Not strongly influenced by. Rather, determined by. researchgate.net/publication…

So true. My concern is that almost everyone is too scared to face the root cause - the awful, highly toxic food environment. @TheNoakesF

How exactly is that intervention alone going to reverse the type 2 diabetes epidemic? Until the South African medical profession acknowledges that the root cause of type 2 diabetes is fully understood and this knowledge is included in the teaching of medicine and dietetics throughout South Africa, little is going to change. Those at great risk of, or with type 2 diabetes must restrict their daily carbohydrate intake to less than 25-50g carbohydrate/day. That's the prescription. (Unless you have a better solution) @TheNoakesF @UCTHealthSci @virtahealth @samiinkinen

For those who believe that muscle glycogen (the Large Glucose pool- LGP) is a more important determinant of exercise performance I invite you to look at this graph from the iconic study of Professor Ed Coyle in 1986. This was the study that helped drive the current belief that the the LGP not the Small Glucose Pool (SGP) that is the more important CHO source determining prolonged exercise performance. I have shown this slide frequently in the past 40 years without seeing what is obvious. Such is the power of intellectual blindness/conformity. The data are from their study entitled muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate (Journal of Applied Physiology, 1986). It is an iconic paper in the exercise sciences. The top panel shows changes in blood glucose concentrations during 3-4 hour exercise when 100g CHO was ingested every hour. This reflects what happened in the SGP. Note that clinical hypoglycemia developed after 2 hours when subjects did not ingest CHO during exercise. It's not possible to continue exercising when the blood glucose concentration is falling. That is established fact. The bottom panel shows changes in muscle glycogen content ie the LGP. Clearly there is no difference in metabolism in the LGP between trials so this cannot be the cause of the premature fatigue when CHO in not ingested. (Remember the story that CHO ingestion during exercise improves performance by slowing depletion of the LGP? Well that is clearly not the case in this example). Thus my definitive conclusion: "It should be blatantly obvious that (in this iconic study - the world first to show that CHO ingestion significantly prolongs exercises performance) the ingestion of carbohydrate during exercise improves performance by preventing hypoglycemia (SGP), not by sparing glycogen use in the LGP". I have stared at this figure and used it in lectures for more than 40 years. But it was only on Wednesday night this week when preparing a lecture for the @TheNoakesF annual World Nutrition Summit that I finally saw its real message. The key was to add the terms SGP and LGP to the top and bottom panels of the slide. When I did that the answer became obvious. @PhilipPrins11 @AKoutnik @PaulBLaursen @sweatscience @Brady_H @Nyborger_Nybo @theplews1