Magazine | Type 1 Diabetes and Exercise: Importance, Challenges, and Future Directions

Type 1 Diabetes and Exercise: Importance, Challenges, and Future Directions

Written by Sam Scott · 7 min read

A Global Trend in Diabetes Prevalence

Diabetes is a growing global health challenge. According to the latest International Diabetes Federation statistics, approximately 589 million people worldwide are currently living with diabetes, a number projected to rise to 853 million by 2050. Diabetes manifests in several forms, with type 1 and type 2 being the most prevalent. Type 2 diabetes accounts for about 90% of all cases, half of which are managed with medications that carry a risk of hypoglycaemia, primarily insulin. Type 1 diabetes, affecting an estimated 9 million individuals globally, is the most common endocrine condition among children and young adults.

What is Type 1 Diabetes and what does it mean for those living with the condition?

Type 1 diabetes is a chronic autoimmune condition that targets and destroys the β-cells in the pancreas, which are responsible for producing insulin. Insulin is crucial for regulating blood glucose levels, and without it, the body struggles to manage glucose effectively.

For those living with type 1 diabetes, managing blood glucose levels is a daily challenge. The goal is to spend as much time as possible within a safe target range, typically between 3.9 and 10 mmol/L (70 and 180 mg/dL). Straying outside this range can have serious health implications, making constant vigilance a necessity. This involves a complex interplay of diet, activity, and medication to maintain a healthy, active life.

Living with type 1 diabetes is a 24/7 challenge, with no breaks or days off. It has been estimated that someone living with type 1 diabetes must navigate an additional 200 decisions every single day, from counting carbs and insulin dosing to checking glucose levels. The relentless demands can be overwhelming, significantly impacting quality of life. Beyond daily management, there is an ever-present concern about potential complications such as vision impairment, nerve damage, kidney failure, and an increased risk of heart attacks. These challenges affect both physical health and mental well-being.

Why Physical Activity and Exercise are Important for People with Type 1 Diabetes

Physical activity plays a pivotal role in diabetes care. It aids in weight management, lowers blood glucose levels, and improves insulin sensitivity. Regular exercise also reduces the risk of cardiovascular disease and offers numerous psychological benefits. A proactive approach enhances well-being and is cost-effective for public health systems by reducing long-term treatment costs and diabetes-related complications.

The World Health Organization recommends that people with diabetes engage in 150-300 minutes of moderate or 75-150 minutes of vigorous physical activity per week. Unfortunately, many struggle to meet these guidelines, often due to motivational challenges, logistical difficulties, and limited support. For those on insulin therapy, fear of hypoglycaemia (dangerously low blood glucose levels) and the complexity of managing glucose levels around exercise present additional barriers.

A (very) brief overview of the Effect of exercise on blood glucose in type 1 diabetes

Exercise can lower or raise blood glucose levels. During exercise, blood glucose can decrease due to muscles using glucose as energy and increased insulin sensitivity. However, blood glucose can also increase due to the release of other hormones such as adrenaline. Everyone's diabetes is different, and individuals react differently to exercise. It is crucial for people with diabetes to understand how their blood glucose responds to exercise to manage these fluctuations and prevent hypoglycaemia or hyperglycaemia. Exercise must always be prepared for in advance, and insulin or food adjustments might be needed to stay within the optimal blood glucose range.

But exercising with diabetes is possible with the right level of support.

Managing diabetes and maintaining an active lifestyle is achievable. In my career to date, I’ve had the incredible opportunity to work with elite and professional athletes living with type 1 diabetes across a variety of sports. I’ve also completed doctoral and postdoctoral research focused on helping people with diabetes exercise safely and effectively.

Key Considerations Before and During Your Workout

Here are some key aspects of glucose management before and during exercise:

Starting Blood Glucose Concentration: Check your glucose levels before exercising and understand how to interpret and act on these levels.
Exercise Modality: Consider the type, intensity, and duration of exercise.
Managing Insulin on Board (IOB): Make insulin adjustments as needed and account for insulin already delivered and active in your system.
Nutritional Considerations: Understand the impact of consuming carbohydrates and other macronutrients before and during exercise.
Timing of Exercise: Consider the time of day you exercise and how it relates to the timing of meals.
Impact of Previous Events or Activities: Consider any recent exercise or episodes of hypoglycaemia.
Technology: Tools for monitoring blood glucose levels and managing insulin delivery.

Exercising Under variable or Challenging Conditions for the Athlete with Type 1 Diabetes

Sport can be unpredictable. Factors such as competition stress or changes in environmental conditions can significantly impact glucose management. Even if you are not a competitive athlete, numerous scenarios can dramatically affect your glucose levels or require additional considerations. These may include changes in altitude or temperature during winter sports, variables related to playing recreational sports, or scuba diving while on holiday. When exercise conditions vary, it is essential to be strategic and consider specific factors to manage glucose levels effectively.

Pre-Competition Stress and Hyperglycaemia-Related Anxiety

Athletes often experience stress or anxiety before a competitive event, which, for those living with type 1 diabetes, can significantly impact blood glucose levels. Stress hormones such as adrenaline and noradrenaline trigger a significant increase in glucose levels. In response, athletes might adjust their insulin management or avoid carbohydrates, fearing a further rise in glucose levels. This can backfire, resulting in insufficient fuel consumption during the event and potentially impairing performance.

Competition stress remains understudied and underreported, but it is crucial for athletes to monitor how glucose levels respond to specific stressful situations. Developing a pre-competition strategy tailored to individual needs, including meal timing, insulin management, and starting blood glucose levels, is essential. Sports psychology support can also help reduce stress and prepare the athlete mentally for the event.

Exercising in High Temperatures

In high temperatures, insulin absorption from the injection site may speed up due to the dilation of blood vessels, enhancing blood flow to the skin and extremities for heat dissipation. This increased absorption rate can lead to a more rapid onset of insulin action, elevating the risk of hypoglycaemia. At the same time, the body's demand for glucose may increase due to the increased energy requirements for thermoregulation and the intensified metabolic rate during exercise. These factors make it challenging for individuals with type 1 diabetes to predict their blood glucose response to exercise in hot environments, underscoring the need for vigilant glucose monitoring and proactive management strategies.

Exercising at Altitude

The reduced oxygen levels at altitude can impair physical performance and alter the body's response to insulin, making blood glucose management more complex. The initial stress of high altitude can activate the sympathetic system and trigger the release of counterregulatory hormones, leading to hyperglycaemia. Conversely, after some time at high altitude, the risk of hypoglycaemia increases due to hypoxia-induced enhanced insulin sensitivity with potentially increased glucose uptake by muscles. Additionally, the symptoms of altitude sickness can mimic or mask those of hypoglycaemia, making it difficult to distinguish between the two. Therefore, people with type 1 diabetes must be vigilant in monitoring their blood glucose levels, adjusting insulin doses accordingly, and staying hydrated while exercising at high altitudes.

Exercising in Cold Temperatures

Cold temperatures can slow down insulin absorption from the injection site due to vasoconstriction, which reduces blood flow to the skin and subcutaneous tissue, leading to a delayed onset of insulin action and increasing the risk of hyperglycaemia during exercise. Cold temperatures can also affect the functionality of insulin pumps and continuous glucose monitors (CGMs), potentially leading to device malfunctions or inaccurate readings.

The Future of Diabetes Management and Sport

Digital wearables, such as exercise trackers, hold great potential for enhancing physical activity adoption and improving diabetes care when integrated with diabetes technology. By offering real-time activity data, boosting motivation, and facilitating informed decision-making around exercise and glucose levels, these tools may empower individuals to increase physical activity levels. As the field continues to evolve, addressing current challenges and establishing a robust evidence base will be crucial to maximizing the benefits of these innovative technologies.

By leveraging AI technology and clinical expertise, new tech may empower users to optimise their health and performance, achieving remarkable results. AI-powered platforms have the potential to revolutionise how people with chronic conditions manage their health. By providing personalised, accessible guidance, these platforms empower individuals to take control of their health and achieve their goals.

Published: July 11th, 2025

References

1. T1D Index

2. The Diabetes Atlas

3. Type 1 diabetes

4. Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults

5. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study

6. Physical Activity and Diabetes

7. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review

8. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

9. Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diab...

10. Exercise management in type 1 diabetes: a consensus statement

11. Exercise-induced fall in insulin: mechanism of action at the liver and effects on muscle glucose metabolism

12. Malcolm, G., et al. – Managing diabetes at high altitude: personal experience with support from a Multidisciplinary Physical Activity and Diabetes Clinic

13. Bergford, S., et al. – The Type 1 Diabetes and EXercise Initiative: Predicting Hypoglycemia Risk During Exercise for Participants with Type 1 Diabetes Using Repeated Measures Random Forest

14. Riddell, M. C., et al. – Individual glucose responses to prolonged moderate intensity aerobic exercise in adolescents with type 1 diabetes: The higher they start, the harder they fall

15. Riddell, M. C.–Peters, A. L. – Exercise in adults with type 1 diabetes mellitus

16. Moser, O., et al. – Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes

17. Brar, G., et al. – Practical considerations for continuous glucose monitoring in elite athletes with type 1 diabetes mellitus: A narrative review

18. Koufakis, T., et al. – The Effects of High Altitude on Glucose homeostasis during short-term and prolonged exposure to high altitudes

19. de Mol, P., et al. – Physical activity at altitude: challenges for people with diabetes: a review

20. Dugan, C. W., et al. – Effects of Simulated High Altitude on Blood Glucose Levels During Exercise in Individuals With Type 1 Diabetes

21. Oberg, D.–Ostenson, C. G. – Performance of glucose dehydrogenase‑ and glucose oxidase‑based blood glucose meters at high altitude and low temperature

22. Hill, N. E., et al. – Continuous Glucose Monitoring at High Altitude‑Effects on Glucose Homeostasis

23. Brubaker, P. L. – Adventure travel and type 1 diabetes: the complicating effects of high altitude

Author: Sam Scott

Sam Scott is the CEO and Co-Founder of Enhance-d, which helps people with diabetes exercise by providing guidance, coaching and community. Sam has a PhD in Exercise Physiology with clinical and applied research experience in the field of obesity, diabetes, and continuous glucose monitoring technology. As an academic, his primary research focus has been on developing strategies to overcome the major barriers to exercise for people living with diabetes.

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Coaching

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12 min read

How to take health into your own hands

What two decades of getting my own health back and helping hundreds of clients doing so has taught me.Everyone begins their health journey at a different starting point. Some feel that they are getting older and look at preventing decline or getting their youthful energy back. Others are preparing for athletic competitions, aiming to enhance their performance and optimize their recovery. Again, others are very sick and try to solve the puzzle of getting their health back together.For me it had been the latter. In years of competitive endurance sports in my youth, I kept pushing through increasingly frequent strep throat infections with several courses of antibiotics per year. At the same time, I slept very poorly, suffered from anxiety, and consumed a rather poor diet, all while trying to somehow keep up a high level of performance (which, no wonder, declined continuously).After starting university, adding a demanding law study including a gap year at Oxford University, my energy levels tanked further. I stopped exercising, except for snowboarding, which kept adding whiplash accidents into the mix. When starting to see doctors for my extreme exhaustion, nobody could tell me what was wrong until eventually, my body gave up completely.Years of seeing any doctor or naturopath imaginable followed. The span went from the most prestigious medical institutions in Germany to underground shamans treating me in Australian parking lots (where we had been testing whether a warmer climate would make any difference – spoiler: it didn’t). Nothing helped – in fact, many treatments made things worse.A year or so later, after another round in an IV clinic which provided a tiny plus in energy, I got myself into a psychosomatic clinic to see if working through the years of forcing my body to perform despite its brutal decline would add another piece of the puzzle. What it did was giving a spark of a new perspective. A spark that lit a fire of radical ownership of the situation.Nobody could help. Nothing had helped. I have to help myself.Taking full responsibilityI started looking. Putting every fraction of a day’s energy into research. At that time, functional medicine and biohacking was getting increasingly popular in the US. Finding resources from these fields and people that had been deciphering their biology gave a new sense of confidence. The confidence that everything in the body can be healed.Months and years of research, education and qualification followed. Tons of trial and error. Dozens of labs and measurements. And tens of thousands of euros spent.Taking health into my own hands meant becoming the CEO of my mind and body. Addressing all systems that had been broken, working on my mindset and nervous system and showing up every day doing so. Finding root causes, changing my environment and providing everything my body needed to heal.Starting with the basicsFor most people and also for me personally, this started with the basics:Establishing a super clean, nutrient-dense diet and continuously adapting and improving it to this day. I internalised the notion of “you are what you eat” (to be more precise: what your gut absorbs). The lever here is immense: every cell of your body consists of the raw material that you provide via your diet. The choice is yours – for example, do you want your mitochondrial membranes to be composed of highly processed, oxidized seed oils or evolutionary compatible, healthy, as well as anti-inflammatory fats that optimize energy production? Moreover, food is a signal. It can tell your body to prosper and heal or to get sick and inflamed. Going deeper here could and does fill books.Prioritizing and optimizing high-quality sleep. Without proper sleep, the body cannot regenerate. The importance of this cannot be overstated. While in today’s society short sleep is being glorified and connected to productivity, it in fact makes you weak and sick in the long run. Diving deeply into and addressing the topics of circadian rhythm, sleep hygiene, cortisol, neurotransmitter metabolism and other related topics has helped me triple my deep sleep, double my REM-sleep and drastically increase my rejuvenation at night.Addressing the body’s stress and autonomous nervous system. This is another fundamental when it comes to healing: nature designed our stress system very cleverly over thousands of years. It is designed to respond to short-term stressors, such as predators, a chase, or a fight-flight situation very rapidly and with extreme vigilance. For the last century however, this ancient system has been exposed to an environment that has been becoming exponentially faster. Due to constant availability, deadlines, societal pressures etc., stress has become the new norm. For many of us, this system designed for short-term stressors now gets triggered chronically and we find ourselves in "fight or flight" mode for very long periods of time, sometimes even permanently. Biologically, the body, brain, and psyche take a massive toll from this. It is impossible to heal in this state and addressing it has been a fundamental part in getting my health back.Time in nature, adequate sunshine, gentle (or, if your health allows, more intense) movement, grounding. Those seemingly profane things can have a huge impact on our health. Next to being biochemical beings (think for example enzymes, hormones, peptides…), we are also physical beings. Albeit this hasn’t been addressed in the biohacking and functional medicine space too much yet (which is changing, luckily), to my healing it has been crucially important. Take for example natural sunlight: while some people fear every bit of tan they might obtain, getting adequate amounts of sun is fundamental for our body to be healthy. Its health benefits are so numerous, it is hard to put them in a nutshell. But let’s just briefly take the famous Vitamin D, which our body could not produce without UVB hitting the skin. In our body, this hormone alone has countless functions, and many systems cannot work properly without healthy amounts of it. Or take the sun’s infrared wavelengths which have so many healthy functions, that I like to call them “essential nutrients for our body battery”. However, the list is far, far longer.Supplementing the basics. Why? Even though I generally and fully agree with the notion “food first”, our modern time requires for almost everyone to at least supplement with high-quality basics. This mainly has two reasons: first, our foods contain less micronutrients as our soils are getting increasingly depleted of them, even if you eat mainly organic, seasonal, as well as regional (which is by far the best option you can choose in my opinion). Second, our high-paced, modern lifestyle with all its little stabs on our biology increases our bodies’ needs for vital nutrients. So, what do I consider as basics? For my clients and me personally, I would at least subsume Omega 3 EPA and DHA, Magnesium, Iodine, as well as Vitamin D3, at least in winter and ideally combined with K2 and A, under this category. Depending on lifestyle and diet, others could become basics, too. As always with supplementation, aim for high-quality, third-party tested, trustworthy brands. Also, it is best to check your status via lab work and supplement accordingly. For the above basics however, it is also possible to take low to moderate doses without testing and still get their benefits.Those are the fundamental basics. Without having those set, it will be hard for anyone to achieve optimal or even good health. Hence, while addressing them in my own life, I recommend all my clients to get those in order, as is possible with their lifestyle. If their lifestyle does not allow it, I recommend they change their lifestyle. For most, this helps tremendously or even solves all problems already.Prevention is easier than healingHowever, if a certain threshold of dysfunction has been reached (as had long been the case for me), addressing the basics alone is an important start, but might not suffice in getting one’s health back.At this point, it is important to highlight the importance of preventing vs. curing. The former is so much easier than the latter. Hence, I recommend taking care of your body as much as you can (without obsessing) while you’re still healthy. This means sticking to the basics above. Getting regular, functional check-ups – looking under “the hood of your car” once or twice a year. Being mindful and not ignoring first symptoms or warning signs our body is sending us. We are great at ignoring way too many of those and push through. Certainly, I had a Master’s degree in this discipline.Once chronic disease has started and perpetuated, it is much harder getting optimal health back. Here, advanced strategies such as more complex functional medicine, biohacking or modern therapies are often needed to bounce back. Also more, sometimes much more time.When deeper healing is neededFor me and some of the people I work with, this meant diving into the following advanced health strategies (note: if you are happy with the basics and don’t feel the need to dive into more complex medical topics you can skip this part and finish with the conclusion):Structural integrity, especially cranio-cervical health. If one was to ask which factor has been the root cause tying all my symptoms together, I would probably choose this one: cranio-cervical instability. This area of the body is pretty much the bottleneck of our human physiology. A little protected part, bringing together crucial parts and functions such as blood flow to and from the brain, our brain stem, our nervous system, our spinal cord and vertebrae. For me, a decade of snowboard accidents had heavily damaged this area resulting in severe cranio-cervical instability, vagus nerve and jugular vein compression. The biochemical and physiological implications of such damage are vicious. Getting ahead of this can be very complex. For me, it meant travelling to the US several times to get more than a dozen of ligament injection therapies as well as a surgery. The process is still ongoing but has brought great results already. However, for more “normal” problems in this area such as imbalances or subluxation, seeing a competent osteopath does help a lot of people significantly.Optimizing gut health. This again could and does fill books. Even Hippocrates coined this area with his famous quote: “all disease begins in the gut”. While I would not fully agree to that, its importance can hardly be overstated. Our guts are suffering from our modern diets and lifestyle and are certainly playing a part in most modern disease. From a therapeutic perspective, however, a significant part of healing can be achieved through sticking to the basics above. If this does not bring the results needed, it is worth getting accurate gut testing and looking into the areas of microbiome, gut barrier integrity (“leaky gut”), SIBO, gut motility, and vagus nerve function. Problems in these areas are common. For me and many of my clients, addressing these helped with digestion, inflammation, brain fog, as well as immune function tremendously.Immune function / chronic infections. At least since 2020, these are widely popular topics. As long as our bodies are strong and healthy, our immune systems are usually keeping infections at bay. When there is weakness and dysfunction (think stress, poor diet, toxins, etc.), our immune system might start losing this arm’s race and open some doors to bacteria, viruses, or fungi. When I was a kid, I had been diagnosed with Lyme disease. Later, with the strep infections, Epstein-Barr virus followed. As my health was continuously deteriorating, these kept being active and likely caused a host of problems. Only when I brought my energy metabolism and immune system back online, I could address those with the help of herbal antimicrobials and other therapies. As far as I can tell, this might be the case for many chronically ill people.Detoxing the environment, food intolerances, and mast cells. We are living in a soup of environmental toxins. Some of those are deemed save below certain levels yet nobody knows what the combination of thousands of toxic chemicals does to our bodies. Many of my clients are highly sensitive to an array of substances. Their immune system goes haywire. While it needs to be rebalanced on a deeper level, it certainly helps cleaning up the environment around you. Some examples would be organic food, natural cosmetics, non-toxic cookware, filtered or glass-bottled water, air-filtration and non-native EMF mitigation.Advanced supplementation. This is often needed to provide an extra boost and help the body function until it is back in balance (“homeostasis”). However, as especially in complex cases supplements can backfire, I recommend working with an experienced functional medicine practitioner who is also checking your lab work. For me, I closely pay attention to keep all my vitamins, minerals, amino- and fatty acids in optimal ranges. Moreover, I optimize my energy metabolism with mitochondrial compounds as well as support my gut with targeted pro- and prebiotics. To keep neuroinflammation at bay, I use specific polyphenols and deploy certain amino acids to support neurotransmitters. Sometimes, I do also use IVs. There’s more – yet this would break the boundaries of this article.ConclusionNow, please don’t feel overwhelmed by the last part. Taking health into your own hands is absolutely possible and for 90% of people comprises sticking to some very doable basics. The results can be tremendous. If more is needed, do not lose hope. Take ownership. Start small and work your way up. Ideally, get support from an experienced functional medicine practitioner who helps you set up your healing path. Then, one step at a time, regain your health and come back stronger.

The 3 Hard Truths About Longevity Nobody Wants to Admit

Lifespan Extension Interventions

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6 min read

The 3 Hard Truths About Longevity Nobody Wants to Admit

Last week, a VC asked me to settle a marital dispute. His wife ate an apple every afternoon. He wanted her to switch to $8 macro-balanced longevity bars because "fruit is just sugar." His entire diet was balanced, although 90% was processed.This is modern longevity: optimizing the microscopic while ignoring the obvious.As a Stanford-trained physician founder practicing longevity medicine and advising health companies, I see both sides of this industry—the exam room reality and the marketing machine. The gap between what we know and what we're sold has never been wider.Here are three hard truths about longevity, plus a practical guide to navigate the noise.Truth #1: We Can't Extend Maximum Human Lifespan (Yet)Modern medicine has added decades to average life expectancy through vaccines, antibiotics, and cardiac care. But what the industry doesn’t advertise? There is no solid evidence that any drug, diet, or supplement can extend maximum human lifespan.The oldest verified person, Jeanne Calment, died at 122 in 1997. Nobody has broken that record since.Why we're stuck:Lifespan trials are impossible. You'd need to follow thousands of people for 80+ years. No researcher, funder, or participant can commit to that. None of us want to wait for that.No accepted shortcuts. The FDA maintains a list of surrogate endpoints—biomarkers that predict clinical benefit. "Biological age" clocks aren't on it.What we do have:Animal wins. The NIH's Interventions Testing Program has extended mouse lifespan with rapamycin (up to 26%), acarbose (22% in males), and 17-α-estradiol (19% in males). Promising, but mice aren't humans. Not to mention, only about 10% of interventions that work in mice translate to successful human treatments, and the rate may be even lower for complex processes like aging.Healthspan signals.Low-dose mTOR inhibitors improved vaccine response in older adultsThe CALERIE trial showed 12% calorie restriction modestly slowed one aging measure (DunedinPACE) but didn't change other clocksBottom line: We can improve how you feel at 80. We can't yet guarantee you'll reach 100.Truth #2: Marketing Runs Ahead of MedicineWalk through any health store or scroll any wellness feed: "anti-aging" products are everywhere. How is this legal if aging isn't treatable?The regulatory loophole:Aging = natural, not disease. The FDA doesn't recognize aging as an indication, so companies pivot to supplements, wellness services, and lab tests—all with lighter oversight.Clocks ≠ clinical outcomes. Those biological age tests? They can stratify population risk but aren't validated to predict individual lifespan. The FDA's 2024 rule will bring many under medical device oversight, but enforcement is just beginning.The supplement gray zone. Take NAD+ boosters: heavy marketing, ongoing litigation, evolving regulatory status. Science in progress, sold as settled.New guardrails emerging:The FTC now requires human evidence for health claimsA 2024 rule bans fake reviews with civil penalties up to $51,744 per violationTranslation: Much of what you see is experimental science wrapped in confident marketing. Treat bold claims as hypotheses, not proven outcomes.Truth #3: Most "Evidence" Isn'tThe longevity evidence base resembles a noisy restaurant—everyone's shouting, but it's hard to hear what matters.The replication crisis hits longevity:Small studies, big claims. When 23 teams tried replicating high-profile cancer biology findings, effect sizes shrank by 85%.Paper mills pollute journals. Publishers retracted 8,000+ papers from Hindawi/Wiley alone in 2023. Retraction Watch now tracks over 50,000 retractions.Preprints ≠ peer review. That exciting mouse study on Twitter? It might change completely before publication—or never get published at all.Red flags to watch for:Studies with <50 participants claiming breakthrough resultsMultiple endpoints tested, but only positive ones reportedNo pre-registration (moving goalposts mid-game)Missing adverse event dataIndustry funding without independent replicationWhat to trust: Large, pre-registered, multi-site trials with transparent data and CONSORT-compliant reporting.What Actually Works (The Boring Reality)While we wait for breakthroughs, these interventions have the strongest mortality benefit evidence:Exercise supremacy. Moving from the bottom to top quintile of VO₂max is associated with a 5-fold reduction in mortality risk—stronger than the difference between smoking and not smoking.Blood pressure control. Each 10 mmHg reduction in systolic BP reduces major cardiovascular events by 20% and all-cause mortality by 13%.Mediterranean diet pattern. Associated with 20-30% reduction in cardiovascular disease and 13% reduction in cancer incidence. Yes, this includes apples.Social connection. Loneliness increases premature death risk by 26-32%—comparable to smoking 15 cigarettes daily.Sleep optimization. Both <6 and >9 hours associated with increased mortality. Sweet spot: 7-8 hours.Your Longevity BS DetectorWhen evaluating any longevity claim, ask:☐ Is this a peer-reviewed study (not a preprint, press release, or blog)?☐ Does it measure actual health outcomes (disease, function, mortality—not just biomarkers)?☐ Were there >100 participants followed for >6 months?☐ Is it pre-registered at ClinicalTrials.gov or similar?☐ Has another team replicated it?☐ Is funding disclosed and are raw data available?☐ Does it report adverse events prominently?If you can't check at least 4 boxes, remain skeptical.The Practical Protocol: What to Do TodayForget overwhelming optimization lists. Here’s one doable framework - the Quarterly Focus Method:Every 3 months, pick:ONE thing to lower:Blood pressure below 120/80LDL cholesterol below 100 mg/dLFasting glucose below 100 mg/dLResting heart rate below 60 bpmONE thing to raise:VO₂max by 1 MET (3.5 mL/kg/min)Grip strength by 5%Weekly Zone 2 cardio minutes by 30Strength training sessions from 2→3 weeklyONE habit to lock:7+ hours sleep nightly8,000+ steps dailyMediterranean diet adherence score by 2 pointsOne new social activity weeklyTrack these three. Relax about everything else for 90 days.Reasons for OptimismThis article focuses on hard truths, but the future isn't bleak. Here are a few developments I’m following closely:TAME trial is testing whether metformin delays multiple age-related diseases simultaneously—the first FDA-negotiated aging trial.VIBRANT study is looking at rapamycin for delaying menopause (essentially being used as a surrogate marker of aging).Dog Aging Project is running the largest companion animal longevity trial ever, with results translatable to humans.Progress is happening. It's just slower and messier than marketing suggests.The Bottom LineThe longevity field sits at an awkward adolescent stage: past childhood fantasies, not yet mature science. We have powerful tools to improve healthspan today—exercise, nutrition, sleep, connection, medical basics—but no proven way to extend maximum lifespan.Smart engagement means:Banking the basics (they work)Experimenting carefully (with reversibility in mind)Demanding evidence (real outcomes, not just biomarkers)Supporting rigor (pre-registered trials, data sharing, replication)The future of longevity is bright. But today, the most radical thing you can do is probably a boring thing: take a walk, call a friend, get your blood pressure checked.And yes, it’s fine to eat the apple. Your 90-year-old self will thank you.

Cycle Syncing: Hype or Your Monthly Superpower

Hormone Balance

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7 min read

Cycle Syncing: Hype or Your Monthly Superpower

Fifteen years ago, if you’d mentioned “cycle syncing,” most women would have blinked at you. Men might have guessed it was something to do with syncing Spotify playlists. Now, it’s a buzzword on wellness podcasts, Instagram feeds, and in group chats.If you’ve ever wondered why one week you feel like conquering the world and the next you want to cancel plans, curl up in bed, and survive on carbs, it’s not in your head. Hormonal shifts can change everything from your energy and mood to your appetite, digestion, and libido. That week you feel bloated for no reason? Hormones. That sudden burst of motivation? Also hormones.Cycle syncing is about working with these changes, not against them. It’s the practice of matching your nutrition, workouts, work, and social calendar to the natural rhythm of your menstrual cycle. The goal? Less fighting your body, more flow.Men vs Women: The Hormone Plot TwistMen’s hormones run on a neat 24-hour cycle. Testosterone peaks in the morning, giving them more focus, competitiveness, and often a higher libido. By afternoon, energy and motivation dip. By evening, testosterone is at its lowest, which is why most men feel more relaxed and less inclined to take on big challenges at night. Women’s hormones follow a more complex monthly pattern. A typical cycle is around 28 days, though anywhere between 21 and 35 can be normal. It moves through four distinct phases, each with its own hormone profile, influencing mood, energy, focus, sleep, and yes, your sex drive. The Four Phases: Go’s and No-Go’sMenstrual Phase (Days 1–5)Hormones are at their lowest and the body is focused on shedding the uterine lining and repairing itself. Energy often dips, and your system benefits from warmth, rest, and extra nourishment. Sleep: Aim for 8–10 hours. Short naps help with fatigue. Keep evenings calm and lights dim to support melatonin.Nutrition: Focus on iron-rich foods like leafy greens, red meat, lentils, and beets. Add mineral-rich broths and soups. Include healthy fats such as avocado, nuts, and olive oil. Herbal teas like nettle, raspberry leaf, or ginger are soothing.Supplements: Magnesium to ease cramps, vitamin C to boost iron absorption, iron if tested low.Exercise: Walking, stretching, restorative or yin yoga. Avoid high-intensity unless you feel genuinely energised.Do: Journal, reflect, set gentle intentions. Keep your workload manageable.No-Go: Cold exposure or ice-cold foods, which can worsen cramps and drain energy.Follicular Phase (Days 6–14)Estrogen begins to rise, FSH is active, and energy and focus return. Creativity and motivation get a boost.Sleep: Seven to nine hours is usually enough. Get morning sunlight to reset your circadian rhythm.Nutrition: Eat fresh, light meals such as sprouts, citrus, berries, and leafy greens. Lean proteins like chicken, eggs, and white fish support muscle and recovery. Fermented foods help gut health. Pumpkin and flax seeds can gently support hormones.Supplements: B-complex for energy, probiotics for digestion, omega-3s for brain health.Exercise: Cardio, dance, boxing, or skill-based training. Try new workouts — your body adapts more easily now.Do: Start new projects, brainstorm ideas, network, and declutter or organise your space.No-Go: Too much caffeine on an empty stomach, which can spike cortisol and disrupt hormones.Ovulatory Phase (Days 15–17)Estrogen peaks, testosterone gets a small boost, and LH triggers ovulation. You’re at your most confident, articulate, and physically strong.Sleep: Seven to eight hours, but make recovery a priority after busy or active days. Avoid excess screen time before bed to protect melatonin.Nutrition: Fill your plate with colourful raw vegetables and salads. Include cruciferous vegetables like broccoli and kale to help metabolise estrogen. Add zinc-rich foods such as oysters and pumpkin seeds to support fertility and libido. Hydrating foods like cucumber and watermelon are great in warm weather.Supplements: Zinc for reproductive health, vitamin C for ovary support, maca root for libido if you like.Exercise: HIIT, heavy lifts, spin, or group classes. Aim for personal bests in performance.Do: Schedule important presentations or negotiations. Batch creative content or collaborative work.No-Go: None. You are ready to conquer the world.Luteal Phase (Days 18–28)Progesterone dominates in the early luteal phase, promoting calm and deeper sleep, before both progesterone and estrogen drop toward menstruation. This is when PMS symptoms can appear if hormones are imbalanced.Sleep: Keep your bedroom cool to counter the higher body temperature late luteal. Magnesium before bed can support relaxation.Nutrition: Choose warm, grounding meals like sweet potato, squash, and lentils. Include complex carbs to keep mood stable. Magnesium-rich foods like dark chocolate, spinach, and pumpkin seeds are beneficial. Sesame and sunflower seeds can support hormone balance.Supplements: Magnesium glycinate for sleep and mood, vitamin B6 for progesterone and serotonin support, omega-3s for inflammation.Exercise: Early luteal is great for strength training or moderate cardio. Late luteal is better for yoga, walking, or pilates.Do: Wrap up projects, prioritise self-care, and prepare for the next cycle.No-Go: High-intensity training in the final days before your period.Myth-Busting Cycle SyncingMyth 1: It’s just a TikTok trendThe term might be new, but the concept is grounded in decades of endocrinology and women’s health research. Functional medicine practitioners have been talking about aligning lifestyle with hormonal changes for years.Myth 2: Everyone’s cycle is 28 days Twenty-eight days is an average, not a rule. Anywhere between 21 and 35 days can be normal, and syncing still works — you simply adjust your phases to match your own cycle.Myth 3: If you miss one workout or eat “off-phase,” you’ve ruined itCycle syncing isn’t all-or-nothing. The benefits come from consistency over time, not perfection.Myth 4: It’s only for women with PMS or fertility goalsEven women with regular, symptom-free cycles can improve energy, focus, workout recovery, and overall wellbeing by syncing with their hormones.Myth 5: Men don’t need to think about hormonesMen have hormone cycles too but theirs reset every 24 hours. Testosterone is highest in the morning, making it a prime time for strength training, problem-solving, and intimacy. Levels dip in the evening, which is when rest, lower-pressure tasks, and winding down come more naturally.Why This MattersCycle syncing isn’t about perfection, it’s about awareness. When you know your monthly rhythm, you can work with it instead of feeling like it’s working against you. You’ll be able to plan your workouts, projects, and social life around your strengths, and give yourself permission to rest when your body needs it.This approach can be transformative for women with PCOS, endometriosis, or irregular cycles, but it’s just as helpful for those with regular cycles. Even small changes can reduce PMS symptoms, improve energy, and make daily life more predictable.Some couples even plan their holidays around the ovulatory phase, when energy, mood, and libido tend to peak.So what now? Is it hype or your new monthly superpower? Hormones shift — that’s not hype, it’s biology. The way they infl uence your mood, focus, digestion, and relationships is real. So I’d say, learning to live in sync with those shifts isn’t just self-care, it’s your monthly superpower.And if keeping track of all this feels overwhelming, that’s where tools like reina come in — giving you daily, personalized insights based on your cycle so you can spend less time decoding your hormones and more time living your life.