked to a lower risk of chronic diseases. 

• Plant-based and Mediterranean diets are especially effective. These diets are shown to reduce inflammation, improve metabolic health, and protect against heart disease and cancer.

• Micronutrients are essential for long-term health. Vitamins like D, B-complex, omega-3 fatty acids, and antioxidants help reduce the risk of age-related diseases such as dementia, osteoporosis, and cardiovascular issues.

• Nutritional monitoring by professionals enhances prevention. The involvement of trained nutritionists significantly improves the prevention and management of noncommunicable diseases through dietary planning and education.

• Early-life nutrition impacts long-term disease risk. Proper infant and childhood nutrition is linked to reduced risks of allergies, obesity, diabetes, and cardiovascular diseases later in life.

Conclusion: A nutrient-rich, balanced diet is one of the most powerful tools for preventing chronic diseases and promoting long-term health. View the full AI review (and references) from two sources, HERE

 
And last, adding some of the latest wrinkles in the literature and zooming from wide to narrow - 

• In a study of more than 100 countries that looked at dietary patterns and longevity, concluded that in particular, where we get our protein (animals vs plants), plays a significant role in longevity with a decreasing value of animal-based protein after the age of 5 with the risk-benefit tipping toward plant-based protein by 15 years old (figure 5).

• Zoomed further to the small-group level, in generally healthy young adults (50 university students), new research showed that dietary patterns high in processed sugar and saturated fat (i.e. those mimicking the "Western diet") had immediate impacts on brain-body function, most specifically in students' ability to navigate a virtual reality maze which relied heavily on spatial awareness.

• Zooming way in, at the tissue level, a new randomized-controlled trial showed that in regards to building muscle, after stimulating growth with strength training, as long as we get enough protein, the source (animal vs. plant) may not matter all that much. The individuals eating an omnivorous diet did about the same as those eating vegan.

Or in the fewest words possible, it seems Michael Pollan's message is still generally right - "Eat Food. Not too much. Mostly Plants.".

Have a great weekend,
Mike E.

Apr 11

When it comes to health, some bits of information have proven so reliable that they have attained the lofty standard of being a generally accepted truth. "Eat Right, exercise and get good sleep" certainly fall within this category, and "don't smoke, learn to manage stress and practice good hygiene to minimize the spread of disease" are also on most people's lists. However, and as we hope is made clear each week here, the details contained within those truths are always being examined. Occasionally, new information is so impressive it shifts the narrative toward something simpler than we previously thought, making the benefits of a healthy lifestyle more accessible to an even larger number of people. Exercise has experienced such a shift. The last few years have seen significant refinements in what we thought we knew, showing clearly that benefits can be gained earlier, easier, and in a way that fits into more people's lives. 

 For example, while knowledge that there are major benefits in accruing 150 minutes per week at a moderate intensity, we also (now) know that to some extent we can trade time for intensity and either cut the total time required if we are willing to push a little harder or still get impressive gains when we need to go a little easier. We also know that so much of the benefit comes so early in the process that even "movement microdosing" (stairs, squat breaks, etc) inserted into an otherwise sedentary day can be especially powerful; and in March of 2023 we learned that the beneficial threshold for incidental movement (as measured by steps per day) might be lower than we previously thought - 8,000 steps is enough to make a major difference in risk - even when only achieved twice per week.

Over the last six months, we learned that the frequency of exercise sessions can also be compressed without losing much benefit. This study, which we blogged about in October of last year, was great news for those who feel too busy during the workweek to fit in a consistent movement practice. Contrary to conventional wisdom, it showed that even "weekend warriors" who do all of their exercises in a compressed two-day window, can get most of the benefits that those who have a more consistent pattern get. New research that tested the weekend warrior method against a different dataset found that for some risks, we might even do BETTER this way.

When a research team looked at data from nearly 100,000 accelerometers (such as those in our phones or watches that measure movement) worn by individuals who they tracked for nearly a decade, they found that those who got a full week's worth of exercise (e.g. 150 minutes) over a two-day window, such as the weekend, actually did marginally better than those who had a more consistent pattern of exertion. "Weekend Warriors", who accounted for about 42% of the total group (nearly double the 24% classified as "regularly active"), had more than a 30% lower risk of dying from any cause or from heart disease when compared to the sedentary group as well as more than a 20% lower risk of dying from cancer. While the active group also had a significant risk-lowering effect for all causes, cardiovascular disease, and cancer, the benefit was 6-8% less in each area. The only caveat, as mentioned in the American Heart Association's press release, is that "ramp rates" matter - that is, muscles, joints, bones, and connective tissue (the moving parts) need to be ready for heavier loads so while "winning the weekend" is clearly a win for future health, building up a load-tolerance before (literally) jumping in with both feet, would be a wise choice. 

It's a great time of year to get out there. There's wisdom in working up to it but there's health in making this weekend one that moves.

Have a great weekend,
Mike E.

Mar 28

Imagine watching someone getting ready to do a "push-up" for the first time, maybe your child. They assume the position with hands on the floor, body straight, core tight, and knees off the ground and then suddenly they let go of all muscle tension, flop to their belly with a loud thud, slowly push up, return to the starting position and proudly exclaim "one"...only to repeat it a few more times and then look to you for approval. You might think of a creative way to suggest that something seems a little off...can you spot it?

It may not be obvious to everyone, but, despite the name of the exercise, most people who've done it know that "pushing-up" is only part of the movement...and that "controlled lower" and "brief stop"(or sometimes "hands off" even) broadly represent the other parts. As humans, we are constantly changing directions...which means we are also accelerating, decelerating, stopping, and then accelerating again. When it comes to injuries, it's during the deceleration and stopping where things often go wrong and yet few people actually focus on improving or maintaining the ability to do so.

Recently, however, eccentric training (the technical term for focusing on the controlled deceleration of the load more than the acceleration of it) has gained more attention. Studies from the last few years have shown that focusing on getting stronger by resisting while the muscle lengthens can improve strength and also promote gains in joint flexibility, muscle performance, and injury risk over time (especially in the lower body), and may even have more holistic health benefits like lowering blood pressure. This week, from a team in Australia, the news got even better after they found improvements in strength, flexibility, fitness, and well-being scores after 4 weeks of a low-dose home-based plan that emphasized eccentric exercise.

The protocol, a 5-minute bodyweight circuit that included 10 repetitions of chair squats, chair reclines, wall push-ups, and heel drops was performed daily. While there were no appreciable changes in global health measures or muscular power movements (such as body composition, resting heart rate, blood pressure, or various jump tests), there were notable gains in strength, flexibility, fitness, and mental health (such as isometric leg strength, push-ups, sit-ups, sit and reach, 3 min step test and the SF-36 as wellbeing survey).

While in the study's press release, the author acknowledges that 5 minutes doesn't achieve physical activity guidelines, he makes a point of saying it's a great starting point for those who need one. I couldn't agree more...don't be surprised if your local Pro-Activity professional incorporates a few eccentrics into your next visit.

Have a great weekend,
Mike E.

Mar 14

Life moves pretty fast these days. At times, it seems like what was new yesterday is commonplace today and outdated by tomorrow. Of course, the speed of innovation wasn't always so fast. By some accounts, it took at least 1800 years from the first proposal of the sun as the center of our planetary system (heliocentrism) to become conventional wisdom. However, as communication improves and ideas are less degraded by "the telephone game" of person-to-person verbal transfer (stories), they can spread much faster. In a very simplified way, this may explain why the "meme" has become so powerful as an agent of change. It is fast to transfer and arrives mostly intact, passing on from person to person quickly and often aided when it is funny, strange, or too emotionally gripping to not pass along to those you care about most.

Health information is often at the mercy of the meme. What actually works (eat right, exercise, get good sleep, manage stress, and connect with others) is not particularly exciting or funny or emotionally gripping. Unless used as a lever for an adventurous life, ironically it is the lack of health and the chaos it tends to bring, which is more emotionally gripping than the relative ease and low-stress nature of many generally healthy days. It's just not that exciting to tell friends over and over and over that no matter how many times they are studied, those same 5 actions pile up to success.

On the other hand, since the funny and weird ARE super entertaining, every once in a while, I like to bring you a few of those. It's entirely possible that these ideas will grow up to be major changes in our thinking - that we here on earth are not, in fact, the center of the universe, for example - or, they may just be entertaining health memes for around the dinner table...only time will tell. So in that spirit, here are three bits of strange science that caught my eye:

1 - Fish is CONNECT Food: Changing the inflammatory load in our diet can have an almost immediate impact on our brain. This animal study from The Ohio State University for example, showed that older rats eating a diet more heavily loaded in saturated fats had rapid changes in memory and learning functions. However, where it gets a little strange is on the other end of the age spectrum. This study observed that children who ate fish more frequently, a known source of "good fat" among other nutrients, were more prosocial. That is, by the time they were 8 years old, they showed a better ability to work in teams and with peers. The researchers recommend 2 servings of fish per week. It's probably a stretch, but if yours is the child who is not playing nice in the sandbox, or you find yourself with the same tendency in the work "sandbox", check your FUEL.

2 - Long Ring Fingers Return: In March of 2024, I wrote about this study, which showed a connection between long ring fingers (4th finger) as compared to index fingers (2nd) called a 2D:4D ratio. That study concluded that soccer players with longer ring fingers, which the authors suggest arise from more testosterone exposure when a developing fetus, tended to have better maximum exercise capacity than those who didn't. It was an idea that was super intriguing but just too strange for me to buy into. Well, they're back again in this study, where they show in a small group that long ring fingers also correlate to lower levels of lactate accumulation during exercise, which means an ability to exercise harder, longer. I'm still not convinced, but I am a bit less self-conscious of my weirdly long ring fingers, if I'm being honest. More to come.

3 - Finding the Flow Signal through the Noise: Creative and extreme sports (BMX, Skateboarding, Aerial Skiing, etc) are amazing to watch. The boldness required to hurl yourself through space and the concentration required to defy the laws of physics in order to land draws the spectator in. Clearly, it requires a finely tuned nervous system. New research on skateboarders suggests it's not just the "skater's eye" that drives things... but also their ear. While blocking sound is a smart choice when the world is loud enough to create harm (such as an industrial workplace), it's possible that skaters are proof positive that working with the sounds around us might help us get better at finding enjoyment and flow in a noisy world. While there is definite peace found in blocking out the noise with earbuds and headphones at times, it's possible that in order to achieve creative flow, those who practice finding the signal through the noise may have better odds. Protected hearing is good for our brains; sheltered hearing may not be. This may especially be true for nature-based sounds, which are shown to calm the nervous system. You may not need to be on a skateboard, but the science says to get "out there" and listen.

Hope you found these as interesting as I did.

Have a great weekend,

Mike E.

Feb 28

I had the great fortune of meeting a new-to-me client group this week: people we have worked with for a long time, but I have never personally had the opportunity to meet. It required some travel to a city I've never been to. It was, as always, an honor to be given the stage to share Pro-Activity's essential message - that investing time and effort into health is a worthy pursuit; that consistency (even a little bit) will outperform attempting to catch up (even with extra intensity) later and that, although there is great personal benefit from being stronger and happier, the real "why" which gives it such great power, is the far-reaching ripple-effect that pass on to those we care about the most, even for generations.

Since rule number one in these situations is "know thyself", I did what I always do - I set my watch so I wouldn't run over - and then dove into the information containing some of the latest health headlines. In what felt like a few minutes and after a little Q&A, the hour was up. We exchanged thanks, and I got off the stage...and then something really cool happened: a small group used the well-timed break to ask individual questions. This attracted more friends, who eventually became a group of folks who were genuinely curious about using their health to thrive in an otherwise complex world. They asked great questions and allowed me to poke at the barriers that stood between today and an even better tomorrow. I felt lucky to be there working on behalf of one of a growing number of employers who understand that good health is good business...who make easier access to good information a priority for their teams. 

Here are 3 great questions that I wish they would've asked in front of the full group as I am sure many people would benefit from the discussion:

(1) Sleep Health: I currently get 5-6 hours of sleep per night. Why is short sleep such a problem if I feel fine in the morning? 

This is, of course, a great question with a really long answer... but the short-short version is that our sleep cycle generally follows a pattern with deep non-REM sleep cycling in the earlier part of the sleep window and REM cycling in the later part. If we are constantly chopping off an hour or more at the end, we are chopping off a critical portion of our recovery, one that has been implicated in worsening cognitive health as we age. Although there is a minuscule portion of society that can go well on short sleep, it's more likely that you are waking when you are in a higher arousal state, that is "closer to the surface", and have been doing it so long your body is trained to wake up. It would be worth diving a little more deeply into, but one question that's easy to ask yourself is - are you sleepy during the day? If so, that's a pretty good sign your body is under-rested.

(2) Keeping Arthritis "at bay": I'm active and enjoy soccer. I had a knee injury that I rehabbed, and everything is going well, but colleagues have told me I'm more susceptible to arthritis in the future - should I worry about this, and is there anything I can do to keep it under control?

This is a great question that impacts a lot of people. The most important thing to poke at, in my opinion, is - is arthritis (i.e., roughening of the joint surface) always "bad"? What if it's there but not limiting you? Almost everyone who lives an active life will have some roughing of the surfaces of the joints - we work them hard - but if what you see on an x-ray isn't impacting your function, maybe it's not super worrisome. By staying strong and mobile, joints keep working for a very long time. By eating a healthier diet which may decrease dietary acid load, the roughening exists, but it's not as painful or limiting. Google "blueberries and knee arthritis" and dive into the findings a little - it's fascinating stuff (here is 1). Punchline: it's a risk, but maybe it shouldn't be as much of a worry if you have a plan and follow it.

(3) What's the Future: Do you think there will ever be a blood test or marker that tells us enough information early enough to do something about?

Well, yes and no. With studies clearly showing that our health is impacted before we are born and maybe even influenced by the actions and environment of our family tree generations before us, I'm not sure I really believe there is such thing as "early enough". Health is a generational asset - investing in it now will help your grandkids! Now, if I get off my soapbox, I'd say it's promising. This study out just this week showed that proteins from our organs and how they are "aging" can tell us about our health risk DECADES before disease. Most of them were direct lines - if your heart was showing signs of aging, heart disease was the future problem, for example, BUT not all. Kidney aging was tied to a variety of diseases, and, counterintuitively, immune system aging was the strongest predictor for brain risk. There's a lot more to learn there, but that definitely makes me want to keep my fitness up, eat in a way that doesn't over-inflame my system, and get plenty of rest - all of which are tied to immune health.

There were so many more great ones...I sort of wish we recorded the conversation because it's always SUPER fun for me to see the lightbulb go on for people and them realize how much power over their future health they really do have.

Thriving is complex, but we don't have to over-complicate it. If we invest some time, every day, even if only a few minutes when life is especially busy, we and everyone around us will be rewarded for the effort. 

Have a great weekend,
Mike E

Feb 14

So here we are, our final chapter in the blood glucose monitoring experiment. 30 days of experimentation went by pretty fast. We've learned a ton about our habits, how surprisingly easy they can be to change under the right conditions, how counterintuitive that feels to write, and a bunch about why metabolic health is truly a priority along the way.  Honestly, it's too much to capture in a blog that is designed to be a few minutes read each week, so if you're looking for the "TLDR" version of this journey, I'd say the following 4 sentences contain most of what you should know:

If you are a US-based consumer, sugar is everywhere, and you are probably ingesting more than is healthy. Unless you are training for something, even if you do hard physical work every day, it is unlikely you are moving enough to use it all for FUEL. This creates an energy log-jam that our bodies & brains are valiantly fighting to keep up with, but, sad as it may be, are losing over the longer term if we consider the millions who are progressing to diseases now tied to this root cause. For those who desire to more deeply explore their day-to-day AND are evidence-oriented enough to actually follow the path it lays out, a continuous blood glucose monitor can make it easier to change course when needed. In short, this is a story of hope...but not necessarily ease.

Let's start with 3 observations from this week:

1. Doubling down on deferring, getting the most from the important meal of the day: Building on last week, changing the AM routine was hard at first, but it's been good enough to work to make it a keeper. By replacing the order of our eating from one that is carb-dominant in the AM to one that shifts more toward protein and fat in the morning, we saw cool changes. Sugar spikes were blunted, and we felt fuller longer, but that's not all. Early indicators say our bodies are getting more efficient at using the "other" physiological fuel, the energy stored as fat during the day, which is also known as "fat adaptation," a phenomenon studied as early as 1985. It feels important to point out, however that while this approach DOES likely turn the dial toward burning more fat throughout the day, it is not a "keto diet" or an attempt to enter ketosis per se. This website does a nice job of illustrating the differences, but it's not all about fat burning. This review, for example, showed that a higher protein breakfast was linked to better muscle mass in adults and a cardiometabolic effect was also seen in groups as young as adolescents. HOWEVER, there are ripple effects. I noticed a clear need to increase my water consumption after making this switch, a factor associated with increased protein consumption that has been known for a while.

2. Context Matters a LOT - as the 30 days have gone on, we have seen a wide variety of spikes and drops of blood glucose under a variety of conditions. At times, it took some effort to remind myself that spikes are not necessarily good or bad in the absolute sense, but rather a normal response from the body...which can become problematic if too extreme or left unchecked for too long. For example, after moderate-intensity exercise, glucose values dropped as expected, one of the main reasons why post-meal exertion is so powerful and, in my opinion, why a movement break after eating should become a routine for almost everyone. But after intense or "fasted" exercise (i.e., before eating in the AM) things were very different. My glucose values actually climbed. While this makes total sense physiologically - when it is not readily available in the bloodstream, the body taps the liver's reserves to solve the immediate need (intense muscle work or an adrenaline spike), it could EASILY be confusing to the point of being alarming.

3. Better RECOVER means better everything - one of the most impressive findings has been in the "energy" category. Waking up refreshed is not only a nice way to start the day, it also provides greater ease in every action taken and decision made. For Lindsay in particular this change has been hard to put into words but very positive overall; as blood glucose has become more tightly controlled, her energy levels have become not only more abundant (more energetic overall) but also better, including outlook, stress, etc (more energized about making the change). In an otherwise busy world, everything gets a little easier when energy levels rise. Again, this is less surprising when diving into the evidence. The link between metabolic health and brain health seems to be getting more and clearer all the time. For example this review published in January, showed a strong link between metabolic risk (insulin resistance) and brain risk (future dementia) and this new research from Rutgers University showed that the same things that improve one (brief exercise) made a difference in the other (brain markers) in as little as 2 weeks.

So, where does this all leave us? To try to wrap it all up succinctly, we posed 4 questions: "which changes could become permanent?", "Are there any learnings you'll use more as a tactic or tool?", "How will you prevent slipping into old habits when it comes to shopping, snacking or other zombie sugars?" and last, "If a friend asked to summarize the 30 days in one sentence, what would you say?".

So what would we keep? For me, the shift to more protein and less carbs at breakfast, timing movement breaks before or after meals, and being more cognizant of the order in which I eat (goal = fiber first) are all impactful enough and still doable enough to strive to make them permanent.  For Lindsay, it was similar. She said, "The savory breakfast, the order in which you eat and working to consume more veggies overall are worth the effort".

In regards to tactics or "good to know for use when needed," Lindsay said "being aware of what a high-carb meal can do makes 'prioritizing priming' (e.g. with a salad) and 'blunting the spike' (e.g. with a walk) good tactics for future use". For me, switching to oil & vinegar instead of something more creamy could be an easy one to use when the opportunity presented.

When it comes to shopping, snacking, and other ways to keep the gremlins at bay, Lindsay said shopping smarter became the clear strategy - there has been a notable and deliberate drop-off in foods that are designed to sit on a shelf in the pantry these last few weeks. For me, trying to continue to get myself to recognize the difference between "sweet" and "treat", now that I have seen the impact, will be important. For example, the contrast between unsweetened Greek yogurt (a high protein) snack and the sweetened version of the same brand was striking. The first showed almost no sugar jump (and therefore no need for an insulin response from my body), and the second behaved like I had eaten a cookie. It was powerful and obvious. While this is not to demonize foods or even sweet treats...it seems to me that we should at least know when we are eating one.

Lastly, to wrap it all up in one sentence to a friend, Lindsay said "the real-time feedback has made it easier to make changes and those changes have produced positive benefits - I can't quite put my finger on it because it's as much a feeling as it is a metric, but I just feel better, more energetic and maybe even more comfortable in my body which I know is a struggle for many; I think the experiment helped me kickstart something good". For me the sentence to a friend would be less interesting and about what any friend might expect. It would go something like this "you know I love this stuff...the more we know about how things are working BEFORE they are breaking or broken the easier it is to stay that way. If you can approach it less like a dieter and more like a scientist, picking apart what you see and learning as much as possible along the way, it might be worth the effort.".

All said, this was fun and enlightening. We hope you enjoyed tagging along and are considering ways you can benefit, too. Reach out with questions.

Have a great weekend,

Mike E.

Jan 31

When we left our heroes last week things were mostly novel & new. They were uncovering a few buried truths about their daily habits, finding a few ways to make them a little better, and maybe even nudging their health in the right direction in the process. The undeniable data in front of their faces made it easier to confront the brutal facts, which like a trailer for some sort of terrible movie was a realization that they sort of LOVE simple carbs but the feeling wasn't mutual - they mostly just felt tired and empty inside. And, since this is usually when the hero starts their slog through the dark cave which inevitably includes a fight with some beast that was previously too big to defeat without newfound inner strength, we pick up our story with our heroes in a similar environment - the pantry. Filled with snacks, some that were previously thought to be "mostly OK", it turned out the shelves were actually packed with sneaky little gremlins just waiting for the clock to strike the witching hour. Now back to our story...

Onto Hack 3

If hack 1 (the vinegar preload) was interesting but not super tasty, then hack 2 (the veggie preload) was far more likable. Not a huge surprise from a preference perspective, we both generally like the freshness of a good salad, but having one consistently every evening makes the benefit much more obvious. 

For Lindsay, the changes have been most clearly related to energy levels. In her words, "It's hard to quantify 'feeling better' but you definitely know it when you do - more energetic and less lethargic at the end of the day for sure". In regards to measurable changes - "I haven't really lost any weight per se, but I do notice my clothes fitting a little better and I feel like my workouts are better" - which of course are all early signs of progress for those working to make health changes.

For me, as someone who is typically trolling for snacks by 4 PM, hungry enough for two servings by dinner, and still easily swayed by the snack gremlins a few hours before bed, the effect of consistently putting in a fiber "fill" before the main dish was real and obvious. Timing it before dinner made it easy to push off the late afternoon snack and, in line with one of the major health benefits of consuming foods that are both high in fiber and low in process (slower digestion makes you feel fuller), I have found myself far less hungry when starting on the main dish. I now eat a little slower and 1 serving at dinner feels filling enough. It's a small change but a lower calorie-load later in the day is generally a good thing, as this review of the research shows. The pantry gremlins still called in the hours before bed in the first few days, but since progress is motivating it was easier to say "no". The result? I was down more than 5 lbs in the first 14 days, and my sleep, which was pretty good to begin with, has continued to get better as going to bed "fully empty" has become the standard. 

It probably shouldn't surprise me since shifting eating to match wake-sleep cycles tends to improve metabolic health as reviewed here, but in addition to my Garmin sleep and HRV data continuing to improve, I have definitely been feeling more refreshed in the morning which makes everything easier, including starting hack 3 (5 minutes of exercise immediately before or after eating). We've tested stairs, various forms of push-ups (wall, stairs, floor, etc), air squats, walking fast enough to be huffing and puffing, and even a rowing machine - all seem to work pretty well. To be clear, it doesn't outright stop the rise in blood sugar, as expected there is a normal rise and it's sharper after high-carb foods but logically the blip resolves far more quickly when the muscles are primed and ready to soak it up for use.

Crowd-sourcing

One of the coolest things that's happened during our little experiment of ours, is YOU. I've had several people reach out, curious to learn more, ask good questions and even offer some ideas. One person suggested kombucha over vinegar as a tastier & gut-biome-boosting option. As it turns out, there is a small study from a team in New Zealand that supports it. I could definitely see this becoming part of the final ("extra") 5 days. Another wondered (paraphrasing) "Are you trying to eliminate the rise and fall totally?" - the answer here is no, this is a normal and healthy metabolic reaction, however like most things seeing extreme reactions by the body only in extreme circumstances is probably closer to "right"...so that's the goal.

Device Hiccups 

Several people have also inquired about the devices we are using and whether we like it so far. For those considering a similar experiment I would say, up until day 15 it would've gotten a strong thumbs up. On day 15 however, when it was time to change out the sensor (each lasts 15 days), things got a little off track. Lindsay's new sensor didn't pair with her phone and so she had to pause her portion of the test while a replacement was being sent and my values were very different from my first sensor. To be fair - Dexcom's (the parent company) customer support bot was great and Lindsay's replacement was in the mail within 24 hours of the issue being reported and I am getting my brain wrapped around the sudden jump in my baseline, something that, given our sensors' inability to calibrate against a fingerstick blood test to give the truest value, like a prescription-only model does, is probably reasonable. So while building in 5 extra days in our experiment for glitches now seems smart, it also reinforces the fact that these devices are on the health side of the spectrum and more educational than medical or diagnostic.

Last up (hack 4) is starting the day with a "savory breakfast". Tune in next week to learn how it went.

Have a great weekend,
Mike E.

Jan 17

Just last week I got an increasingly common question - "What is that little pod I'm seeing people stick to the back of their arms...and is it a good thing?". As a data geek and someone who loves the idea of wearables and biosensors to help me be more precise in my day-to-day actions, the Continuous Glucose Monitor (CGM) has been an intriguing idea for a few years. Like a heart-rate monitor for how we process food into energy (metabolism), this little plastic pod, smaller than a silver dollar, sticks onto the skin and sends data on blood sugar (glucose) to an app on the phone, creating a digital trace of the ups and downs, both normal fluctuations and responses to activity and diet. Over the last few years, they've become more common but as a prescription-only device and harder to get without boxing out someone who needed it more than me during the post-pandemic supply chain woes, up until recently the idea was frivolous at best.

Fast forward to late last year when one of the leading manufacturers received FDA approval for an over-the-counter version along with our recognition that metabolic health was a big area to watch in 2025 and now seemed like a perfect time to see what we could learn and share.

How it works - an overview: At the risk of wildly oversimplifying an incredibly complex process that impacts almost everything we experience daily, metabolism is the biochemical act of converting our FUEL to energy. When we are healthy, we do it predictably and efficiently, changing carbohydrates into "fast energy", which tends to be better for higher-intensity efforts, and fats more slowly which is ideal for lower-intensity sustained efforts. Whatever we don't use gets stored. Too much all at once, low-quality foods, or simply not using what is available through physical activity increases the risk that the system will lose efficiency and eventually become diseased, the most common of which is diabetes type 2, which impacts 40 to 130 million Americans depending on whether we include those with prediabetes in the tally. At least 1 expert's research into what drives cancer says it's a common root in that category of diseases too.

Most of us know that with low-quality, sugary, and cheap foods everywhere and daily routines that make it easy to NOT be physically active, we are definitely all at some level of risk. Things get even more urgent when we consider data like this which shows a clear connection between metabolic disease and injuries. This is not a "someday" problem, it's a now problem that seems to only get worse if left alone. Since it also only gets harder to reverse as time passes, if we can take the mystery out of it and know where we stand - which is what the CGM + app is built to do - it can be a good thing...and so, we experiment.

The Experiment: 

For the 30 days from Jan 12th to Feb 12th I (and my wife b/c she's a good sport and there are definite differences between men and women) will be wearing a CGM and trying to closely track and document the experience. The first 5 days (ending today) will be a baseline week, where no significant changes will be made. Then, every 5 days after that, we will implement 1 strategy known to help smooth out blood sugar spikes and keep people in a healthier range. We will be putting 4 of the "hacks" discussed by a popular expert & influencer on the subject (@glucosegoddess) to the test, "stacking" them each time we add one so that by the end, we are doing all 4 things simultaneously. We've built in 1 extra 5-day block as a buffer for any difficulties we run into but may also use it as a bonus block if everything goes smoothly. Our first will be to consume vinegar before the "biggest meal of the day" - about 1 tablespoon mixed in a glass of water, something that has been shown (for example here and here) to blunt the rise in blood glucose and "flatten the curve" - before dinner. 

Disclaimer

Now, while I generally LOVE the idea of people making small "experimental" changes to learn more about what works for them, such as "don't eat a slice of cake as the first course of lunch", a micro-test I ran (and failed miserably) on Tuesday, I can't in good conscience, recommend it this time.  Without knowing someone's health or relevant history, possible interactions with medications, or any number of other factors that might make "playing along" unsafe or unadvisable, doing so would be irresponsible. With that, we will not be making recommendations in any way - these are observations only.

For those who read along, I hope it's fun and you learn something you can talk about around the dinner table or with a friend. As always - feel free to send questions or ask you local member of the Pro-Activity team.

Have a great weekend,
Mike E.

Jan 3

With my youngest child now old enough to be out celebrating with friends, it would be the first "quiet" New Year's Eve in a very long time. Although, to be fair, since 2024 was just the usual chaos and nothing really to complain about, it had been busy enough that getting in bed at a reasonable hour (well before Auld Lang Syne) felt like a win. After a couple of hours which felt like minutes, I woke to the sound of Charlie the Yellow Dog loudly protesting a neighbor's use of fireworks to commemorate the moment. Then, after a few minutes that felt like hours (oh, the barking!), I knew 2024 was a thing of the past and I could go back to sleep. 

It's one of the reasons I love New Year's Day. At a time when we often hear about the benefits of quieting thoughts about the past and/or future to "stay in the moment" (aka mindfulness), it is one of few scheduled pauses, brief as it may be when the mental time travel of reflecting on the past 12 months to help plan the next twelve (future) is a good thing.

So what if we apply this approach to the goal of staying safe, living healthy now, and improving our odds of thriving longer? What fascinating findings from 2024 should help inform our plan for 2025? 

Here are few of the most important to know about in my opinion:

(1) Build Reserves: Whether it's this massive study of studies published in September which showed that for every 1 unit increase in cardiorespiratory fitness, adults had a double-digit drop in the risk of dying or this March 2024 review of 130 different studies which showed that "inadequate physiologic reserve" as we age (aka frailty) was definitively linked with important social drivers of health such as loneliness and isolation, the big message is clear: Improving or maintaining fitness, strength and power now can be one of the best investments we can make.

(2) Fiber First: If a headline read "Eat enough of this every day and lower your risk of dying by more than 20%" many of us might take a look. If the fine print said it was a study of more than 3 million people, even those who like to dive into the details might be satisfied. Well, that is exactly the observation made in this January 2024 review of 64 different studies on the subject. As a bonus, this study which does a deep dive into interventions shown to improve blood sugar control showed that not only does consuming more fiber (>=10g/day) help lower the risk of metabolic disease (sections 6.4 and 7.2 in the article) but points to emerging evidence that suggests if we eat it first, that is, order our eating patterns so we eat the veggies first and the carbs last, we might get an even better effect.

(3) Energy Vampires are REAL: This review from a team in Italy early in 2024 points to an important theme when it comes to the well-being and performance of groups and teams - attitudes really are contagious. While most of the work in this area has been done on leaders as the "sender" and followers as the "receiver", the authors point out that this relationship has also been established in those who tend to command attention (i.e. the loudest or most expressive person in the group). If you are on a team or work in a group, assessing and creatively addressing the emotional energy in that group might be a powerful risk-lowering strategy in 2025.

Of course, these are only 3 themes...and fascinating is most definitely subjective, but there's enough here to build on. Keep an eye out for more as we journey through 2025.

Have a great weekend and Happy New Year,
Mike E.