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How to Avoid Running Out of Blood Sugar

During a long bicycle race, the leading rider falls and lies shaking in a seizure. He has "bonked", or passed out from low blood sugar. Your brain gets almost all its fuel from sugar in your bloodstream. When your blood sugar level drops, your brain cannot get enough fuel to function properly and you feel tired and confused and can pass out. There is only enough sugar in your bloodstream to last three minutes. To keep your blood sugar level from dropping, your liver has to constantly release sugar from its cells into your bloodstream, but there is only enough sugar in your liver to last 12 hours at rest. During exercise, your muscles draw sugar from your bloodstream at a rapid rate. Your liver can run out of its stored sugar and your blood sugar level can drop and you "bonk". This is common in bicycle races when a rider does not eat frequently, but is rare in long distance running races.

When you run, your leg muscles are damaged from the constant pounding on the roads and you must slow down. However, you pedal in a smooth rotary motion which does not damage your muscles, so you can continue to use up blood sugar at a rapid rate for a much longer time. To prevent your blood sugar from dropping too low during exercise that lasts more than a couple of hours, you need to take in calories while you exercise. It doesn't matter whether you eat carbohydrates, fats or protein; your body makes sugar from any food source.


Dear Dr. Mirkin: Can massage help to prevent muscle soreness from exercise?

For more than 100 years, competitive athletes have taken massages after training. A vigorous massage two hours after hard exercise can improve athletic performance. Athletes train by taking a hard workout that makes their muscles sore and then taking easier workouts until the soreness disappears. Anything that helps alleviate next-day soreness allows the athlete to recover faster so he can do more work and perform at a higher level. A 30-minute massage two hours after hard exercise reduces muscle damage, shown by lower blood levels of the enzyme called CPK which is released from damaged muscle. See report #1825 on delayed onset muscle soreness (DOMS)


Dear Dr. Mirkin: How can you tell if a mole is cancerous?

Most moles on your skin will never harm you, but some can turn into a cancer called melanoma that can spread through your body. Moles are a type of fleshy dark spot in your skin. The moles that are likely to turn cancerous have irregular borders and multiple colors, but even with these signs, only a small proportion will become cancerous. Scientists at Dartmouth Medical School set out to find out if there is any way to predict which atypical moles turn malignant (Cancer Epidem Biomarker Prev, March 1998). They showed that people who have many moles and at least one atypical mole are the ones most likely to have cancers. For example, those with 100 or more benign moles were 26 times more likely to have an atypical moles.

Other factors that increase a person's chances of having melanoma are freckling, presumably because it is a sign that some areas of skin are not protected from the sun by pigment; and difficulty tanning, because these people do not build up protection against sun damage. A surprising finding is that pregnancy appears to protect a person from having atypical moles. If you have moles with irregular borders and multiple colors, check with your doctor or a dermatologist, who will probably remove them with simple office surgery. More on skin cancer


Dear Dr. Mirkin: Will cutting out carbohydrates help to keep me from developing diabetes?

It’s unfortunate that the low-carbohydrate diet fad has caused many people to believe that all carbohydrates cause obesity, diabetes, heart attacks and other diseases. A major review in the European Journal of Clinical Nutrition (May 19, 2004) confirms that there are "good" carbohydrates and "bad" carbohydrates, and that a diet which includes whole grains, beans, vegetables, fruits and other plant sources of carbohydrates can actually help to prevent diabetes.

The carbohydrates to avoid are REFINED carbohydrates found in foods made with flour or other refined grains, and all types of added or extracted sugars. See report #1555 on preventing diabetes.


Three easy, delicious lentil soup recipes:

Italian Lentil Soup
Canary Island Soup Pot
Orange Lentil-Root Veggie Soup

List of Diana's Healthful Recipes


June 27th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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