Testosterone Update September 2016


Along with testing my cholesterol and HbA1c after 15 days of the Whole 30, I also checked my testosterone levels.  It’s something I’ve checked in the past maybe once a year just to get a sense as to where I stood.

Here are my prior posts:

Nutritional Ketosis and Testosterone
Cyclic Ketogenic and Testosterone
My Health Test Results from March 2015

I’ve tried to search for other good resrouces on testosterone testing and results, but haven’t found anything better than the Art of Manliness series I referred to in my first post.  In fact, I’ll just quote what I wrote previously:

The best resource I found actually came from a website called, “The Art of Manliness.”  He had a whole series of posts dedicated to testosterone (Part 1, Part 2, Part 3, Part 4, and Part 5).  This was more insightful and entertaining than the journal articles and textbooks I referred to.  If you’re interested in this at all, I definitely urge you to read the series.

Here is a brief synopsis:

  • Due to our current way of life, men have lower testosterone now compared to someone of the same age two decades ago, and the exact causes aren’t clear yet (but may have to do with environmental toxins, lack of sleep, obesity, etc.)
  • Some of the benefits of testosterone include: improved mood, decreased body fatincreased muscle mass, improved cardiovascular and bone health, improved libido and improved cognition.
  • Testosterone is a hormone that is made from cholesterol and comes in 3 forms:
    • Free testosterone – the active form
    • Bound to a protein called sex hormone binding globulin (SHBG)
    • Bound to a protein called albumin
  • When you get a blood test to check your testosterone, there are two tests you can get:
    • Free Testosterone – This measures the amount of free testosterone in your blood
    • Total Testosterone – This measures the sum of the free testosterone + testosterone bound to SHBG + testosterone bound to albumin.
  • When interpreting the results of your testosterone exam, don’t rely so much on the reference ranges since they don’t account for variability in age.  Testosterone naturally and normally goes down with age.  If you are a healthy 25 year old (whose normal should be on the upper end of the spectrum), you don’t want to compare yourself with the values of a healthy 85 year old (whose normal should be on the lower end of the spectrum).
    • Refer to Day 4 of the Art of Manliness series where he has table breaking down the normal testosterone for each age group (he references two studies for these)
  • The most accurate way of measuring blood levels of Testosterone is the LC/MS method (liquid chromatography-mass spectrometry).



… and of course in tabulated format:


How do I stack up?

Here are the age range tables referred to in the Art of Manliness posts, which were taken from here:

AVERAGE TESTOSTERONE LEVELS BY AGE IN MEN Vermeulen, A. (1996). Declining Androgens with Age: An Overview. In Vermeulen, A. & Oddens, & B. J. (Eds.), Androgens and the Aging Male (pp. 3-14). New York: Parthenon Publishing.

Vermeulen, A. (1996). Declining Androgens with Age: An Overview. In Vermeulen, A. & Oddens, & B. J. (Eds.), Androgens and the Aging Male (pp. 3-14). New York: Parthenon Publishing.


NORMAL TESTOSTERONE LEVELS IN MEN (NON-DIABETIC) Simon, D., Nahoul, K., & Charles M.A. (1996). Sex Hormones, Aging, Ethnicity and Insulin Sensivity in Men: An Overview of the TELECOM Study. In Vermeulen, A. & Oddens, and B. J. (Eds.), Androgens and the Aging Male (pp. 85-102). New York: Parthenon Publishing.

Simon, D., Nahoul, K., & Charles M.A. (1996). Sex Hormones, Aging, Ethnicity and Insulin Sensivity in Men: An Overview of the TELECOM Study. In Vermeulen, A. & Oddens, and B. J. (Eds.), Androgens and the Aging Male (pp. 85-102). New York: Parthenon Publishing.

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Since I’m 36 years old, my Total Testosterone of 820.9 ng/dl is in the upper end of 1 std dev of the mean in the first table and well within 2 std dev above the mean in the second table.

My Free Testosterone of 10.1 pg/mL is right at the mean in the first table.

Unfortunately I didn’t measure my SHBG… which is something I’ll do next time.

Final Thoughts

Not much more to add here.  It looks like whatever I’m doing is having a good effect on my testosterone, so I’ll just keep on keeping on.

*Image found here

HbA1c Update September 2016: I finally figured it out!


Since the beginning of my career documenting my self experimentation on this blog I’ve been dealing with a borderling elevated HbA1c.

Here’s the first post on my HbA1c from March 2013 while doing my ketosis experiment:

The Effect of Nutritional Ketosis on HbA1c


Before I go further, for newer readers to the site and those unfamiliar with what an HbA1c actually is, I’ll copy and past what I wrote from that initial post:

  • Everyday your body makes new red blood cells (RBCs) and breaks down old RBCS at an equal rate so you have a constant number of RBCs (assuming you are healthy).
  • The lifespan of a RBC is somewhere between 100 – 120 days.
  • The main function of the RBC is to bring oxygen to your body by using an oxygen carrying protein called hemoglobin
  • When your RBCs are exposed to glucose, some of this glucose sticks onto the hemoglobin protein forming a sugar-hemoglobin
  • The more glucose there is, the more hemoglobin proteins it sticks to, forming more sugar-hemoglobins
  • Also, the longer your RBC is alive, the more it is exposed to glucose, hence it will have more sugar-hemoglobins
  • The HbA1c test measures the average percentage of sugar-hemoglobins of ALL the RBCs in your body, giving you an idea of how much sugar they’ve been exposed to in the past 90ish days.
  • So if you are diabetic, and your blood sugar is high all the time, you will have more sugar-hemoglobins, and thus a higher HbA1c.
  • This is an important tool that doctors use to track diabetics because even though they can have a normal blood sugar measurement (which is a snapshot in time), if their HbA1c is high, it tells the doctor that their blood sugar has been poorly controlled on average in the past 3 months.
  • HbA1c is a function of your blood glucose level and how long your red blood cells live.  If this were put into an equation it would look something like this:  
    • HbA1c ~ (RBC lifespan) x (avg blood glucose concentration)

Summary of My Previous HbA1cs

So in that initial post from March 2013 after puzzling over why my HbA1c didn’t improve despite being in documented ketosis for 72 days, I concluded that:

My low carb diet and subsequent low blood sugars actually help my RBCs to live longer.  RBCs that live longer are then exposed to blood glucose for a longer period of time causing me to have a higher HbA1c.  My ABNORMAL lab result actually reflects a HEALTHIER change in my body.

The curious thing is, there is virtually no data out there in the scientific literature examining the effects of a low carb or ketogenic diet on HbA1cs.

Inuitively it should look something like this:

  • Low Carb -> Lower Blood Glucose -> Lower HbA1c

But from all the data I’ve just presented, it looks like it’s actually more like:

  • Low Carb -> Lower Blood Glucose -> Longer RBC lifespan -> Higher HbA1c

I calculated that a HbA1c of 5.7% equates to an average blood glucose of 117 mg/dL, and so I wanted to prove to my self that my blood sugars weren’t actually that high.  Since I didn’t have a continuous glucose monitor, I tested my blood sugar at 17 points over the course of a day, and found that my blood sugar ranged between 71-91 mg/dL with an average of 83.5 mg/dL.

That’s a 33.5 mg/dL difference from the calculated 117 mg/dL from my HbA1c which further supported my initial conclusion.

I tried a Carb Nite, a cyclic ketogenic diet, which also left my HbA1c unchanged at 5.7% in October 2013.

Later on I discovered a test that measured something called fructosamine that can also be used to measure an average blood glucose.  At the conclusion of 10 weeks of Carb Nite, I measured both my fructosamine and HbA1c just for kicks.  While my HbA1c was steady at 5.7%, here is what my fructosamine level was which muddied the waters a bit:


This test is similar to the HbA1c in that it calculates your average blood sugar, except that it reflects values in the prior 2-3 weeks rather than the 3 months that HbA1c calculates.  This is because this test measures how much glucose binds to proteins in your blood (primarily albumin) which has a turn over of around 2-3 weeks.

The reason I wanted to get this test is to obtain another marker for my average blood glucose that is independent of RBC lifespan, which would confirm my explanation of why my HbA1c is higher than expected.

Fructosamine = 229 umol/L (Normal 0 – 285)

According to the equations found here and here:

HbA1c = 0.017 x Fructosamine + 1.61


Estimated Avg Blood Glucose = { [ (0.017 x fructosamine) + 1.61 ] x 28.7} – 46.7

Therefore, plugging in my fructosamine of 229 umol/L, my HbA1c should be 5.5% and my estimated average blood glucose should be 111 mg/dL.

While these numbers are slightly better than what my HbA1c indicates, I’m not quite sure it confirms my hypothesis of an extended RBC lifespan causing a falsely elevated HbA1c.

In October of 2014 I tested my HbA1c again and it remained stable at 5.7%.

When my lipidologist tested my HbA1c near the end of 2015 we saw that it had creeped up to 5.9%, and this is what she thought about it:

  • Despite a normal fasting glucose and insulin, my HbA1c is up.
  • HbA1c of 5.9 – Technically classifies me as pre-diabetic. This can explain my high particle count
    • (This is also the worst it’s been.  I think this could be related to my recent increased intake of carbs or possibly just due to differences in lab technique… but in any case, this is something I’ll need to keep a close watch on).
    • Because I’m not eating any sort of high carb diet and am pretty fit, this tells her that there is clearly a genetic predisposition to insulin resistance.
    • I can try to address this via life style, or can consider taking it a step further by taking a medication.
    • She’s had experience using Metformin or Actos, to help address people with pre-diabetes and elevated particles and ApoB. In some cases the particles can drop significantly.
    • There are studies on Actos lowering LDL-Particles and less data on Metformin, but a lot more data on how it addresses pre-diabetes.
  • Given my current data, she is confident that I have borderline insulin resistance.
  • My insulin isn’t elevated, so this tells her that I don’t have severe insulin resistance

After fiddling around for a few months with various supplements for my cholesterol I tested things again a few months later and saw that my HbA1c came back down:

HbA1c: When the lipidologist checked my HbA1c in July it had bounced up to 5.9 from being rock solid at 5.7 for the past two years, which made me worry a little.  It’s back down to 5.7 now, despite all the changes I’ve made, including increasing my carb intake.  This makes me think that the 5.9 value was likely due to lab variation.  I normally get my blood tests through Labcorp, but the blood tests done with my lipidolologist went through her lab, Health Diagnostic Laboratory.

My Current HbA1c:


A slight bump up to 5.8%… with an estimated average glucose of 120 mg/dL, despite my finger sticks never going higher than 95 mg/dL while I tested during the first 15 days of the Whole 30.

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… Along came a reader

One of my favorite things about this blog is interacting with readers who comment on the blog or send me e-mails.  I’m always learning something new and in this case, reader Saf directed me to a great resource:

hi caveman – you could try estimating your RBC lifetime, to validate your hypothesis, using the method here: http://www.precisionnutrition.com/blood-sugar-testing

What does Precision Nutrition say?

Things started out sounding very familiar…

First, folks with healthy blood sugar levels may have longer-lived red blood cells than those with poor glucose regulation.

The better you regulate and manage glucose, the longer your red blood cells can survive. The longer your red blood cells live, the higher your circulating hemoglobin. And if circulating hemoglobin is high, that will probably show up in the A1c blood panel.

But then things quickly get interesting:

How long do your red blood cells live?

If longer-lived red blood cells can lead to higher hemoglobin A1c levels, despite healthy glucose levels, maybe doctors should be evaluating the lifespan and turnover of red blood cells in their patients.

Here’s a calculation for doing that. It’s just an estimation, as blood chemistry calculations aren’t perfect. Still, it may give a bit of insight into your personal red blood cell lifespan and it offers food for thought.

To do this calculation, you’ll need to know your reticulocyte count and your hematocrit.

Reticulocytes are early red blood cells. Produced in the bone marrow, they’re released into circulation as reticulocytes, and in a few days transform into fully mature red blood cells.

Reticulocytes can be used as a marker of red blood cell production.

For example, in someone who is losing blood (for example, from a bleeding ulcer or heavy menstruation) or in someone with short-lived red blood cells, the reticulocyte count may be higher. This is because the body will attempt to increase blood cell production to make up for the loss.

On the other hand, a low reticulocyte count can indicate that the body is generally happy with the amount of red blood cells or their lifespan, and doesn’t need to pump out as many reticulocytes.

The equation for determining how long your red blood cells are surviving is:

Red blood cell survival (days) =100 / [reticulocytes (percent) / reticulocyte life span (days)]

Here is an example:

Let’s say your reticulocyte count is 0.8% and your hematocrit is 45. Pulling from corrected reticulocyte count tables, the number for the reticulocyte life span (RLS) number would be 1.0.

Thus your equation would look like this:

100/[0.8/1] = 125 days

If your hemoglobin A1c number is a little higher than you’d expect given your current diet and lifestyle, and your red cell survival is longer than 120 days, your longer-lived red blood cells may be the reason.

Ah… now I know what I needed to do!

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How long do MY red blood cells live?

In order to calculate the life span of my RBCs I needed to know two things:

  1. Reticulocyte count
  2. Reticulocyte life span which is based on the hematocrit.

Check and check:



So, since my hematocrit is 44%, using this table we can see that my reticulocyte survival aka life span = 1.0 days




Plugging the variables into the equation for RBC survival from the Precision Nutrition post:

Red blood cell survival (days) = 100 / [reticulocytes (percent) / reticulocyte life span (days)]

Reticulocyte % = 0.4 %

Reticulocyte life span = 1.0 days

RBC Survival = 100/[0.4/1] = 250 days!

If you want to nerd out more about where this equation comes from, here’s a good resource.

Ketonix - Breath Ketone Analyzer

Final Thoughts

According to this my RBCs live more than twice the average life span of 100-120 days… which at first sounds amazing, but on second thought makes me doubt the veracity of this equation.  While they probably don’t live 250 days, they definitely live somewhere between 120 and 250, which is enough to cause a false elevation in HbA1c.

In any case, I feel satisfied in finally getting to the bottom of why my HbA1c is what it is, and that is because my RBCs live longer than normal, and I now have data to prove this.

I probably won’t be testing my HbA1cs anymore unless things change drastically with my blood glucose.

This also made me think… the typical referene ranges provided by these labs are calculated from actual patients that have been measured.  I wonder how many of those patients are young healthy active individuals.  I mean if you have normal blood sugars and are reasonably fit, there is NO reason a doctor would even think about testing your HbA1c.  It just wouldn’t be worth the cost… and therefore none of these subjects would be factored into the referene ranges of the labs.  I imagine if you tested the HbA1cs of healthy athletes, they’d like higher than expected also.

I hope you learned something from this post… I know I did!  So glad to finally put this issue to rest.

*Image found here

Cholesterol Update September 2016



It’s been about 6 months since I last checked my cholesterol and I’ve had a few readers ask me how my numbers look.  Before I jump into what the results are I thought it might be helpful, especially to new readers, to detail a little bit about where I’ve come from, and what I’ve been doing in the mean time.

I’ve written quite extensively on my cholesterol history and some of the research I’ve done on the subject throughout my blog.  Here’s a link to everything I’ve written on cholesterol thus far.

My History

Without going too in depth the brief summary of my history of high cholesterol goes something like this.  I had a normal which inexplicably started climbing higher and higher.  I experimented with the Slow Carb Diet from The 4 Hour Body, by Tim Ferriss, which got even worse when I experimented with Nutritional Ketosis, despite losing weight and improving my body composition.  I tried a cyclic ketogenic diet (Carb Nite) and then a targeted ketogenic diet (Carb Back-Loading) which didn’t seem to help at all.

I experimented with a few other various things here and there without any significant impact and finally got my act together and met with an expert, Dr. Dall a board certified lipidologist.  Here are some posts I wrote about my meetings with her:

I learned a lot from my meetings with her which helped me develop a plan of attack… which worked!

For a more detailed narrative of this history and a summary of the test results immediately following the implementation of my plan, you can go here:

Did My Anti-Cholesterol Gameplan Work?  YES!

The next step for me to do was to parse out which specific components of the plan had the strongest effects, which lead me down the next path of experimentation with these series of posts:

Which leads me to where I am now.

What I’m doing now

The BJJ Cavewife and I decided to join our Crossfit gym in doing the Whole 30, which is essentially a strict paleo diet.  After following this diet for 15 days I had my blood drawn.  If I planned things better I would have gotten the blood test after the full 30 days, but things just didn’t work out.

Here is my average daily macronutrient and caloric intake for this time period:

Calories: 1986
Carbs: 79
Protein: 142
Fat: 128
Sat Fat: 48

If you want to see what I ate in detail, I logged everything on MyFitnessPal.

I tested my blood ketones and saw that I was in low level ketosis for about half the time.

My activity consisted of 3-4 days of BJJ and 1-2 days of Crossfit.

Here are the supplements I took:

Athletic Greens
Thorne Research Lemon Berry Flavored Fish Oil
Thorne Research Curcumin
Great Lakes Collagen Hydrolysate

For more detail about what I did during this time period, take a look at this post: The Whole 30, Days 1-15.

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What happened to my cholesterol?




And of course, like in all of my prior posts, I tabulated it all:


I know the text in the table is small so I just wanted to point out that you can click on it to bring up the larger image.

LDL-P: Dropped to 1974 from 2269 for a loss of more than 10%.

Small LDL-P: Now at 984 compared to 996, with no significant change.

LDL-C: Dropped to 161 from 180 for a loss of a little over 10%

Triglycerides: Still under control at 84, unchanged from before when it was 85.

HDL-C: Now at 40, the lowest it’s been in the past 6 years.

Total Cholesterol: Dropped to 218 from 255, for a loss of 14%

CRP: Still low at 0.61

Fasting Insulin: Still under control at 3.6

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What does this mean?

It’s interesting to see the improvement in LDL-P, LDL-C, and Total Cholesterol without any probiotics, berberine, or bergamot.  Of course the unchanged Small LDL-P is still concerning.  I wonder how much of it is simply related to the reduced saturated fat intake (althought this didn’t seem to help much before) or the changes in the diet with increased fruit and vegetable intake.

While things still aren’t ideal, I think knowing that the changes brought on by the Whole 30 have this sort of effect, simply after 15 days is reassuring.

I still need to experiment with berberine on it’s own since I suspect that is the most powerful of the things that I’ve tried, but I’m getting used to this way of eating and so will also be interested to see how far this can go.

*Image found here

The Whole30, Days 1-15



After learning about The Whole 30 from our Crossfit gym and reading It Starts with Food, the BJJ Cavewife and I were ready to begin.

To kick off the Whole 30, we were asked to state our commitment on the Facebook page.

Here is my statement:

“I am committing to the Whole 30. Exception is some white rice for post workout carbs.

I’m also going to be doing some metabolic measurements which I was planning on doing already, so this might go against the whole not taking measurements thing.”

Step 1 complete.

One of the rules is to not do any measurements at all.  Since I had just received the new Breezing device to play with, this was definitely a rule I was going to break.

I also figured that since the only carbs allowed are sweet potatoes, potatoes, fruits and veggies I’d essentially be in ketosis for much of the challenge.  I estimated my carb intake to drop from 100-150 gm (pre Whole 30 semi-clean/semi-dirty eating)… to maybe 50-100 gm.

Taking into account my activity level of 3-4 days BJJ and 1-2 days Crossfit, I would quickly burn through any consumed carbs along with my glycogen stores pretty and become ketotic for most of the diet.

I thought it’d be fun to test this and since I had some extra test strips lying around, so I dusted off my Precision Xtra, Freestyle Lyte, and Ketonix and started logging my blood sugar, blood ketones, and breath ketones.

I also logged my meals in MyFitnessPal.

This was one of my first meals:


A salad bowl from Chipotle made of chorizo, lettuce, salsa, fajitas, and guac. I got a little flack from the FB community because the chorizo supposedly had some ingredients that were not Whole 30 approved. I looked into it and there was maybe a small amount amount of sugar in some of the salt and spices being used… but we’re talking less than 3 gm. I decided then and there that I wasn’t going to be militant over a few grams here and there of sugar.

Having read the book, I knew that the purpose of avoiding added sugar was to avoid the havoc it could wreak on my blood sugars and insulin.

When considering my training volume, splitting those sorts of hairs just wasn’t worthwhile. And if my blood tests confirmed ketosis, it would further reinforce that a few grams of sugar here and there were meaningless in terms of my insulin and other hormones.

One thing that did catch my attention was the amount of fat in chorizo, 18 gm of fat and 8.5 gm of sat fat.

Because of my Apo E 3/4 genotype and cholesterol issues, I’m still trying to reduce my saturated fat intake, so despite how delicious chorizo tastes… it wasn’t something I could continue.

The next meal at Chipotle I switched the chorizo out for carnitas which has 12 gm of fat and 6.5 gm of sat fat… slightly better.

Since one of the goals of this challenge was to cook at home more, the BJJ Cavewife cracked open some of the paleo cook books lining our shelves. Her favorite is the Nom Nom Paleo book. She even followed Nom Nom’s Instagram and snapchat for even more tips.

This is one of the first things she made.


Spaghetti with grassfed ground beef and zoodles made with the OXO Good Grips Spiralizer we bought a while back.

With every new dietary challenge there are bound to be a few missteps.

My first screw up was when I was eating a salad!  I was enjoying my way through 80% of it when I realized that one of the things I liked most about the salad was the walnuts because they were a little sweet.  Then I realized this was probably because they were honeyed.  Definitely a Whole 30 no no.  I finished my salad… and the remaining 3 or 4 walnuts (why let them go to waste amirite?), and resolved to skip out on the walnuts next time.

In a near screw up, we went out to dinner with some good friends and of course this stared me in the face:


The bread was gently toasted, fresh from the oven.  Warm bread and melted butter…. two of my favorite things.  I seriously almost caved… but managed to resist.

Luckily my entree came shortly after so I ignored the gluten and just enjoyed my bone in rib eye and brussels sprouts.


Supplements I Took:

Athletic Greens
Thorne Research Lemon Berry Flavored Fish Oil
Thorne Research Curcumin
Great Lakes Collagen Hydrolysate

Average Macronutrient and Caloric intake:

Calories: 1986
Carbs: 79
Protein: 142
Fat: 128
Sat Fat: 48

This is a sample MFP entry:


I noticed it was extremely difficult to over eat since consuming whole foods were just too satiating. I barely cracked 2000 calories on many days despite my training volume.

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Blood Sugar


Nothing to complain about here.

Blood Ketones


I was in low level ketosis for a little less than half the days.  The highest ketone level I reached was 1.1 mmol/L.  I was a little surprised that there weren’t more days in ketosis but the fact that my dinners were the most carb heavy meals probably played a role since my blood measurements were done in the first thing in the morning.

Breath Acetone


This also confirmed low level ketosis.

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The thing I missed the most?  Heavy cream in my coffee.  This was one of those treats I would allow myself once a week… that somehow became twice to three times a week… then every day of the week.  The Whole 30 made me quit the cream habit cold turkey.  From day 1 and on, it was only black coffee with a sprinkle of cinnamon for flavor.

It was at this midway point that I had blood tests drawn so in the next few posts we’ll go over some of those results…

* Image found here

The BJJ Caveman’s Random Reading: November 24, 2016


  1. The Caveman Doctor, Colin Champ MD shares is tips for an “Anti-Cancer Thanksgiving,” which includes organic pasture raised turkeys and using grass fed ground beef instead of grain based stuffing, among other things.
  2. In a previous post he wrote about his personal ketogenic diet protocol including the supplements he uses and his preferred workouts.
  3. As you can tell, I’m a fan of his.  He wrote a book titled, Misguided Medicine, if you’re interested in reading more from him.  Here’s a review I wrote on it.
  4. While I understood that every organ in our body has it’s own circadian clock, all of which are governed by the master clock in our brain, the suprachiasmatic nucleus, I was surprised to learn that our clock also regulates our inflammation, and that even our intervetebral discs have their own clocks!
  5. Joel Jamieson wrote a powerful piece tying together the importance of aerobic conditioning, neuroimmunology, chronic inflammation, and the stroke is mother suffered.
  6. Rebecca Latham is someone I’ve been following ever since I started my own blog.  She is a very detail oriented self-experimenter who puts my own efforts to shame.  Here is the final post from her most recent 91 day fasting challenge, consisting of alternating days of fasting and feasting depending on how much weight she lost.  While it’s definitely not a challenge I would do, I am in awe of how well she tracked things.  She meticulously measured her weight, blood sugars, body circumferences, and body composition and detailed them all in charts.  On top of that she took before and after pictures.
  7. The BBC ran an experiment comparing 150 minutes of moderate level activity per week to 15 minutes of HIIT per week.. and well, the title says it all, HIIT: Is there a shortcut to exercise?
  8. Here’s another informal experiment run by the BBC trying to explore the benefits of apple cider vinegar and they found that it could decrease blood sugar by up to 30% and lower cholesterol by up to 13% when taken before meals.  Interesting stuff.

*Image found here.