Day 3: Why High Quality Muscle Tissue is Your Key to Superior Diabetic Health



Day 3: Why High Quality Muscle Tissue is Your Key to Superior Diabetic Health

 By Cyrus Khambatta, Ph.D.

In yesterday’s lesson we learned briefly that you can make your muscle tissue hungry for glucose simply by exercising.  In today’s lesson, we’ll go into more detail about how that process occurs.
Imagine if we were able to separate you into a number of piles and weigh each pile separately, based on the type of tissue.  In one pile we might find your bones.  In another pile we would find your muscle.  In a third pile we would find your body fat.
What proportion of your total body mass would your muscle tissue weigh?  Take a guess before you look at the table below:
Tissue Type
Male
Female
Bone
15%
12%
Muscle
42%
36%
Fat
16%
27%

Average Body Composition of Men and Women in the United States.  The average body composition of males and females in the United States is shown here, broken down by bones, fat, and muscle tissue.  On average, males tend to be composed of a larger proportion of lean body tissue (bones and muscle), whereas women tend to be composed of a larger proportion of fat tissue.  

Muscle tissue is the largest tissue in the body by mass.  What that means is that your body has more muscle tissue than any other single tissue type (unless you are obese, in which case fat may occupy a larger proportion than muscle).  This is great news for you as a diabetic because muscle tissue is also the hungriest tissue in the body, and is responsible for more glucose vacuuming than any other tissue. 

Why Is Muscle Tissue Important?
Muscle tissue is important for many reasons.  For one, muscle tissue allows you to perform movement because they are directly connected to bones all throughout your body.  Through a coordinated collection of muscle contractions and relaxations you are able to perform movements as simple as turning your head and as complicated as running in a straight line.  Muscle tissues often cross over one or more joints so that a single contraction results in the movement of that joint.  Manipulating the position of a joint is the basis of human movement, and muscles provide the infrastructure to make that possible.  

Muscle tissue is also unique in that it responds to physical movement by changing shape, size, and function.  This is the very nature of exercise “training.”  When a muscle contracts, the fibers that comprise the tissue contract.  In the process of contracting, the muscle consumes small amounts of fuel that are stored within the tissue itself.  These “onboard” fuels are mainly carbohydrate and fat. 
In response to repeated contractions, the contracting muscle fibers get depleted of their onboard fuel stores because the mitochondria are being asked to generate energy continually.  In addition to using up onboard fuel, the muscle fibers undergo a series of micro-tears that are by-products of repeated contraction cycles.
Frequent and repeated muscle contractions result in muscle fiber micro-tears and depleted “onboard” fuel stores that are then repaired in the resting state.
When the exercise session is complete, the muscle fibers enter a state of recovery in which the damaged muscle fibers are hungry for nutrients from the bloodstream to (1) replenish fuel stores, and (2) grow in preparation for the next exercise session. Let’s look at these a little more closely.

Replenish Fuel Stores: Muscle Supercompensation
The way muscle tissue adapts to exercise is by supercompensating in the resting state.  What this means is that the repair process not only fixes the micro-tears that occurred during the previous exercise session, it repairs itself to be stronger than it was originally so that the muscle can withstand longer durations of exercise and generate more force.  This is known as the supercompensation effect, and is the main reason why exercise training over time results in muscle tissue growth.  If this were not the case, muscle tissue would not grow larger or become stronger over time, and you would not notice a difference in endurance, speed, flexibility or strength.  

Think of a car.  When the gas tank in your car gets low, you head to the gas station to refill the tank.  If your car has a 15 gallon fuel tank, 15 gallons is the most fuel that you can carry at any one time.  But imagine if you drove a “smart” car that adapted to the amount that you drove.  Over time, the size of the gas tank would grow.  Today it’s 15 gallons.  Tomorrow it would be 16 gallons.  Next week it would be 17 gallons.  Over time, this would mean that the more you drove, the more fuel your car could carry.  

This is exactly how your muscle tissue responds to exercise.  The more you exercise, the larger the glucose stores become.  This process does not continue forever, but strategic exercise training can increase the amount of glucose that your muscles store as glycogen.  How convenient. 
Unlike tissues like your liver and spleen that cannot be manipulated to change size through movement, you are in control of the shape, size and function of muscles in your body.  And that’s great news for you because you can decide how you want them to look and function!

The Difference Between Muscle Quality and Quantity
Most people don’t differentiate between muscle QUANTITY and muscle QUALITY.  Most people think that exercise will lead to large muscles.  This can be an especially large deterrent for women, who want to maintain a petite physique. 
Simply exercising muscle tissue will not make it larger, unless you specifically design your exercise program to gain mass.  The truth is that your muscle will respond to the type of exercise training you perform.  Therefore if you want to maintain long, slender, skinny muscle, then you can easily do so by performing the right activities.  Instead, if you want to gain 10 pounds of muscle and enter a bodybuilding competition, you must specifically train your body to gain muscle mass. 

As a diabetic, muscle quality is more important than muscle quantity.  This is because muscle quality is a measure of how well the muscle tissue in your body responds to glucose, whereas muscle quantity is a measure of the size of your muscle tissue.  The two do not have to be mutually exclusive, however it is important to note that you do not have to look like the bodybuilder on the left in order to have high insulin sensitivity.  The truth is, you can’t look from the outside to determine which of these three athletes are the most insulin sensitive.  Instead, we have to examine the muscle tissue from the inside, and ask ourselves the following questions.

What are Characteristics of High Quality Muscle Tissue?
As far as diabetes is concerned, the most important determinant of muscle tissue quality is how well the muscle tissue responds to insulin.  Therefore, the following two points are important to understand:
If a small amount of insulin can push a large quantity of glucose into the muscle, then the muscle is considered high quality (insulin sensitive). 
If a large quantity of insulin is needed to push a large quantity of glucose into the muscle, then the muscle tissue is low quality (insulin resistant). 
Characteristics of High Quality Muscle Tissue
Even though the predominant characteristic of muscle tissue that you should care about as a diabetic is it’s responsiveness to insulin, there are a number of other factors which ultimately determine the quality of muscle.  Not all of these factors must be present at the same time in order for your muscle to be considered high quality.  In other words, strive for these muscle qualities, but don’t get hung up if you don’t possess them all. 
(1)    Flexibility
Flexible muscle is limber, easily stretchable, and resistant to injury.  Flexible muscle has a low level of inflammation, a low degree of collagen adhesions, and allows for easy pain-free movement. 
(2)    Strength
Muscle tissue that is routinely strength trained is dense and capable of withstanding considerable force.  Strong muscle requires the support of strong connective tissue, namely tendons that connect the muscle to an adjacent bone.  In the process of developing muscle and tendon strength, bone tissue is also strengthened in order to withstand increased force.  The combination of strong muscle, strong tendons, and strong bones are extremely important factors in maintaining athleticism as you age. 
(3)    Endurance
High quality muscle tissue possesses a large degree of endurance, which allows the muscle to contract and elongate hundreds to thousands of cycles for extended durations of time.  Building endurance into muscle tissue tends to increase the proportion of oxidative muscle fibers which are extremely hungry for carbohydrates and fatty acids following exercise.
(4)    Vascularization
Frequently exercised muscle tissue undergoes a process called angiogenesis which results in an increased number and cross sectional area of blood vessels.  By increasing the number of blood vessels, the muscle tissue is able to receive valuable nutrients and exchange waste products efficiently.  The more vascularized the muscle tissue becomes, the more resistant it is to fatigue during exercise. 
(5)    Short Time to Recovery
Muscle tissue that can rebuild itself quickly following an exercise session is capable of being exercised frequently.  Indicators of fully recovered muscle include reduced soreness (or none at all), a good degree of flexibility, and a mental desire to exercise.  Muscle with a poor ability to recover may require up to 96 hours before it can be used again, and muscle with a short recovery time can be exercised in as little as 6 hours following strenuous exercise.  The shorter the recovery time, the more efficient the refueling process!
(6)    High Demand for Nutrients (Hungry)
If you exercise frequently, chances are your muscle tissue has developed an ability to deplete it’s onboard glycogen and fatty acid fuel tanks efficiently.  When those tanks become empty, your muscle tissue gets fatigued, and signals to your brain that it’s time to slow down.  Often, the feeling of being tired during exercise occurs when the carbohydrate and fatty acid fuel tanks get depleted.  In the recovery phase following exercise, these muscles are so hungry for glucose, they can vacuum it out of the bloodstream using a very small amount of insulin.  This is great news for you, because it reduces your level of insulin resistance.
(7)    Low level of inflammation
Inflamed muscles are painful, tight, and problematic for other tissues in your body.  When your muscle tissue becomes inflamed, a valuable enzyme named creatine kinase is leaked into the bloodstream, along with stored myoglobin, a molecule which traps oxygen inside the muscle tissue.  The leakage of both of these valuable molecules can wreak havoc on your liver and kidneys, and can be very painful.  Healthy muscle tissue may become sore following exercise, but not painful.  Reducing your level of inflammation by exercising the appropriate amount can keep you from this painful and dangerous condition.





Photo credit: Pensiero / Foter / CC BY-NC-ND 



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